Job Details
QUALIFICATIONS:
- High School Diploma or GED. Must have office administrative skills (e.g. typing, filing, copying, phone communications, composing correspondence, etc.). Incumbent should be knowledgeable and proficient in the use of office equipment, standard software packages and maintenance.
- Experience should include data entry and word processing. Resource will prepare correspondence, file, copy, answer phones and perform general clerical duties.
- Possess an understanding of the PA Medical Assistance Program, the Utilization Management Review processes, medical terminology, Nursing Facility, and Home and Community based service operations.
- Basic computer skills to include, but not limited to, Microsoft Office Products.
MAJOR POSITION DUTIES AND RESPONSIBILITIES:
- Act as a resource for exchange of information through verbal and/or written communication with Long Term Care Providers to enhance awareness of applicable state and federal requirements, including Medical Assistance waiver requirements.
- Be knowledgeable of and know where to locate applicable Medical Assistance, State and Federal regulations and Departmental requirements as they pertain to the Office of Long-Term Living services.
- Travel to and assist monitoring representatives with reviews at skilled nursing facilities.
- Assist in reviewing Residents Rights Packets (401s) to ensure completion, accuracy, and timeliness.
- Assist in reviewing Preadmission Screening Resident Review (PASRR) forms for timeliness, completion, accuracy. Resource for nursing facilities regarding questions and criteria for PASRR process. Performs tracking and data entry of forms and related letters.
- Assist in reviewing Home and Community Based Service (HCBS) forms for timeliness, completion, accuracy. Resource for HCBS providers regarding questions and criteria for Medical Assistance waiver program participation and monitoring. Performs tracking and data entry of forms and related letters.
- Assist with monitoring reviews by pulling relevant medical, facility and participant data from databases, and compiling data into format for review by nurses, financial representatives, and social workers.
- Assist with financial reviews by reviewing resident list and the facility census.
- Assist staff with notifying providers of pending reviews and assist with follow up to request any relevant information.
- Act as a liaison for screening calls from providers and refer to appropriate staff.
- Assist with coordination of provider trainings, meetings, and workgroups.
- Coordinates and organizes nursing facilities surveying information from the Department of Health for processing.
- Proofreads and prepares various kinds of correspondence, reports and documents related to OLTL activities in accordance with established protocols including correct use of medical terminology and record request information.
- Assist in ordering and monitoring office supplies.
- Ensures records are stored timely and accurately.
- Handles all mail, telephone calls and office management.
- Assist in making hotel, travel, meeting room and parking arrangement for staff.
- Must be knowledgeable in the use and maintenance of office equipment.
- Travel as needed, which may include overnight stays.
- Perform other related job duties as required.