Branch Coordinator

Job Summary:

Southwestern Private Services, Inc. Branch Coordinator works efficiently to direct and coordinate Medicaid/Private Pay home care services at his/her designated site. They are responsible for ensuring compliance, accurate EVV/timesheet entries, and promote open communication between the Agency and Medicaid.

Requirements:

Must have a clean criminal background check. Assure HIPAA compliance at all times. At least a high school diploma. Must have clean driving record to be placed on the company's insurance policy. Be in a supervisory role for at least 1 year. Willing to travel as deemed necessary.

Duties and Responsibilities:

1. Ensure Compliance with Medicaid Regulations Stay up to date on Medicaid rules and changes implemented at both the state and federal levels. Ensure that documentation, coding, and prebilling align with Medicaid guidelines. Conduct internal audits regularly to identify potential compliance issues before an external audit occurs. 2. Maintain Accurate and Complete Documentation Ensure care plans, physician orders, and service notes are complete and updated. Confirm that caregivers properly document time in/time out for services rendered. Keep records well-organized for easy retrieval during audits or claim reviews. 3. Process Medicaid Claims Efficiently Assist the Biller to ensure claims are submitted as requested. Assure eligibility checks are being completed in the absence of the Care Facilitator. 4. Train Caregivers & Staff on Medicaid Requirements Educate caregivers on the importance of accurate documentation and timekeeping. Support Human Resources in delivering annual training on fraud prevention to mitigate billing errors and ensure compliance when necessary 5. Maintain Open Communication with Medicaid & Managed Care Organizations (MCOs) Develop professional relationships with Medicaid representatives and MCOs for quick resolution of issues. Stay informed on Medicaid policy changes, authorizations and other procedural updates. 6. Monitor & Address Audit Requests Proactively Prepare for Medicaid audits (like those from Qlarant) by keeping records organized. Assist the management team in responding to audits with clear, well-documented evidence of service provision. Implement corrective action plans (CAPs) developed by management team if any deficiencies are identified. Audit 10% of Consumer/Member files by list provided by management team, quarterly and report findings in writing to the Administrator by the given deadline. 7. Utilize Medicaid Management Software Use electronic visit verification (EVV) systems to track caregiver visits selected by the Agency. Ensure Consumer/Member information is up to date in the absence of the Care Facilitator. Assist the caregivers in the use and maintenance of the EVV system. 8. Advocate for Consumer/Members & Ensure Service Authorization Provide Consumer/Members with information on Medicaid application process and re-certifications to prevent coverage lapses. Confirm that service authorizations are active and match the care plan. 9. Teach CPR/First Aid in branch or designate another CPR/FA instructor Successfully complete CPR/First Aid Training and provide demonstration and testing to caregivers. Plan classes and obtain needed materials prior to scheduling 10. Attend in-state continuing education classes/conferences 11. Supervise branch staff and ensure compliance with Agency, state and federal regulations 12. Ensure the site they are responsible for has adequate staff 13. Attend scheduled department meetings in person or via Zoom 14. Review Critical Incident Reports, Consumer/Member complaints, on the job injuries and report to Administrator and/or Human Resources as they occur. 15. Must participate in On-Call Duties.

Job Type:

Full-time Pay:

$16.50 per hour Expected hours: 40.0 per week

Benefits:

401(k) 401(k) matching Dental insurance Life insurance Paid time off Vision insurance

Education:

High school or equivalent (Preferred)

Experience:

Caregiving:

1 year (Preferred)

Supervising:

1 year (Required)

Work Location:

In person