Therapy Intake Coordinator

Company Description

MGA Homecare specializes in providing private duty nursing, personal care services, and therapy to the medically complex population. We deliver high-quality care in the home and community-based setting, the setting which is the lowest cost to the payers. We aim to be the employer of choice and the partner of choice to referral sources, state government agencies, and health plans. We currently provide care in Arizona, Colorado, Texas, North Carolina, Washington, and Tennesee with a plan to grow into new states and markets.

Job Description

The Therapy Intake Coordinator is responsible for completing referrals using gathered information to provide data necessary to coordinate service eligibility, insurance verification, authorization and care coordination, handles requests for facilitating problem-solving of referral source information specific to coordination of patient admissions, and ensures maximum third-party reimbursement through monitoring insurance verification and authorization process. This position also communicates with provider/clinical staff/caregivers as necessary to obtain pertinent information and acts as the point of contact, aiding providers and organization.

• Organization Communication
• Handles all daily patient referrals and intake operations and reviews and processes pending referrals.
• Enters all demographic and insurance information for new customers and updates as needed.
• Completes registration of clients into the home care management program in an accurate and timely manner
• Informs location staff of received referral/s with full details on deductible, coinsurance and copay.
• Adheres to the rules regarding confidentiality of HIPAA protected health information
• Assists with the identification and reporting of potential quality management and non-coverage issues
• Communicates with relevant parties to obtain authorization of home health services, initial and ongoing
• Interfaces with providers/office staff/clinical staff/caregivers for the purpose of attaining additional information required for authorization approval
• Provides direct support regarding utilization, authorization, and referral activities
• Contacts providers and families with authorization, denial, and appeals process information
• Completes monthly authorization expiry reports and informs location of upcoming renewals
• Completes any and all changes to health insurance in KanTime
• Verification
• Verifies eligibility of members and member benefit coverage at initial start of care and ongoing eligibility and benefits verification on the 1st and 15th of each month
• Reports all discrepancies to the Director of Clinical Services, Director of Therapy, Account Manager, and Director of Central Intake
• Insurance knowledge experience
• General knowledge of state Medicaid plans, private insurance plans, Medicare and Veteran Affairse
• Supports and executes the mission, ethics, and goals of the company effectively
• Represents themselves in a positive and professional manner in the company and community
• Adheres to dress code with a clean and neat professional appearance
• Reports on time and as scheduled to complete work within designated time
• Adhere to all company policies and procedures outlined in Employee Handbook, Employee Agreement, or communicated from executive team
  

Qualifications

• High School Education- Associates Degree preferred
• Must have insurance experience
• Home health experience preferred but not required
• Exceptional Customer Service
• Must be detailed oriented
• Familiarity with ICD-10 coding
• Able to work independently
• Able to work remotely
• Ability to perform basic to intermediate applications with Excel
• Strong verbal and written communication skills (Additional languages preferred)
• 1+ year experience in a clinical environment preferred
• Requires in depth knowledge of benefits and authorizations
• Proficient use of standard computer programs for data entry and data organization
  
  

Additional Information

Benefits are available to eligible employees on the first of the month after 30 days of employment and include:

• Hourly pay $20.00 - $21.00
• Health, Dental & Vision Coverage
• Health Savings Accounts (HSA)
• Flexible Spending Accounts (FSA)
• Employee Assistance Program (EAP)
• 401(k) retirement plan
• Paid Time Off (PTO)
• Company Paid Holidays
• 100% Company Paid Life Insurance
• Critical Illness/Accident Insurance
• Hospital Indemnity Insurance
• Identity Protection Plan
• Legal Care Plan
  
  

All your information will be kept confidential according to EEO guidelines.