Overview Customer Service Rep - Older Adult Care, Mercyhealth at Home -Day Shift Hours -80 hours / 2 weeks Works in the Older Adult Care Department of Mercyhealth at Home for the Community Care Program (CCP) and Adult Protective Services (APS) under the program rules & guidelines of the Illinois Department on Aging (IDOA). The Customer Service Rep (CSR) is responsible for answering the phone, triaging calls and/or assisting the caller as needed. Responds to walk-ins when needed. Acts as a liaison between the client/family, various provider agencies, the CCP Care Coordinator and/or the APS Case Worker. Takes CCP referrals/intakes for CCP and reports for APS. Processes CCP files, Choices for Care Pre-Screens or the like and accurately inputs data into the Illinois Department on Aging’s system in order to generate billing. Maintains client records so they remain updated, organized and easily accessible. Responsible for faxing paperwork to authorized vendors, mailing paperwork to clients and filing all paperwork in the appropriate client record. Maintains file cabinets for active records and archives old records as appropriate. Assists with other projects as needed. Mercyhealth is committed to offering our partners a best place to work and continually evaluates new programs and benefits. We have been recognized locally, regionally and nationally for helping our workers achieve a work/life balance through benefit offerings and innovative programs. Our unique workplace Culture of Excellence is built upon: Employee engagement, empowerment and growth Teamwork toward our common goal – providing exceptional health care services with a passion for making lives better An atmosphere of caring and quality that cascades throughout the organization Responsibilities Answers the phone in a friendly and professional manner and directs callers to the appropriate program staff. In absence of the program staff, handles the client calls with appropriate follow up and brings the issues to the program staff’s attention. Completes accurate and detailed intakes for the Community Care Program and/or Adult Protective Services program. Responsible for assisting walk-in referrals as needed. Keeps all client- identifying information confidential. Data Entry: enters info into IDOA software for CCP intakes/referrals and assessments and APS reports. The CSR will be responsible for one or more of the following duties as assigned: Billing: Demonstrates knowledge of various program rules, billing and what is required to accurately submit each assessment or prescreen for payment. Completes daily transmittals, weekly & monthly billing. Reviews and corrects billing rejects. Choices for Care: Determines if a prescreen is needed. Processes nursing home prescreens to ensure accurate billing. Completes nursing home verifications as needed. Logs post-screens in IDoA website. Reporting: On a monthly basis runs 6-month and Annual assessments due and distributes the list to each Care Coordinator accordingly, checks Critical Events (CERAs) daily and assigned to appropriate CCP Care Coordinator, uploads documents to IDOA Partner Portal for Medicaid and Care Coordinator Training. File Maintenance: Assures that Client related paperwork is accurately faxed, in a timely manner, to the appropriate Provider agency for each client needing in-home services. Tracks Client Agreements for Provider signature then files when complete. Accurately files all paperwork and/or mail in the appropriate client record. Archives old records. Maintains a spreadsheet to ensure easy finding and retrieval of old records when needed. Supplies Management: Puts together Assessment packets with needed forms for the Care Coordinators and maintains a sufficient supply. Orders needed forms from the Illinois Department on Aging. Orders office supplies and the like as needed. Quality Assurance: Reviews the CCP file for accuracy, completes any item that is missing if able, or hands the file back to the Care Coordinator to make the necessary corrections. Mentors new staff as applicable. Assists Supervisor with various administrative duties. Makes sure all records are securely locked in a file cabinet at the end of each day. Participates in departmental staff meetings as well as all-agency staff meetings. Completes annual required educational requirement for both IDoA and Mercyhealth. Education and Experience High School diploma or equivalent Five years of customer service experience required, or Associates degree and 2 years customer service experience required. Special Physical Demands Be able to sit for extended periods of time. Culture of Excellence Behavior Expectations