Intake Specialist

We are seeking a detail-oriented and proactive Intake Specialist to join our Coordination Team. As a Home Care Intake Specialist, you will be responsible for receiving and processing referrals from referral sources; contacting patients and families to explain services and gather required information; verifying patient insurance and determining eligibility; and educating patients and families on home care services. T

1. Discharge Case retention

• Receive and process referrals from referral sources
• Monitor active caseload for patients approaching discharge or end of current level-of-care authorization.
• Coordinate with case coordinator, and the patient/family to support retention of the case rather than an unplanned discharge.
• Contact patients and families to explain services and gather required information
• Verify patient insurance and determine eligibility
• Verifies insurances and long-term insurance benefits.

2. Case Processing

• Answers phones and gathers all required information to work towards admissions for referrals under MLTCs, MCOs, Private Pay and any other Medicaid centered approvals.
• Send referrals to MLTC plans for potential enrollment or Medicaid assistance
• Communicates with patients and their families throughout the life of a referral through to the start of cares.
• Communicates with providers regarding the status of services and to obtain the authorization for those services.

3. Documentation & Cross-Functional Coordination

• Inputs data and maintains notes and pertinent information in the referral management system.
• Advises staffing and coordination teams of upcoming enrollments to ensure appropriate staffing.
• Monitors all emails and responds in a timely manner.
• Monitors and follows up on all referral under their workflow in the referral management system on a daily basis.
• Reviews all authorizations received to ensure accuracy for proper entering by the authorization team.
• Communicates clearly, following company guidelines, with other departments to ensure a smooth transition of enrollments for consumers.
• Stay updated on LHCSA regulations, Medicaid/Medicare guidelines, and insurance requirement.