Job Description

Home Health Staffing Coordinator (part-time) Miami, FL (remote position FL residents only) Currently seeking a part-time Home Health Staffing Coordinator for a great opportunity working remotely at a healthcare organization based in the Miami, FL area. The ideal candidate will be multi-task oriented with 3 years experience working in home health staffing. JOB SUMMARY: Responsible for receiving and staffing faxed orders for new and updated Home Health Orders. Conducts screening and data entry of requests for authorization, coordinates the case managers review process and the staffing. ESSENTIAL JOB FUNCTIONS: Duties of the Home Health Staffing Coordinator include, but may not be limited to:

• Receives requests by e-fax for new and updated orders for Home Health services.
• Order is processed accordingly the day that it is received. The member is staffed with a Network agency.
• The demographic and clinical information is entered into the supporting software, and the authorization is faxed to the accepting agency.
• Performs pre-certification and/or authorization activities for all requested Home Health services included as contracted services that meet eligibility and benefits coverage.
• Reviews available information in order to ensure that it meets pre-established medical necessity/appropriateness criteria.
• When necessary, requests additional clinical information. If no response within 48 hours, requests will be referred to Health Plan for review and determination.
• Receives additional clinical information and make a certification determination and send written authorization number to referring physician, and referral provider.
• Once the orders are verified to be complete and meeting appropriate criteria, it is processed accordingly the day it is received.
• Refers requests that do not meet pre-established medical necessity/appropriateness criteria to peer clinical review for determination.
• Conducts, tracks and trends: customer satisfaction (next day) surveys.
• Assists in resolving member questions, concerns or problems.
• Develops and maintains working knowledge of current home health criteria and services offered by Coastal Care Services, Inc. an all applicable insurance guidelines regarding eligibility for coverage and reimbursement.
• Maintains communication log to record client, physician and referral source communications.
• Manage incoming calls from members and providers in regards services coordinated by Coastal.
• Coordinates with other Coastal departments as appropriate.
• Notifies supervisor of issues requiring higher- level resolution.
• Complies with all applicable Coastal Policies and Procedures.
• Maintains a working knowledge of, and adheres to applicable federal/state regulations including but not limited to, laws related to patient confidentiality, release of information, and HIPAA.

MINIMUM QUALIFICATIONS:

• High School graduate with office experience in the healthcare industry.
• 1-3 years of experience in home health staffing.
• Knowledge of CMS home health care requirements
• Effective verbal and written communication skills.
• Typing skills of 30 wpm.
• Ability to data enter, file, maintain records
• Bilingual (English/Spanish) required.
• WAH (Work at Home) Requirements - Must have reliable high speed internet. Minimum standard speed for optimal performance of 10 x 1 (10mbs download x 1mbs upload) required. Must have a separate private workspace / desk area designated for home office to ensure absolute and continuous privacy while at work.
• The company is an Equal Opportunity Employer, in accordance with State and federal law. Coastal does not discriminate in employment opportunities or practices on the basis of race, color, religion, sex, national origin, age, disability, sexual orientation or any other characteristic protected by law. Opportunity is provided to all employees based on qualifications and job requirements. We are a Drug-Free Work Place, we test for THC. This position is contingent upon completion and passing of Level 2 Criminal Background check, a drug screening and verification of previous employment. No relocation/Local candidates only (FL state)

Job Type: Part-time Pay: From $18.00 per hour Expected hours: 20 – 24 per week Benefits:

• Flexible schedule

Application Question(s):

• Can you work on Sundays and Mondays from 10am to 6pm?
• What is your availability in the afternoons after 2pm for Tuesday to Friday?
• What are your salary expectations per hour?

Experience:

• home health staffing: 3 years (Required)
• CMS home health care requirements : 1 year (Required)

Language:

• English and Spanish fluently (Required)

Work Location: Remote