Outpatient Service Coordinator - ABA Therapy

West Virginia University Hospital, Inc; United States; Remote; USD 50,000 - 80,000; Full time

Job summary

An established industry player is seeking a compassionate and skilled professional to oversee patient care coordination within their Applied Behavior Analysis Therapy program. This role involves managing pre- and post-service access processing, ensuring financial viability, and fostering effective communication among patients, caregivers, and providers. With a focus on delivering exceptional customer service, the ideal candidate will thrive in a dynamic environment, utilizing their expertise in social work and healthcare reimbursement. Embrace the opportunity to make a meaningful impact in a supportive and innovative setting, where your contributions will enhance patient experiences and outcomes.

Qualifications

• Master's degree required with relevant licensure in social work.
• 3 years experience in healthcare reimbursement preferred.

Responsibilities

• Oversee patient access processing and reimbursement authorization.
• Coordinate outpatient therapy scheduling and maintain patient records.

Skills

Organizational Skills

Time Management

Problem-Solving

Customer Service

Communication Skills

Knowledge of ICD-10 Codes

Knowledge of CPT Coding

Knowledge of Revenue Cycle Operations

Education

Master's Degree in Social Work

Licensed Certified Social Worker (LCSW)

Licensed Independent Clinical Social Worker (LICSW)

Certified Rehabilitation Counselor

Tools

EPIC

Cadence

Microsoft Word

Spreadsheet Applications

Email Applications

Job description

Welcome! We're excited you're considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you'll find other important information about this position.

Responsibilities

Responsible for overseeing and managing the patient during pre- and post-service access processing including verification/certification of patient care services to ensure the financial viability of the clinic. Assists with coordination of care provided by interdisciplinary team facilitating communication to patients, care givers as well as third party payers and referring providers.

Minimum Qualifications

Education, Certification, and/or Licensure:

• Master's Degree in Social Work OR Rehabilitation Counseling
• Current or temporary Licensed Certified Social Worker (LCSW) OR Licensed Independent Clinical Social Worker (LICSW) OR Certified Rehabilitation Counselor in West Virginia. Permanent licensure within 90 days of hire OR if a recent graduate, must be working with a current provisional or temporary West Virginia permit.

Experience:

• 3 years' experience with healthcare reimbursement.

Core Duties and Responsibilities

The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

1. Identifies and obtains reimbursement authorization on all patients requiring pre-certification or pre-authorization prior to services being provided.
2. Documentation within appropriate EPIC modules.
3. Obtains necessary clinical documentation from the requesting provider to use in the pre-certification process.
4. Documents referrals/authorization/certification numbers in the registration/EPIC systems.
5. Coordinates the scheduling of patients for outpatient therapy in order to organize and ensure quality patient care. Maintains master schedules in EPIC (patterns and templates) for each therapist in the department. Update daily with vacations, meetings, classes, etc. to assure accurate schedules.
6. Coordinates treatment planning and maintains ongoing contact with referring providers to facilitate transitions of care.
7. Respects the confidentiality of all patient information and conforms to hospital/departmental policies on the handling and disclosure of patient information.
8. Assesses patients and members of their support system in order to identify potential needs, to determine appropriate level of care and to identify necessary interventions.
9. Takes an active role in the coordination and facilitation of goal-oriented family meetings.
10. Works with Financial Counseling to facilitate reimbursement opportunities.
11. Evaluates, coordinates and acts in accordance with current laws and hospital policies in reporting targeted populations (suspected child/disabled adult/elder abuse or neglect).
12. Demonstrates a high level of initiative and performs as a self-starter in daily activities.
13. Acts in a professional, caring, customer service focused manner in all interactions with patients, families, peers, medical team members and community agency representatives.
14. Supports and participates in multidisciplinary patient/family education and care planning with the entire healthcare team.

Physical Requirements

Ability to sit for prolonged periods of time, manual dexterity. Heavy/Hard work: Work requires strength and/or stamina, lifting, moving, stooping, reaching, standing, walking, and carrying of materials and equipment weighing 40+lbs. Specific vision abilities required include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus.

Working Environment

Office environment and clinical setting. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Skills and Abilities

• Skill in organizational matters, including time management, prioritization, multitasking, and problem-solving.
• Ability to establish and maintain effective working relationships with patients, physicians and other clinical staff, and the public.
• Excellent customer service, written and oral communication skills.
• Adheres to the established Performance Expectations for WVUH Employees in the areas of People, Service, Performance Improvement, and Shared Values & Culture.
• Basic knowledge of computer programs such as word processing, spreadsheet and email applications.
• Knowledge of ICD-10 Codes and CPT coding, insurance authorization with Third Party Payers, payment provisions and regulations, revenue cycle operations, third party reimbursement regulations and medical terminology.
• Knowledge of all aspects of payer relations, claims adjudication, contractual claims processing and general reimbursement procedures.
• Knowledge of clinic policies and procedures.
• Knowledge of computer systems and software especially Cadence.

Additional Job Details

This position will specifically work with our Applied Behavior Analysis (ABA) Therapy program. The position can be fully remote, but local candidates will be highly considered. Please note licensure/certification requirements.

Schedule and Compensation

• Scheduled Weekly Hours: 40
• Shift: Day (United States of America)
• Exempt/Non-Exempt: Exempt

Company and Cost Center

• Company: WVUH West Virginia University Hospitals
• Cost Center: 8203 WVUH CH Pediatrics Applied Behavior Analysis Therapy