Specialist - EVV in Bartlett, TN at D&S Community Services

Date Posted: 6/19/2020

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Bartlett, TN
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    6/19/2020

Job Description

ESSENTIAL DUTIES AND RESPONSIBILITIES

Authorizations:

  • Responsible for obtaining authorizations from the MCOs
  • Builds schedules from the service authorizations as they are received based on MCO(s) frequency, duration, and modifiers
  • Ensures authorizations in system match paper authorization for frequency, duration, and modifiers to ensure accuracy in billing
  • Ensures MCO Care Coordinators communication with client for respite hours and follows-up/receives respite authorizations
  • Monitors time frames for updated authorizations
  • Responsible for making sure discharge (D/C) is received for each client as they no longer need services
  • Coordinates/works-in-conjunction with scheduling to ensure CHOICES, ECF Choices and DIDD PA authorization books agree with schedules
  • MCO Maintenance:
  • Maintains missed visit log and applies reason codes and descriptions to submit to MCO immediately following missed visits
  • Reports changes in client statuses to MCO Care Coordinators
  • Communicates with MCO(s) and Care Coordinators for change of address, phone numbers, etc. for each client 
  • Sandata/Healthstar Maintenance/Scheduling:
  • Confirms and merges daily calls (including after hours)
  • Monitors dashboard every hour for missed visits and/or no-shows and reports to scheduling coordinators
  • Makes changes to the schedule daily in system
  • Makes changes in schedules for daily clocks to match Sandata/Healthstar system
  • Trains employees (caregivers) for clocking purposes and assigns each caregiver a Sandata/Healthstar ID
  • Maintains active and inactive clients in the system (hold versus off hold)
  • Maintains active and inactive employees in the system
  • Maintains respite tracking log to ensure Agency does not exceed 215 hours/year
  • Sends timesheets that units have been restored to Reimbursement Specialist to ensure caregiver gets retro-pay
  • Monitors and reports to Management and Scheduling anyone clocking repeatedly on personal cell phones versus client’s phone
  • Back Billing:
  • Completes “back billing” that includes monitoring of 120 day closeout
  • Emails timesheets and information to MCO(s) to restore units for missed visits
  • Ensures that timesheet discrepancies are corrected and returned to Medical Records for filing or Accounting for retro-payAny other duties, as assigned.
  • Responsible for on-call/routine maintenance of dashboard on weekends and holidays.

 ADDITIONAL DUTIES AND RESPONSIBILITIES

  • Must have the ability to deal tactfully with others, to exercise good judgment, to understand and follow written and oral instructions, and to express ideas clearly, both verbally and in writing, in English.PHYSICAL REQUIREMENTS
  •  
  • Physically able to perform the essential functions of the job as described in the essential duties and responsibilities sections including; walking, bending, stooping, kneeling, squatting, sitting, reaching overhead and lifting up to fifty (50) pounds.
  • Problem-solving skills
  • Ability to handle stressful situations calmly and courteously