Care Coordinator

We are looking for a Care Coordinator AIM to join our team. This position will directly report to the Director of AIM and is responsible for managing all day to day business affairs and other operational activities related to the administration of the advanced illness management (AIM) and palliative care department by performing the following duties personally, including intake function, billing function, medical record maintenance function, and marketing function.

Essential Functions of Position

• Coordinate and direct all day-to-day operational activities related to the administration of the AIM and palliative care department.
• Process referrals by obtaining sufficient admission and insurance information in order to ensure appropriate and timely admission of patients.
• Record the outcome of calls either manually or in an automated manner, make follow-up calls as necessary, and identify/refer to alternative resources when applicable.
• During business hours, contact the patient and family within 1 hour of referral to inform of receipt of referral information. Any referrals received at night or on weekends, should be followed up on the next business day.
• Maintain communication with pending patients, their families, and referral sources and routinely follow the progress of prospective patients and those referrals not taken under care (NTUC).
• Coordinate and maintain effective and efficient scheduling for the Nurse Practitioners to include geographical considerations that may impact time management and company cost.
• Ensure appropriate reimbursement by identifying potential payer sources, verify benefits with payer sources (as required by department organizational structure), obtain initial authorizations if necessary.
• Assist staff with submitting documents related to the credentialing with payors and maintain a credentialing log.
• Advise AIM Team of patient acceptance of services and provide all relevant information including accurate insurance and admission information in order to ensure appropriate disclosure of rights and responsibilities, financial liabilities and benefit plan details to patients and their family (if applicable).
• Manage all daily clinical records functions including establishing and implementing clinical records policies. Ensure clinical record systems are maintained in compliance with state and federal regulations and company policies.
• Coordinate information for interdisciplinary team meetings and other essential meetings of the AIM Team.
• Submit all information from site to Billing Department required for timely billing and collection of charges. Work with Billing Department staff on timely responses to all billing denials, requests for additional information, and post-payments audits of submitted claims.
• Establish and maintain professional and productive relationships with all referral sources, including the Gentiva family of companies
• Act as a resource for customers and community as a whole regarding AIM, Palliative Care, and Hospice.
• Maintain standard of high quality customer service, and monitor and track referral sources’ satisfaction levels. Identify opportunities for additional or improved services to address unmet customer needs through family and physician satisfaction surveys. Communicate customer service issues to the Director as appropriate.
• Participate, as applicable, with quality assurance and performance improvement activities for AIM program and necessary data collection and reporting.
• Implement marketing and promotional initiatives as directed by the Director.
• Adhere to and participate in Company’s mandatory HIPAA privacy program/practices, Business Ethics and Compliance programs/practices, and all Company policies and procedures, including the Employee handbook.
• Adhere to code of conduct conducive to Company policy.

• High school graduate or equivalent. 
• College graduate preferred.
• Minimum of three years health care delivery or related business experience required; experience in Part B billing setting preferred.
• Experience with Computer applications and Electronic Medical Records.
• Strong knowledge of medical terminology and a customer service focus.
• Knowledge of insurance reimbursement process.
• Effective data entry and word processing, problem-solving, human relations, and oral/written communications skills.
• Some travel may be required as requested.