Job Summary

Coordinates IV and/or enteral services for patients at home or in contracted long term care facilities. Communicates and interactes with case management, discharge planners, intake personnel, insurance companies/payers, clinical dietitians, materials handlers, and delivery coordinators; ensures patient services are appropriate, qualified for coverage, and timely. Participates in educational in-services and discussions related to the ongoing development and improvement of the process and procedures within the department.

Essential Functions
 

Monitors and identifies new home infusion and enteral referrals communicated via the online referral software. Communicates with referral source and intake personnel to ensure medical record documentation is complete and appropriate for reimbursement. Verifies insurance and 3rd party coverage and pre-certifies services as required. Communicates coverage requirements to provider teammates. Monitors the processing of documentation which creates claims for various funding sources through data entry. Serves as a liaison between patients, referral sources, and physician offices to assist with concerns/questions related to services, including financial responsibilities for services. Communicates with teammates as appropriate for timely delivery of necessary supplies to patient home. Communicates with patients and caregivers to ensure understanding of services which includes initial delivery, setup, training, procedures, report problems or follows up with teammates as required. Provides coordination of patient care and accuracy of patient records with nurses and physicians. Manages enteral service coordination (deliveries, changes, etc.) on a monthly basis for designated contracted nursing home facilities. Assists with regular maintenance and follow-up calls to patients and processes refills and any adjustments to ensure appropriate patient outcomes. Maintains patient database. Sends, tracks, receives, records CMNs, SMNs, PAs, and/or DIFs as needed. Audits record storage systems as necessary. Provides input regarding marketing plan and referral process.

 

Physical Requirements

Works in a busy, analytical, physical, and managerial environment. Each teammate has the responsibility to work in a safe manner. Operates and uses equipment including computers, printers, and carts. Job requires the ability to sit at a desk as well as to stand, bend, lift, and load boxes of formula and supplies to prepare for shipment.

Education, Experience and Certifications
 

High School Diploma or GED required. Bachelor's Degree preferred. Marketing or Care Coordination related field experience preferred.