At Home Care Hospice · 1 day ago
Finance Case Manager
US-WA-TUKWILA
Full-time
Onsite
Entry, Mid Level
2+ years expAt Home Care Hospice is an affiliate of BrightSpring Health Services, providing support to individuals with disabilities. The Finance Case Manager will be responsible for managing client referrals, overseeing pre-screening processes, and ensuring compliance with company policies.
Health CareWellness
Responsibilities
Receives/responds to incoming calls from referral sources/potential clients and exchanges information to identify the clients' needs and consults with Director of Clinical Management to determine the Company's ability to meet them
Completes all viable referrals by setting up and carrying out pre-screening assessments, completion of pre-screening reports, and preparation of case proposals and other related pre-admission paperwork (i.e., obtains authorization for payment, coordinates availability of an appropriate treatment team)
Oversees, directs and supervises field staff assigned in assisting with pre-screening process
Accesses national/state/company account information, including the account names and terms of contracts or other past payer agreements, as appropriate
Consults with third party representatives regarding client benefit coverage, client financial responsibility, company service authorization and specific reimbursement procedures. Presents company’s services, interprets potential reimbursement options and negotiates reimbursement levels with third party payer
Contacts referral sources to advise them of case acceptance and provides information on the clinical team responsible for client's case
Develops/maintains a working knowledge of all services/resources provided by the Company and services available within the community. Assists in identifying alternative community service sources when company solutions are not appropriate or available
Maintains relationships with standard referral sources and payer case managers. Contacts identified referral sources and seeks referrals as appropriate. Records outcome of calls and keeps the SAR informed
Monitors/tracks referral sources' satisfaction levels, tracks/reports on conversion ratios and provides summary reports to management at requested intervals
Implements/maintains, with the up line management, operational processes to ensure compliance with Company policies, requirements and regulatory mandates
Adheres to and participates in Company’s mandatory HIPAA privacy program/practices and Business Ethics and Compliance programs
Participates in quarterly growth planning meetings/activities including discussions around staffing and recruitment needs
Participates in special projects and performs other duties as assigned
Qualification
Required
Bachelor's degree in a human services field or nursing field
Valid driver's license
Must have two years of experience with case management or related discipline
Must be able to communicate both verbally and in writing
Company
At Home Care Hospice
AT Home Care is owned and operated by caring individuals with over 40 years of Health Care and Clinical expertise, and is the largest independent home health care agency in Virginia.
51-200 employees
Funding
Current Stage
Growth StageCompany data provided by crunchbase