The Ability Unlimited Client Service and Administrative Representative is responsible for supporting the Ability Unlimited Operations Manager and the families served by AU. Duties include answering client and team member questions via phone and emails, providing resources and information, and organizing and processing paperwork.
- Requires documented combination of skills/relevant work experience. Person-Centered Thinking is a plus.
- Have great attention to detail, superior research abilities, be able to work independently yet lead a team through effective communication both orally and written.
- Proven ability to understand a client's needs and effectively answer questions about available services.
- Proven track record of meeting deadlines, responding to communications, and using care with confidential information.
- Two references are required.
- Submit to and pass criminal background check(s).
- Provides excellent client service to every client in all interactions. This is achieved by having passion for the work we do and compassion for the client's with whom we work.
- Maintains strong client relationships, remains objective and demonstrates positive regard for clients/families.
- Accurately identifies the services that best meet the person's needs.
- Mentors families through the Assistive Technology/ Environmental Modifications/ Durable Medical Equipment process (benefits, requirements, and meeting application deadlines), utilizing provided intake/follow up scripts and adjusting as needed. Provides support to these families as requested or weekly/as needed.
- Effectively answers client and prospect questions. Promptly follows-up with additional resources/information.
- Assists families with navigating the appeals process and compiling needed follow-up documentation.
- Demonstrates patience and respect when handling difficult situations.
- Understands and respects the client's rights to make decisions about, direct the provisions of, and control his/her services.
- Enters referrals the day of receiving them that includes complete contact information and details of the referral source.
- Weekly reviews case-load to follow up with needs of the clients served.
- Enters action oriented notes on clients record when following up.
- Effectively researches items and what criteria they fall under as needed.
- Ensure we have all necessary referral documents from appropriate sources as per developed check lists.
- Verify Medicaid coverage before processing. Identify correct agency to work with based on type of Medicaid and insurance coverage.
- Collect all supporting documents necessary as per developed check lists.
- Follows up on faxes sent within 1 business day to confirm receipt.
- Follows up on cases submitted once per week or more frequently if needed.
- Ensure denials are processed, client record is updated, and follow up with client is completed with option to appeal stated and information provided to family.
- Authorizations entered within 1 business day and items ordered, as appropriate, within the service start/end dates.
- Warranty info and approval must be communicated to client once device is ordered to be shipped. Collect any more data needed for finalizing shipment, or ordering devices, and let them know we will follow up in 30 days to fill out a client satisfaction survey.
- Send client satisfaction survey and ask they review us on Facebook/Google 30 days from receipt of device.
- Researches and trouble-shoots service authorization challenges. Will assist other team members to understand how to investigate authorization statuses and challenges, and look to training and other team members as resources when they themselves are having difficulties.
- Displays detailed knowledge of all AU services in regards to Medicaid, waivers, and EPSDT to identify what is available to each client served. Displays a general understanding of additional services available via the waivers and EPSDT.
- Understands the rules and regulations, application process, eligibility criteria, appeal process, rights and procedures, transfer process, and services available.
- Understands roles and responsibilities of all of the entities involved in administering Assistive Technology/ Environmental Modifications/ Durable Medical Equipment Services through Medicaid (KePRO, DBHDS, CSB Case Managers, MCO Care Coordinators).
- Gives sound information about other available resources including who the experts are in those areas and how to contact them (and then leaves the work of pursuing those resources to the client/family).
- Understands and communicates the role of Prior Authorization of services.
- Uses care and discretion when handling personal information and client records.
- Responds to all voicemails and emails within 1 business day.
- Completes all assigned training modules within 5 business days.
- Consistently attends monthly company conference calls.
- Limits short-notice absences to rare occasions and typically requests time off with 2 week advanced notice.
- Utilizes team support tools available to him/her (Company Newsletters, Google Drive, AU website and Chatter).
- Stays abreast of community relevant issues (joins Yahoo groups/support groups/list serves).