Westaff is now seeking a Transportation Intake/Review Date Entry Clerk for a nonprofit health care improvement organization in Helena, MT!!
Schedule: Full Time, M-F, 8am-5pm
Duties and Responsibilities:
- Maintains confidentiality and professionalism in work produced.
- Understands and complies with contract rules and regulations set by the state.
- Attends appropriate meetings and in-services, related to work activity.
- Attends weekly intake staff meetings.
- Maintains knowledge of Administrative Rules of Montana (ARMs) pertaining to the Medicaid Transportation program, and how they apply to travel requests.
- Through telephone interviews, obtains all necessary information from the member, or contact person and processes transportation requests.
- Engages in active listening with callers, confirming or clarifying information, ensuring caller feels valued and diffusing angry callers when necessary.
- When unable to complete, escalates calls to appropriate staff for resolution in a timely manner.
- Returns telephone messages in a timely and efficient manner, within 2 or 24 business hours as required by the contract, depending on when the message is received.
- Enters data into the MARS computer system using tools provided to assure accurate information. i.e.: browse window, provider listings, BC/BS provider listing, Internet, etc.
- Determines at time of call whether medical service is covered by Medicaid insurance for travel reimbursement.
- Evaluates closest appropriate provider/facility for the service based on information provided during the intake interview and applies appropriate ARM for any reductions or denials.
- Uses established notes for most current recipient review decisions in assessing closest provider within a 6-month period.
- Keeps a watchful eye for duplicate travel requests from patients in the same residence or from patients who have travelled together in the past.
- Assures that mental health contract approval is in place for cases in which travel to family therapy is requested at residential treatment placements.
- Assesses and applies the least costly means of travel.
- Assesses the need for per diem and determines appropriate allowed amount.
- Enters brief but thorough comments on all intakes to support actions taken and decisions made.
- Assures that phones are adequately covered during business hours using tools provided. i.e.: Max Agent; Teams chat, real-time display of callers in queue.
- Assures Orthodontia services have been specifically approved by the Department for the member before approving travel unless the appointment is the initial visit for evaluation.
- Maintains working knowledge of available cab, wheelchair van, paratransit, and bus services around the state, and reimbursement rates for these services.
- Maintains strong working relationships with cab, wheelchair van, and paratransit dispatchers and drivers, assuring that services will continue to be offered for Medicaid patients.
- Determines medical necessity for cab and wheelchair van services by seeking information from recipients regarding usual mode of transportation, possible disabilities, ability to use the fixed route or paratransit bus service, etc. and noting the decision for future reference.
- Calls cabs and wheelchair vans to notify them on all same day and next business morning transports and assures availability for the transport.
- Enters appointments for dialysis and Rainbow house patients on a month-to-month basis, in addition to keeping up-to-date information for patient’s residence and payee information through means of tele-communication.
- Enters and evaluates travel requests, lodging receipts, and cab/bus/air fare receipts
- Communicates with the Department of Administration regarding lost, returned, and replaced reimbursement checks.
- Logs information on newborn patients awaiting Medicaid eligibility. Ensures that information is entered into MARS once the Medicaid eligibility is determined.
Knowledge, Skills and Abilities:
- High School graduate or GED
- Familiarity or understanding of medical terminology preferred.
- Experience as a medical secretary, ward clerk, accredited record technician desired.
- Work experience in answering telephones and serving customers.
- Strong critical thinking and problem-solving skills.
- Good oral communication skills.
- Good keyboard skills (typing speed of 50 wpm, experience with 10-key preferred).
- Basic computer skills with experience in Windows operating systems.
- Ability to multi-task using several different programs across multiple screens.
Minimum Physical Requirements:
Sitting, Reaching, Handling/Grasping, Hearing, Seeing: needs to see documents, monitor, information resources daily, Speaking/Talking, Repetitive motion, Keyboarding, Reading, Sedentary work.
Apply today for IMMEDIATE consideration for our Transportation Intake/Review Specialist position!
Military & Veterans encouraged to apply