Enteral Admission Coordinator
Enteral Admission Coordinator
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Job Description
INTRODUCTION
Company Overview:
This position is available with Upstate HomeCare a BioMatrix company.
BioMatrix is a nationwide independently-owned infusion pharmacy with decades of experience supporting patients on specialty medication. Our compassionate care team helps patients navigate the often-challenging healthcare environment. We treat our patients like family and get them started on therapy quickly. We work closely with them as well as their family and their healthcare providers throughout the patient journey staying focused on optimal clinical outcomes.
At BioMatrix the heart of our Inclusion Diversity Equity & Access (IDEA) philosophy is the commitment to cultivate a welcoming space where everyones contributions are acknowledged and celebrated. Our goal is to draw in develop engage and retain talented high-performing individuals from diverse backgrounds and viewpoints. We believe that both respecting and embracing diversity enriches the experiences and successes of our patients employees and partners.
Schedule:
Monday Through Friday From 8:30am Eastern Standard Time To 5pm Eastern Standard Time
Work schedule is subject to change based on business needs.
Location:
Upon successful completion of on-site training it is anticipated that an incumbent in this role will work in a hybrid capacity from our location in Syracuse NY on Mondays Wednesdays & Fridays while working from home on Tuesdays & Thursdays. Work location is subject to change based on business needs.
Job Description:
The Enteral Admission Coordinator is responsible for the processing and coordination of all new referrals with the main objective being to clear all patients prior to service in order to ensure proper payment in compliance within all legal and regulatory parameters.
This person will ensure accurate efficient and timely processing of new referrals for Enteral services to include but not be limited to obtaining all necessary supporting documentation confirming insurance coverage coding and pricing of products documenting patient in applicable computer system submitting for pre-authorization and coordinating of initial pushing of the referral. The Enteral Admission Coordinator provides support and works collaboratively with referral sources hospital liaisons the pharmacy nursing and billing and branch personnel.
QUALIFICATION REQUIREMENTS
- High school diploma or GED required
- Minimum of one (1) year of call center experience required
- Excellent management communication interpersonal leadership organizational and analytical skills
- Skills with prioritization and multi-tasking
- Proficiency with problem resolution
- Self-motivated and self-disciplined
- Computer aptitude
- Mathematical aptitude
QUALIFICATIONS PREFERRED
- Prior enteral or home Infusion experience on the provider or payer side preferred
- Minimum of two (2) years of experience with a home care company preferred
- Strong working knowledge of first- and third-party payer requirements as it pertains to the billing and collection industry
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES
- Receiving new requests for services via phone fax or other means
- Obtaining all information necessary to accurately process the referral according to established procedures
- Completing referral process within time frame required to meet the needs of the patient family and referral source
- Accurately completing the patient record in applicable computer system to include all required demographics insurance and clinical information; recording appropriate progress notes and alerts to present a clear concise picture of patient data
- Confirming insurance coverage for services requested; gathering detailed information regarding but not limited to eligibility deductible out of pocket authorization requirements and patient obligations
- Communicating with referral source or liaison regarding but not limited to insurance coverage information limitations and status of referral
- Obtaining insurance authorization when necessary; entering and documenting authorization according to established procedure; tracking authorizations due to expire and obtaining renewals as needed
- Assuring accurate and complete billing information is obtained and recorded to allow for timely claim submission and payment thus reducing accounts receivable days outstanding
- Communicating any financial obligations to the patient or his/her designee; assuring their understanding and agreement to pay; establishing a payment method up-front i.e. credit card
- Maintaining the pending referral log on a daily basis; attending rounds each morning prepared to discuss status of each patient
- Responding to requests for assistance from pharmacy billing and clinical personnel
- Remaining familiar with specific payer guidelines requirements
- Consulting with VP of Clinical & Financial Services when faced with unfamiliar situations and when decisions outside of the Intake Representatives scope need to be made
- Assisting with special projects and perform other duties at the discretion of the VP of Clinical & Financial Services
- Maintaining monthly Referral Census Log
- Serving as a company resource with regards to service processing and reimbursement
- Demonstrating a professional cooperative and friendly attitude toward all internal and external customers and co-workers; demonstrating excellent customer service skills
- Using discretion in handling confidential matters
- Adhere to departmental/company policies and procedures by:
- Adhering to policies and procedures
- Adhering to regulations set forth by Medicare and Medicaid
- Adhering to regulations set forth by insurance carriers
- Adhering to regulations set forth in established company contracts
- Exhibits exceptional work ethics by:
- Not being wasteful or abusing branch/company resources (vehicles building equipment supplies phone utilities time at work time absent from work etc.)
- Presenting fair and honest reports of expense
- Following through timely on commitments
- Returning phone calls and e-mails promptly
- Being flexible and having the ability to prioritize
- Allowing others to speak without interruption
- Using proper grammar a respectful tone and language free of prejudice harassment profanity or ill will connotations
- Attempting to resolve conflict without third party intervention; refraining from and discouraging gossip
KNOWLEDEGE SKILLS AND ABILITIES REQUIREMENTS
Communication Skills
- Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings.
- Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.
Computer Skills
- Become and remain proficient is all programs necessary for execution.
PHYSICAL DEMANDS AND WORK ENVIRONMENT
- This position requires constant sitting with occasional walking standing kneeling or stooping.
- This position requires the use of hands to finger handle or feel objects and the ability to reach with hands and arms.
- This position requires constant talking and hearing.
- Specific vision abilities required by this job include close vision and the ability to adjust focus.
- This position must occasionally lift and/or move up to 20 pounds
- Required to move/lift physical hardware.
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. If needing a reasonable accommodation within the application process please contact the BioMatrix People & Culture team ator 954.385.7322 x 1425.
While performing the duties of this job the employee is occasionally required to stand; walk; sit; use hands to finger handle or feel objects tools or controls; reach with hands and arms; climb stairs; balance; stoop kneel crouch or crawl; talk or hear; taste or smell. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by the job include close vision distance vision color vision peripheral vision depth perception and the ability to adjust focus.
OTHER
- Will participate in legal and ethical compliance training each year.
- Will consistently behave in compliance with the BioMatrix LLCs legal and ethical policies and procedures.
- Will abide by the policies of BioMatrix LLC as set forth in the Compliance Manual.
- Will not participate in any conduct considered to be unethical or illegal.
EXPECTATION FOR ALL EMPLOYEES
Supports the organizations mission vision and values by exhibiting the following behaviors: integrity dedication compassion enrichment and enthusiasm places patients first is all-in with stacked-hands and is focused on relentless consistency wins.
GENERAL INFORMATION:
The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this position. They are not intended to be an exhaustive list of all duties responsibilities and skills required of personnel so classified.
The incumbent must be able to work in a fast-paced environment with demonstrated ability to juggle and prioritize multiple competing tasks and demands and to seek supervisory assistance as appropriate.
Incumbents within this position may be required to assist or find appropriate assistance to make accommodations for disabled individuals in order to ensure access to the organizations services (may include: visitors patients employees or others).
All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin disability or status as a protected veteran.
Required Experience:
IC
Employment Type
Full-Time
