Farrah Joseph, Msw Email & Phone Number

• Verify eligibility and/or benefit coverage for patients, while communicating authorization status to members • Enter pre-service requests and/or authorizations into clinical system using diagnosis codes and CPT coding; verifies all necessary documentation has been submitted• Answer queue calls relating to UM review and pre-service status and provide referrals and authorization to external providers• Provide information required for denial letters for members whose benefits do not… Show more • Verify eligibility and/or benefit coverage for patients, while communicating authorization status to members • Enter pre-service requests and/or authorizations into clinical system using diagnosis codes and CPT coding; verifies all necessary documentation has been submitted• Answer queue calls relating to UM review and pre-service status and provide referrals and authorization to external providers• Provide information required for denial letters for members whose benefits do not cover requested services • Request necessary clinical information to ensure requests are properly set up for clinical review in the system• Convert clinical information obtained from providers (received via fax, phone, web, e-mail or mail) into electronic records within the system Show less

• Received and process medical provider faxes (averaging 300 per day) to ensure quality care to members• Ensured all received faxes and service authorizations are correctly logged in which entails verifying member/provider information, records, and personal health information• Logged into correct member record and/or re-route faxes to the appropriate department, when necessary• Assessed faxes and escalated matters to the appropriate clinical and non-clinical teams, as… Show more • Received and process medical provider faxes (averaging 300 per day) to ensure quality care to members• Ensured all received faxes and service authorizations are correctly logged in which entails verifying member/provider information, records, and personal health information• Logged into correct member record and/or re-route faxes to the appropriate department, when necessary• Assessed faxes and escalated matters to the appropriate clinical and non-clinical teams, as needed• Processed members' electronic documents, files for inaccuracies, and any other missing data• Created service authorizations in the appropriate PHI system and make determinations as to whether or not they are approved and escalate matters to the Utilization Management team as appropriate• Managed provider and member calls including authorizations and outstanding information• Processed CMS organizational dismissals Show less

• Worked within the interdisciplinary care team to support timely communication of member issues or needs and monitored screening of members effectively to improve quality and cost outcomes• Coordinated communications with community providers to obtain clinical information such as the member's Care Plan• Created new events, re-opened existing events, and made proper changes in fields within internal databases• Made outbound calls to inform service providers of requests for… Show more • Worked within the interdisciplinary care team to support timely communication of member issues or needs and monitored screening of members effectively to improve quality and cost outcomes• Coordinated communications with community providers to obtain clinical information such as the member's Care Plan• Created new events, re-opened existing events, and made proper changes in fields within internal databases• Made outbound calls to inform service providers of requests for information to support decision-making• Informed service providers of authorized services (providing authorization number)• Requested clinical information/discharge dates and verified admission dates with facilities • Received and process incoming correspondence (faxes) including discharge dates, requests for services and authorizations, and receipt of necessary clinical information to support Medical Management decision-making within NY State and Federal (CMS) required time frames. This includes the creation of new CCMS events, re-opening existing CCMS events, and making proper changes in fields within CCMS Show less

• Provided 1:1 emotional support to patients receiving incenter hemodialysis/peritoneal dialysis treatment• Consulted with attending physicians during rounds regarding patient's psycho-social and financial needs• Completed PHQ-9 as needed and psychosocial assessments on an initial, semi-annual, and annual basis• Finalized Kidney Disease Quality of Life surveys and reviewed with patients• Educated and supported patients regarding their Renal disease and treatment• Assisted in… Show more • Provided 1:1 emotional support to patients receiving incenter hemodialysis/peritoneal dialysis treatment• Consulted with attending physicians during rounds regarding patient's psycho-social and financial needs• Completed PHQ-9 as needed and psychosocial assessments on an initial, semi-annual, and annual basis• Finalized Kidney Disease Quality of Life surveys and reviewed with patients• Educated and supported patients regarding their Renal disease and treatment• Assisted in managing the American Kidney Fund Health Insurance Premium Program Show less

• Supported patients and families to manage difficult feelings such as anxiety, depression, fear, confusion, anger, and grief• Facilitated in the decision making about medical care and plans and arranged adequate home, hospital, or nursing home care• Helped family members adapt to role changes brought on by the illness and assisted in improving family communication• Provided patients and families with information about community resources and programs• Resolved financial strain… Show more • Supported patients and families to manage difficult feelings such as anxiety, depression, fear, confusion, anger, and grief• Facilitated in the decision making about medical care and plans and arranged adequate home, hospital, or nursing home care• Helped family members adapt to role changes brought on by the illness and assisted in improving family communication• Provided patients and families with information about community resources and programs• Resolved financial strain through the acquisition of available benefits Show less

• Recruited and onboarded RNs, Medical Technicians, PCTs, and CNAs• Coordinated, facilitated, and developed community recruiting activities such as job/career fairs, College/University events, open houses, and developing corporate recruiting materials/packages for these activities• Ensured affirmative action plan (AAP) through proper candidate assessment on the basis on interview

• Interviewed job applicants, verified licenses, I-9 status, ensured compliance with state health requirements, conducted criminal background checks, and obtained references• Maintained client and personnel data utilizing Elements VISTA software, including scheduling, billing, and payroll• Verified patient insurance benefits, reviewed ICD-9 codes, and submitted bills to providers• Played an active role in preparation for JCAHO accreditation, which was successfully obtained in August… Show more • Interviewed job applicants, verified licenses, I-9 status, ensured compliance with state health requirements, conducted criminal background checks, and obtained references• Maintained client and personnel data utilizing Elements VISTA software, including scheduling, billing, and payroll• Verified patient insurance benefits, reviewed ICD-9 codes, and submitted bills to providers• Played an active role in preparation for JCAHO accreditation, which was successfully obtained in August 2011 Show less

• Interviewed applicants, verified references and immigration status, conducted criminal record checks and insured compliance with NYSDOH health requirements• Coordinated orientation and mandatory continuing education programs with the Nurse Educator• Taught classes on company policies, payroll, and documentation• Helped mobilize services for home patients, including DME and supply deliveries, meals-on-wheels, transportation, and various community services• Liaised with… Show more • Interviewed applicants, verified references and immigration status, conducted criminal record checks and insured compliance with NYSDOH health requirements• Coordinated orientation and mandatory continuing education programs with the Nurse Educator• Taught classes on company policies, payroll, and documentation• Helped mobilize services for home patients, including DME and supply deliveries, meals-on-wheels, transportation, and various community services• Liaised with stakeholders to seek for resolution of patient complaints and service issues Show less