HMO Coordinator

Job Opportunity: HMO Coordinator at Park Avenue Extended Care

Facility: Park Avenue Extended Care

Position: HMO Coordinator

Location: Long Beach, New York

Shift: Monday-Friday, 9 AM - 5 PM

Pay Rate: $20.00 per hour

Position Description:

Join our dedicated team at Park Avenue Extended Care as an HMO Coordinator. In this crucial role, you will ensure effective communication with all HMO, Managed Medicare, Managed Medicaid, and commercial insurance programs to secure appropriate reimbursement for our facility.

Key Responsibilities:

• Review hospital notes for pertinent information.
• Send initial rehab evaluations, orders, nurse’s notes, wound notes, and MD initial assessment to case manager within 48 hours.
• Obtain continued authorization from Case Managers.
• Send updated documentation to Case Managers and maintain regular communication.
• Maintain a list of days used for Managed Medicare residents.
• Coordinate discharge dates with Social Workers and the treatment team.
• Obtain permanent placement authorization.
• Attend weekly discharge planning meetings and utilization reviews.
• Collaborate with the Medicaid Coordinator on submitting permanent placement requests.
• Maintain a schedule for updates and notify the rehab department in a timely manner.
• Advise case managers if assistance is needed with housing or barriers to community discharge.
• Report any significant changes to case managers.
• Coordinate with Social Workers once the NOMNC is signed to ensure documentation.
• Handle appeals and complete billing sheets each month.
• Perform any other tasks assigned by your supervisor.
  
  
  

Requirements:

• High School Diploma or GED.
• Experience in a Sub-Acute, Long Term Care Facility, or medical environment is preferred.
• Ability to organize, analyze, multitask, and prioritize work.
• Exceptional communication and negotiation skills to interact with payors, providers, and patients.
• Initiative and drive to manage projects from start to successful completion.
• Proficient computer skills.
  
  
  

If you are a detail-oriented professional with a passion for ensuring high-quality patient care and reimbursement processes, we encourage you to apply for this rewarding opportunity. Join Park Avenue Extended Care and make a difference in the lives of our residents.

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