Payor Audit Coordinator
Graham Healthcare GroupResponsibilities
SUMMARY
Communicate with referral sources and obtain timely and accurate Face-to-Face (F2F) documentation. Ensure audit packages are responded to on a timely basis.
ESSENTIAL DUTIES AND RESPONSIBILITIES
include the following. Other duties may be assigned as necessary.
- Verify that the Plan of Care meets all requirements to process
- Ensure timely processing of signed Plan of Care
- Learn and maintain changes to Medicare F2F guidelines
- Track F2F progress and follow up any incomplete F2F until completed
- Enter F2F home health coordination notes into HCHB
- Communicate with physicians and referral sources to obtain F2F documentation
- Work with Sales departments on timely collection of F2F and order documents needed for audit submission
- Compile and review medical record documentation for payor audit submission
- Comply with Company’s Core Values and Core Competencies
- Perform other duties as assigned by supervisor
QUALIFICATION REQUIREMENTS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Associate degree preferred
- Minimum two (2) year of experience in home care or hospice
- Knowledge of Medicare regulations and guidelines
- Familiarity with medical terminology preferred
- Proficiency with Microsoft Office suite
- Ability to learn and maintain changes to Medicare F2F guidelines
- Excellent customer service and verbal communication skills
- Outstanding organizational and communication skills
- Ability to work well in a team
CERTIFICATES, LICENSES, REGISTRATIONS
Must have and maintain in good standing professional license, certificate, or registration, as applicable.
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, climb stairs, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
The employee frequently lifts and/or moves up to 20 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
This job generally operates in a clerical office setting. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets, and fax machines. While performing the duties of this position, the employee may travel by automobile and be exposed to changing weather conditions.
COMMENTS
This description is intended to describe the essential job functions, the general supplemental functions, and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities, and requirements of a person so classified. Other functions may be assigned, and management retains the right to add or change the duties at any time.
NOTICE: Successful completion of a drug screen prior to employment is part of our background process, which includes medical and recreational marijuana.
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JR# JR253258
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