Intake Coordinator

The Resource Exchange

Position Title: Coordinator

Department: Navigation and Quality

Teams: Benefits, Billing, Navigation, PAR, Quality, or Quality Review

Reports to: Team Supervisor

FLSA: Non-exempt

Supervisor responsibilities: N/A

Starting Range: $18.00 - $18.20

General Description:

Coordinators at TRE are the heart of this organization. Coordinators work in a variety of functions within the organization to support and serve people of all ages with long-term care (LTC) and in-home supports and services (IHSS) needs. It is the core responsibility of the coordinator to assist and synchronize supports and services with the persons and potential persons we serve (and their families) through each phase of the person's life cycle and time with TRE. Coordinators work in a dynamic and highly regulated environment. Coordinators must remain agile in their approach while being responsive to the needs of the people we serve, maintain a strong understanding of TRE's Mission, Vision, and Values, and be strong stewards of the financial resources at TRE.

Essential Duties/Responsibilities:

• Promote excellent internal and external customer service, through written and verbal communication, to all TRE stakeholders, with the intent of promoting TREs values through intentional communication strategies daily.
• Exhibit strong written and interpersonal communication skills to promote clarity of intent with all levels of communication daily.
• Develop a strong understanding of the rules and regulations that direct LTC and IHSS services to maintain compliance and best support the people served by TRE daily.
• Critically analyze case documentation, behavioral and medical reports, guardianship paperwork, financial documents, and other data pertaining to promote the health and wellbeing of the people we serve daily.
• Enter case notes in multiple systems to promote documentation of all client contact, communication, records, and tasks completed for the people we serve daily.
• Organize and implement service plan development tasks (varies by position) in person, by phone, and/or through the use of technology (i.e. Outlook, Office 365, ZOOM, etc.) to promote and remain knowledgeable of the needs of the people we serve while maintaining compliance with rules, regulations, policies, and procedures daily.
• Develop positive relationships with all TRE stakeholders to promote TRE mission, vision, and values through all interactions daily.
• Maintain client and company records utilizing a variety of internal and external data management systems to support continuity of care, manage client contacts, support transparency, comply with HIPAA standards, and promote state and federal regulations daily.
• Cultivate an understanding of community resources in addition to those provided by TRE to support the additional needs of the people we serve weekly.
• Maintain HIPAA standards throughout all aspects of TRE engagement to comply with regulations and protect the privacy of the people we serve and TRE staff daily.
• Attend departmental and agency meetings and trainings in person, by phone, and/or through the use of technology (i.e. Outlook, Office 365, ZOOM, etc.) as specified by the meeting or training coordinator to maintain and improve your performance, knowledge, skills, and abilities to best support the people served by TRE weekly.

Other Duties/Responsibilities:

• Support team members through providing coverage of essential and other duties to maintain quality of and continuity of services for the people served by TRE monthly.
• Participate in professional goal creation through the development and implementation of your career aspirations at TRE to further you performance, knowledge, understanding of the topics outlined in your career development plan quarterly.
• Adapt to a changing work environment due to last minute changes in state and federal rules and regulations that effect TREs policies and procedures to best support the people served by TRE annually or as needed.
• Assume other duties as assigned to promote the health and wellbeing of the people served by TRE and to promote the health and wellbeing of the organization annually or as needed.

