Job Details

Req Id 86840
Department SNH CALL CENTER
Shift Days
Shift Hours Worked 7.50
FTE 1
Work Schedule GENERAL BENEFITS
Employee Status A1 - Full-Time
Union Non-Union

Job Summary

The Senior Network Health (SNH) Enrollee/Patient Services Intake Coordinator is responsible for assisting enrollees/patients with understanding how to access services; their covered benefits; notice of Action or Appeal determinations; their grievance, appeal or fair hearing rights; or providing enrollees/patients with information on their service requests. Is responsible for relaying information to appropriate internal and external affiliate/community agency or agencies. Assists with Visiting Nurse Association of Utica and Oneida County (VNA) intake and referral process. Complies with all state and federal regulations including Health Insurance Portability and Accountability Act (HIPAA).

Core Job Responsibilities

• Strong working and regulatory knowledge of Home Care Services VNA and SNH.
• Strong working knowledge of SNH’s provider network to assist enrollees/patients with access to services.
• Able to educate enrollees/patients about the rules for obtaining services and assisting enrollees/patients with making appointments.
• Fielding and responding to enrollee/patient questions and grievances, and advising enrollees/patients of their right to complain to the Department, LDSS, or State designated entity at any time.
• Able to answer enrollee/patient questions or facilitate access to a staff member that can assist.
• Assists enrollees/patients with language translation and communication assistance.
• Functions as a resource to internal and external referral services and providers in the community.
• Completes all required documentation and computer database entry as required.
• Complies with all department processes.
• Obtains initial insurance authorizations and documents in the Electronic Medical Record (EMR) the status.
• Enters referral information into the agency electronic medical record system.
• Responsible for computer database entry, phone calls, faxing, copying etc.
• Knowledgeable of the call center processes/equipment and able to mentor/develop new staff in the daily operations of the department.
• Understands and supports referral information flow to ensure referrals and initial insurance authorization are being completed in a timely manner.
• Knowledge of the call center and insurance regulation documentation requirements.
• Completes documentation per company standards/policy utilizing an EMR system.
• Maintains agency productivity standards.
• Requires proficiency and a working knowledgeable base of admission and inquiry data bases (i.e. Logician, AS400, and MIDAS, etc.).

Education/Experience Requirements

Required:

• High School diploma
• Minimum of 1-3 years of office/customer service experience.
• Computer literacy, with proficiency in Microsoft Office, including but not limited to data entry, retrieval, and report generation.
• Ability to effectively communicate with enrollees/patients/families of all ages and referral sources.
  

Licensure/Certification Requirements

EOE AA M/F/Vet/Disability

Qualified applicants will receive consideration for employment without regard to their age, race, religion, national origin, ethnicity, age, gender (including pregnancy, childbirth, et al), sexual orientation, gender identity or expression, protected veteran status, or disability.

Successful candidates might be required to undergo a background verification with an external vendor.