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*Applicants must meet the minimum qualifications for the position as stated in the job posting.
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HME Referral Liaison Facility: OSF Home Care Services, Eastern Region
Bloomington/Pontiac IL, 61701
Department: HME Peoria CSR Schedule: full-time Shift: Day Hours: 8:30 - 5pm Mon - Fri Hours Per Pay Period: 80 Referral Bonus: Job Details:
Position is open to internal OSF Home Care employees in the HME Department.
The HME Referral Liaison serves as a referral management liaison to the medical center, hospital, physicians, community and other referral sources, coordinating the referral to the home care provider in a timely and efficient way. The Referral Liaison is responsible for interacting with all persons according to OSF mission, vision and values. All interactions will be in accordance with the Ministry values of justice, compassion, integrity, teamwork, employee well-being, supportive work environment, trust, stewardship and leadership in our daily interactions
This Referral Liaison will be responsible for the appropriate qualifying medical documentation as defined per payer medical policy, verification of insurance benefits, which may include obtaining prior authorization, medical record account creation and data entry into the patient medical record, communication of patient financial responsibility and delivery of the equipment as defined per established OSF policies and procedures.
The Referral Liaison shall have strong working knowledge of home medical equipment to include but not limited to, ICD.9 and medical terminology, medical policy as established by the Centers of Medicare and Medicaid Services, contracted payers, company policies and procedures, and regulatory and accrediting bodies. The Referral Liaison is responsible for strict adherence to the guidelines and medical policies as defined by the Centers of Medicare and Medicaid Services, third party and regulatory/ accrediting body guidelines. This position is responsible for building and sustaining effective relationships with referral sources by providing support to patients, staff, and physicians during the admission process.
The Referral Liaison will be responsible for meeting established departmental productivity targets through excellent interpersonal communication and telephone skills. This position builds effective relationships by providing support to patients, staff, and physicians during order processing and patient care follow-up. The Referral Liaison must be able to function in a fast paced work environment with a high degree of accuracy and professionalism. The Referral Liaison is responsible for processing and delivery of all HME and Respiratory Equipment, to exclude respiratory equipment identified in OSF policies and procedures requiring a Respiratory Therapist. The purpose of this position is to execute the roles and duties of this position in alignment with revenue cycle goals, quality, regulatory compliance and with a high degree of customer service according to the values of the OSF Ministry.
The Referral Liaison will be a resource for primary care, specialist and midlevel providers to assist in the selection of the most appropriate level of home and respiratory medical equipment for referred patients based on the medical documentation. The position will be responsible for educating and providing guidance on deficient documentation to ensure there are no delays and disruption to patient care. The Referral Liaison is responsible for meeting timeframes for patient discharge and communicating with referral sources when OSF HME is unable to meet delivery expectations. Works with HME leadership to ensure services run efficiently. This position will interact with every position in the HME operational infrastructure.
Though execution of excellent Customer Service, this position will ensure all revenue generated for HME and Respiratory services comply with revenue cycle financial goals.
Duties may include non-clinical related functions (i.e. making copies and faxing information as needed by referral to contracted vendor.) Assist in transfer of delivery paperwork for reimbursement. The incumbent is in daily contact with patients, family members and members of the health care team and require excellent human relations and communication skills.
Works with HME leadership to ensure services run efficiently.
Knowledge, Skills and Abilities Required:
· High school graduate or equivalent.
· 1 year prior experience in HME Customer Service and/or HME billing required
· Must be able to educate and operate home medical equipment
· Must be able to work on a computer, operate fax machine, scanner and copy machine.
· Must be able to type 35 wpm or greater with accuracy
· Ability to work in fast paced environment with a high degree of accuracy.
· Working knowledge of ICD.9 and related HCPC codes.
· Demonstrates ability to work independently and execute own workload.
· Knowledge of reimbursement and regulatory requirements for HME.
· Previous experience working in health care, government and accrediting agency body guidelines.
· Demonstrates excellent communication, human relations, and analytical and problem solving skills.
Provides own transportation and auto insurance and abides by all laws, rules and recommendations for safe driving while on duty. Maintains a valid driver’s license.
· Demonstrates the ability to work independently and execute own workload.
· Work requires analytical ability necessary to assess patients’ physical, psychological and social needs and evaluate patients to medical and nursing interventions as appropriate.
· The incumbent is in daily contact with patients and their family members, employees, physicians, discharge planners and other referral sources, and other health care staff.
· Knowledge of reimbursement and regulatory requirements for HME. Experience working with government and accrediting agency officials.
· Must maintain effective working relationships with all. Must possess ability to remain calm and effective while dealing with numerous interruptions and able to prioritize workload accordingly.
· Insures prioritization of daily discharges.
· Instructs patient/caregiver on proper and safe use of home medical equipment.
· Use of a keyboard/computer on a daily basis. Must be proficient in typing and windows applications.
· Responsible for taking on-call on a rotating basis.
· Expected to take night and weekend calls, and work weekends and/or holiday hours as required.
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