Santiago de los Caballeros, Santiago Province, Dominican Republic
Other
Posted 1 month ago
Job Description
Outsourcing Advantage is actively seeking a highly organized and detail-oriented Intake Specialist. The ideal candidate must have prior home care intake experience.ResponsabilitiesProcess new referrals for Managed Long-Term Care (MLTC), Health Maintenance Organization (HMO), and Certified Home Healt...
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Outsourcing Advantage is actively seeking a highly organized and detail-oriented Intake Specialist. The ideal candidate must have prior home care intake experience.
Responsabilities
Process new referrals for Managed Long-Term Care (MLTC), Health Maintenance Organization (HMO), and Certified Home Health Agency (CHHA) cases across New York State.
Identify case type and eligibility via Electronic Provider Assisted Claim Entry System (ePACES) and related systems.
Schedule New York Independent Assessor Program (NYIA) clinical assessments and follow up on pending or failed assessments.
Communicate with doctors, telehealth companies, and CHHAs to obtain required forms (e.g., M11Q, CHHA progress notes, Plan of Care (POC) forms).
Navigate and process cases in clients' software HHAeXchange, ensuring complete and compliant documentation.
Communicate promptly and professionally with insurance plans regarding authorizations, start of care (SOC)s, and service continuation.
Track pending cases, authorizations, and follow-ups daily to ensure timely activation.
Support the intake department in coordination with marketing and transition teams.
Requirements
Minimum Home Care Intake experience (required).
Working knowledge of HHAeXchange (required).
Familiarity with ePACES, NYIA, CHHA/MLTC processes, and home care documentation.
Strong written and verbal communication skills.
Exceptional organizational skills and the ability to manage multiple priorities with accuracy and speed.
Analytical mindset and ability to identify trends, issues, and opportunities through data.
Preferred Skills:
Familiarity with Medicaid, MLTC, and CHHA regulatory timelines (SOC, POC, authorizations).
Understanding of DOH documentation standards and managed care processes.
Hours
Full-time: Monday – Friday 9-5 EST
Benefits
Competitive salary.
Opportunity to work on diverse and exciting projects