Team Duties/Responsibilities

• The Benefits Coordinator position helps to ensure financial eligibility for individuals receiving LTC Waiver services. They coordinate with staff, clients, providers, and Department of Human Services (DHS) technicians to ensure clients remain financially eligible for Long Term Care Medicaid. Submit CSRs (Level of Care/DSS1) and Redetermination documentation for each individual in services annually to the Department of Human Services (DHS) for continued eligibility. Additionally, they monitor cases in the Colorado Benefits Management System (CBMS) and resolve any concerns if a case has been discontinued which includes reaching out to various contacts, retrieving specific documentation and submitting it to DHS for the reinstatement of Long Term Care Medicaid. They also send tickets to Health Care Policy and Financing (HCPF) to correct errors in coding to ensure successful billing.
• The Billing Coordinator position is responsible for submitting all Targeted Case Management (TCM) billing through Medisked. They are responsible for reconciling the BUS and Medisked prior to submitting billing to ensure TCMs claimed match in both systems before billing is processed. They also will also process all re-bills, voided claims, denial claims, and Service Utilization. In addition to these duties, it is also their responsibility to work through billing issues submitted via the provider, Service Coordinator, or person in services.
• The Navigation Coordinator is responsible for completing and documenting all initial in-home 100.2 assessments (functional needs assessment), Medicaid application, Arbor Review Group (ARG) applications and all corresponding applications for Long Term Care Medicaid waiver services on the individuals behalf in compliance with the rules and regulations set for by Health Care Policy and Financing (HCPF).
• The Prior Authorization Request (PAR) Coordinators complete a thorough review of documentation and state databases to ensure Prior Authorization Requests (PARs) are in compliance with Rules and Regulations set forth by Health Care Policy and Financing (HCPF). They complete revisions, utilization, enrollments, and continued stay reviews in a timely manner and provide feedback when plans need additional information or documentation. They also partner with Provider Approved Service Agencies (PASA), Service Coordinators, and HCPF to complete PARs through a various means of communication. They also keep detailed information and track the progress of each PAR created, revised, and submitted.
• The Quality Coordinators complete reviews of Incident Reports for individuals served by TRE. Reviews of Incident Reports include looking for systemic issues, reporting and tracking of incidents and Critical Incidents to applicable governing entities (i.e. Health Care Policy and Financing or Colorado Department of Public Health and Environment), and trending of incidents. Quality Coordinators are also responsible for partnering with Adult/Child Protective Services and Law Enforcement to complete investigations of alleged incidents of Mistreatment. Additionally, Quality Coordinators assist with facilitating the Human Rights Committee.
• The Quality Review Coordinators complete a thorough review of internal and external documentation of an individuals support needs and strengths. They are responsible for reviewing documentation to look for inconsistencies, areas for further risk mitigation, and gaps in services/supports. They also request documentation and resources to assist with risk mitigation and resource connection for individuals in services.

Job Qualifications:

Knowledge, Skills and Abilities:

• Maintain a solid understanding of case management best practices.
• Must have a friendly disposition and positive attitude.
• Possess empathy for people with long-term care support needs.
• Independently organize daily tasks and activities to ensure strict deadlines are met while prioritizing emergencies as they arise. Qualified coordinators have a strong skillset with organization.
• Complete tasks using computer-based technology. It is a must that every coordinator possesses a strong understanding of how to accurately use and manipulate Apple iPhones, desk phones, Microsoft 365 (TEAMS, Word, Excel, PowerPoint, SharePoint, OneDrive, etc.), Outlook, SKYPE for Business, Adobe Acrobat, and can use or learn to use additional plugins for these products. In addition to these technologies, coordinators are expected to learn several state and proprietary data bases to maintain accurate records.
• Use problem solving and critical thinking skills daily.
• Must possess cultural awareness, emotional intelligence, and be aware of unconscious biases.

Education and Experience Requirements:

Minimum: B.A. or B.S. in a human behavioral science field of study.

Preferred: In addition to the minimum standards, one to three years experience in a case management environment. Experience working with or possessing knowledge of family dynamics. Knowledge of community services and resource development. Working knowledge of Medicaid Waiver programs and requirements.

Material and Equipment Directly Used: Computers, Printers, Copy Machines, Surface Pro/tablets, Cell phones, etc.

Working Environment and Physical Activities: Frequent changes in environments occur with some positions, but most positions maintain a work setting in the office or remotely. Work settings may also include working from the office, at home, or in another location in the community (library, coffee shop, etc.). Navigation Coordinator meetings occur in a variety of settings like private homes, group homes, state and federally managed facilities, and community locations like homeless shelters, and the settings include occasionally working with or in proximity to people who are incarcerate for a variety of crimes which may include violent crimes and sex offences. There is a frequent need to stand, sit, and walk indoors (and outdoors with the Navigation Coordinator position in a variety of weather conditions while carrying up to 10 pounds of equipment), and there is an occasional need to lift 20 pounds. Have access to reliable transportation with minimum insurance levels ($100,00/$300,000/$100,000 liability coverage for driving positions).

This job description is not intended to be an exhaustive list of all duties responsibilities or qualifications associated with this job. Therefore, The Resource Exchange reserves the right to amend and/or modify this job description at any time. The Resource Exchange also reserves the right to stipulate hours of employment; work schedules may be changed to respond to business requirements.

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Employee Signature Date