Position Summary: The Referral and Admission Coordinator (Coordinator) is the initial point of contact for patients, families, physicians, discharge planners, and other individuals seeking information about access to Pioneer Valley Hospice and Palliative Care (PVHPC). The coordinator is responsible for managing all incoming referrals and ensuring that all State, Medicare, Medicaid, and PVHPC policies and procedures are met. The Coordinator must facilitate clear communication between the agency, physicians, referral sources (hospitals, SNFs, ALFs ), and the patient/family to ensure successful admission to hospice services for eligible patients.
Location: Greenfield, MA
Pay rate: $22 per hour
Essential Job Functions
- Acts as the initial point of contact for all new referrals or inquiries regarding PVHPC Services.
- Exhibits commitment to high-quality, patient-centered, compliant care.
- Exhibits excellent communication with all PVHPC customers – both internal and external.
- Exhibits confident and compassionate communication skills when conveying information/answering questions.
- Monitors/responds to all electronic, email, internet, fax, and phone referrals efficiently and effectively.
- Obtains discharge information from Facility Discharge Planners, and Insurance Case Managers/managed care providers on all referrals to ensure a smooth transition to PVHPC care.
- Coordinates and verifies all gathered information for input into the electronic medical record system at the time of referral and ongoing until the patient is admitted, or referral is closed.
- Coordinates with other agencies involved in the patient’s care to ensure that the continuum of care meets the customer's needs.
- Initiates process to obtain verbal certification from Medical Director and/or PCP as needed.
- Assists with determining the patient’s eligibility for hospice services by collecting related health information to support the patient’s prognosis.
- Informs referral sources of the status of the referral:
- The primary physician and/or referral source are informed if a patient is not admitted to PVHPC, is not eligible for hospice services, or chooses not to receive hospice services from PVHPC.
- Documents interactions between hospice staff and the patient/family and referral sources.
- Maintains relationships and ongoing communication with IHC affiliate referral sources as well as those non-affiliate SNFs in the Pioneer Valley.
- Ensures that data entry documents are completed accurately and timely.
- Verifies Insurance for hospice benefit coverage.
- Monitors referrals/admissions reports, conversion reports, and ensures the list and current status of all referrals are maintained.
Overall Skills
Exceptional customer service skills. Exhibit warmth and caring coupled with strong problem-solving ability. Possess the ability to demonstrate superlative oral and written communication skills, in English; work both independently and as part of a team; demonstrate excellent interpersonal and collaborative skills; demonstrate strong organizational skills with the ability to delegate and follow up; manage multiple tasks and stressful situations with a positive attitude; demonstrate a strong work ethic and attention to detail; demonstrate clinical competence and compliance in order to appropriately triage referrals.
Organization/Regulatory Compliance
- Assumes complete responsibility for coordinating referrals from initial contact through admission to services.
- Contacts the Attending Physician to obtain authorization for admission and verbal certification of terminal illness. Documents in the electronic medical record system, and referral comments according to the written script. Faxes to the Attending Physician the appropriate request for clinical documentation supporting the patient’s eligibility for care, and any applicable forms as needed.
- Participates in the development, implementation, and evaluation of policies and procedures for continuous quality improvement as requested.
- Ensures that all services comply with Federal, State, and local regulatory requirements and are in accordance with PVHPC policies and procedures and compliance plan.
- Prepares initial clinical record in accordance with state and federal regulations, CHAP accreditation standards, and the organization’s policies and procedures, including but not limited to Medicare, Medicaid, and State as outlined in PVHPC policies and procedures.
Qualifications
(Minimum qualifications will be considered required unless specifically stated otherwise)
Experience:
- Minimum of 1-2 years of call center experience in a clinical/medical office.
- Previous hospice and customer service experience is preferred.
Education and Training:
(Acquired through formal education, outside study, training on jobs of lesser degree, or by any combination of these. May be expressed in terms of formal educational equivalents):
- A healthcare-related degree or certificate.
- Experience in Marketing/Healthcare will be considered.
License, Certification & Registration:
- Current Massachusetts licensure: if applicable
- Valid driver’s license
Other Requirements:
- Demonstrates excellent verbal and written communication, and organization skills.
Working Conditions
- Uniform / Dress Requirements (Beyond those requirements outlined within Policy No. C:3-015.1):None
Working Conditions:
- The work environment characteristics are representative of those an employee would normally encounter while performing the essential functions of this job in an office. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Works in a business office with computers, printers, copy/fax machines and telephones. The noise level in the work environment is usually light to moderate. The environmental conditions are that of what is to be expected in a temperature-controlled building.
- OSHA exposure category: Category III
- Category I ? Position includes tasks that involve exposure to blood, body fluids, tissues.
- Category II ?Position includes tasks that involve no exposure to blood, body fluids, tissues, but employment may require unplanned Category I tasks.
- Category III ? Position includes tasks that involve no exposure to blood, body fluids, tissues; would not be required to perform Category I tasks.
Physical Demands: (See Attached)
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 sit and talk or hear. The employee is occasionally required to stand; walk; use hands to finger, handle, or feel; reach with hands and arms; taste or smell and push, pull, lift/carry 35 lbs. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus.
The above statements are intended to describe the general nature and level of work being performed by employees within this classification. They are not intended to be construed as an exhaustive list of all duties and responsibilities.
