IDD Patient Benefits Coordinator

We are hiring for:

IDD Patient Benefits Coordinator

Type:

Regular

If you are a positive and personable individual looking for a satisfying and fun opportunity to make a real difference in the lives of people with intellectual, developmental disabilities, and people facing mental health, and substance use challenges, join our team at RHA Health Services!  

Manages the patient benefits for RHA Health Services, LLC. Assesses and oversees administration of patient benefits plans including Social Security, Medicaid (including Special Assistance), and Medicare for IDD services. Creates Electronic Health Record (EHR) records utilized for claims and billing. Ensures thorough and accurate entry of patient benefits information in the EHR utilized for claims and billing. Assists with oversight and direction for other IDD patient related benefits such as Person Specific Specialized Rates, Irrevocable Burial Policies, Special Needs Trust Funds, ABLE Accounts and other government related benefits. Provides oversight and direction to local leadership for IDD Patient Resident Funds Management System, payer specific systems and authorizations for services.

Required Competencies (Manager/Director)

Accepting Responsibility (Supported by Be Proactive) -Takes accountability for delivering on commitments; owns mistakes; and uses them as opportunities for learning and development; openly discusses his or her actions and their consequences, both good and bad.

Setting Objectives and Goals-(Supported by Beginning with the End in Mind) - Sets meaningful, challenging performance objectives with clear measures of success for themselves and team.

Prioritizing and Organizing Work-(Supported by Put First Things First) Allocates time and attention based on what is most important to achieve key goals and objectives.  Effectively organizes and balances tasks and priorities to keep multiple projects on track. 

Managing Performance (Supported by Think Win Win) - Has an authentic interpersonal style that engages others and encourages high performance.  Uses personal influence to encourage and support.

Communicating Effectively (Supported by Seek First to Understand then to be Understood) -Shares information. Listens and involves others. Clearly Conveys ideas in a manner that engages others and helps them understand and retain the message.

Displaying Creativity - (Supported by Synergize) - Uses creativity appropriately to drive progress and encourages others to do the same. Makes innovation a priority among team members; encourages reasonable risk taking.

Managing Stress-(Supported by Sharpening the Saw) Uses healthy and effective methods to manage stress (e.g., maintaining appropriate diet, exercise, and sleep schedules); reacts effectively when faced with high-pressure situations

Championing the needs of the People we Support/Customers (Supports Culture of Caring)-Provides timely and professional service to both internal requests and the requests of the people we support and customers; is responsive to the people we support and customers' needs and requests. Is always courteous to the people we support or customer and considers the needs of the people we support or customer when making decisions

Following Policies and Procedures- Understands and follows company policies; encourages others to follow work rules; calls attention to actions that may violate policies and procedures.

Meeting Basic Work Expectations-Complies with basic job requirements and tasks; arrives at work on time as scheduled; proactively informs others when he/she encounters problems that may limit his/her ability to meet expectations.

Essential Job Related Responsibilities

Provides Oversight and Direction for IDD Patient Benefits- Manages the patient benefits for RHA Health Services, LLC.  Assesses and oversees administration of patient benefits plans including Social Security, Medicaid (including Special Assistance), and Medicare for IDD services.  Ensures accurate, thorough and timely completion of required documents for benefits eligibility including application for benefits and on-going review and maintenance of benefits. 

Creates and Manages EHR Records Utilized for IDD Claims and Billing- Creates IDD Patient EHR records utilized for claims and billing upon admission.  Ensures thorough and accurate entry of patient benefits information in the EHR utilized for claims and billing.  Completes fidelity check to ensure accurate information utilized in EHR for claims and billing, as well as information utilized in the Electronic Medical Record (EMR) where patient services are provided.  Manages EHR for admissions, discharges and transfers.  Provides oversight and direction to the local leadership regarding processes and procedures specific to IDD admissions, discharges, and transfers when related to eligibility, benefits, and authorizations. 

Assists with Oversight and Direction for Other IDD Patient Related Benefits – Provides oversight and assistance to local IDD leadership in identifying patients who meet the criteria for a Person Specific Specialized Rate.  Assist local leadership with completing the payer specific processes to request and maintain a Person Specific Specialized Rate.  Monitors and maintains all IDD Person Specific Specialized Rates.   Provide direction and resources to local leadership for other patient related benefits such as Irrevocable Burial Policies, Special Needs Trust Funds, ABLE Accounts and other government related benefits. 

Provides Guidance and Direction for IDD Patient Resident Funds Management System (RFMS) – Provides local leadership with necessary information from the EHR to create RFMS accounts for new admissions.  Assist with managing information in RFMS to ensure adherence to government regulations as they relate to patient assets.  Provide guidance and resources to local leadership to aide in management of RFMS at the local level. 

Provides Guidance and Direction for IDD Payer Specific Systems and Authorizations for Services – Provides local leadership with oversight, guidance and direction as it relates to the specific IDD payer systems (i.e. Alpha, Provider Direct, etc).  This includes assistance with authorizations, rates, claims and all other payer related questions or concerns.

Pre-employment screening:

• Complete criminal background
• Name checked in the registries. (OIG exclusions database, Child Abuse Registry, and Offenders Against Individuals with Developmental Disabilities)
• Drug testing
• Education verification and other credentialing based on position requirements.
• Proof of employment history or references (if required)
• Positions that require driving Proof of driver's license, driver's insurance, and vehicle, IF required for providing transportation for individuals.

We offer the following benefits to employees:

• Payactiv: early access to the money you’ve earned from hours you’ve already worked, before payday!
• Employee perks and discount program: to help you save money!
• Paid Time Off (full-time employees only)
• Health/Insurance (full-time employees only)
• 401(k) retirement savings program
• Wellbeing Programs: Physical, Emotional and Financial
• Chronic Disease management programs for hypertension and diabetes (for qualifying employees)
• Training: Free CPR, first aid, and job-specific training opportunities

*contract/contingent workers and interns do not qualify for any of the above benefits

EEO Statement RHA is an equal opportunity employer. In addition, we provide reasonable accommodation to qualified employees who have protected disabilities to the extent required by applicable laws, regulations, and ordinances. If you are an individual with a disability and need a reasonable accommodation to participate in the application process, please contact our solutions center.

About RHA:

At RHA Health Services, we help individuals with intellectual and developmental disabilities, mental health and/or substance use needs live their best lives. Our mission is to provide a safe and healthy environment while creating opportunities for personal outcomes.

For over 30 years, the people we serve and support have remained at the very center of everything we do. RHA currently provides services in North Carolina, Georgia, Pennsylvania, Tennessee, and New Jersey.

If you are ready to make a difference in the lives of people we serve and support apply to join the team today.