Description
- Hours for this position are Mon-Fri 11 : 30AM - 8 : 00PM
- Must live in the Pittsburgh area to complete mandatory on-site training period before going remote. Periodic, ongoing trainings are also held on-site so you must reside in or near Pittsburgh.
Please consider before applying!
GENERAL OVERVIEW :
This job facilitates and monitors the referral workflow from the acute care hospital or ambulatory outpatient setting to home.
The incumbent works directly with the Transitional Care Coordinator (TCC) to coordinate the patient’s post-acute care needs.
The incumbent works to complete their work in an effective, efficient, accurate, and timely manner to assure compliance with regulations.
This position requires strong computer and database management skills. It also calls for flexibility, excellent interpersonal skills, project coordination experience, and the ability to work well with all levels of internal management and staff, as well as outside customers and vendors.
ESSENTIAL RESPONSIBILITIES :
Referral processing : responsible for securing services for post-acute care, identified by the clinical care team, (MD office / post-acute facilities / hospitals) via established workflows.
Partner with the clinical team to identify and obtain necessary supportive clinical documentation for compliance, regulatory or insurance / billing.
Equipment delivery Follows established workflows to assure delivery via internal hospital or external partners. Enters prompt, detailed and complete notes. (40%)
Referral acceptance / confirmation : Escalates issues / barriers to clinical partners when alternative planning is necessary when post-acute services cannot be secured due to staffing capacity, geographical location, insurance, and clinical complexity.
Enters prompt, detailed and complete notes. (40%)
- Freedom of Choice : Engages patient and / or family / support person to obtain choice for post-acute care as indicated by policy and documents according to established workflow. (5%)
- Build and maintain relationships with post-acute and Hospital / network partners for the benefit of patients, families, and the health care team. (5%)
- Responds to consumer inquiries regarding post-acute services. (5%)
- Miscellaneous duties and rotational work on-site at network hospitals, e.g., participation in interdisciplinary process improvement efforts, huddles, and special projects associated with assuring effective care transitions. (5%)
- Other duties as assigned or requested.
QUALIFICATIONS : Minimum
Minimum
- High school diploma / GED
- Clinical or medical background
- Data entry
- 1 year experience with Electronic Medical Records (EMR)
Preferred
- Associate’s Degree
- 1-3 years’ experience in the medical profession
- 1 year of Customer Service
Pay Range Minimum : $20.15
$20.15
Pay Range Maximum : $30.93
$30.93
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation / gender identity or any other category protected by applicable federal, state or local law.
Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation / gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities / Women / Protected Veterans / Disabled / Sexual Orientation / Gender Identity ()
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