WI Referral Processing Specialist
Aurora Health Care
Major Responsibilities:
Collects and records medical, social and reimbursement data pertinent to patient admission to initiate home care, palliative care and hospice.Screens, documents and processes requests for home health, palliative and hospice services. This includes taking incoming calls, answering customer questions, completing intake forms, processing referral orders within EPIC or faxed referrals and documenting service requests for coordination of care; including promoting company products and service.Collaborates with the nursing team when reviewing and processing physician orders for instructions on patient's plan of care and prior to sending patients to the appropriate patient service department to ensure activities are performed within the scope of practice.Communicates and documents any new, changed, updated information, orders or referrals received within intake to the appropriate persons and/or departments as needed to not compromise the quality of care and safety of patient(s).Responds to inquiries regarding Aurora at Home services and programs. Explains programs and services, in addition to determining if patients meet criteria for Centers for Medicare & Medicaid Services (CMS) certified agency, admission policies and/or referring requests to other community agencies when appropriate.Maintains knowledge of and reference materials of Medicare, Medicaid and third-party payer requirements, payer coverage, guidelines, documentation requirements and insurance related changes or trends.
Licensure, Registration, and/or Certification Required:
Education Required:
Experience Required:
Knowledge, Skills & Abilities Required:
Physical Requirements and Working Conditions:
This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.
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