The Behavioral Health Community Services (BHCS) division provides a continuum of community-based behavioral health and supportive programs to assist individuals in their recovery from mental illness and/or addictive disorders. The Social Service Counselor works in the BHCS division under the direction of the Mental Health Regional Director.
- Collects necessary clinical documents from the supervisors and completes authorization requests for FFT, FFT-CW, MST, and Community Psychiatric Support and Treatment (CPST) service recipients.
- Submits authorization request packet to MCO and notifies service providers of authorization time frames and units available. Files authorization paperwork in service recipient charts. Scans appropriate documents into the EHR.
- Tracks trends in prior authorization for services approvals or denials, and compiles a list of frequency of denials and denial reasons. Prepares monthly report of these trends and submits to Clinical Director and service program supervisors.
- Tracks any changes in authorization documentation required and claims submission processes (ex. Modifiers) by the five (5) Managed Care Organizations on an ongoing basis. Notifies Clinical Director and supervisors of any changes.
- Attends MST, FFT, FFT-CW team staffing meetings monthly. Documents updates in service recipient cases, upcoming discharges, gaps in service. Notifies supervisor and Clinical Director of outcomes.
- Ensures authorization tracking spreadsheet, authorization submission tracking spreadsheet, productivity report spreadsheet, and referral list tracker spreadsheets are updated at least weekly.
- Performs service record audits for BHCS service delivery programs quarterly. Documents findings and notifies supervisors of any missing documentation. Ensures necessary documentation is obtained within the time frame specified by the Clinical Director.
25% Batching and Claim DenialsPerforms claims batching in the Electronic Health Record (EHR) twice a week.
- Reviews claim submissions for accurate use ofdiagnosis codes, CPT codes, and modifiers. Fixes incorrect or missing diagnoses after confirming with the therapist or supervisor and billing codes; notifies supervisor of any mistakes, and provides supplementary training on Superbills to employees/ contractors if needed.
- Reviews and compares CPST contractor invoices against Superbills entered into the EHR for consistency and accuracy.
Gathers necessary information from Multi-Systemic Therapy (MST), Functional Family Therapy (FFT), Functional Family Therapy-Child Welfare (FFT-CW) program supervisors and EHR to prepare monthly Department of Juvenile Services (DJS) invoice as outlined in DJS contract.
- Verifies new and returning service recipients’ insurance status using the Medicaid website at the beginning of each month and at the initiation of any new services. Notifies the supervisor immediately of any change or loss in coverage.
- Reviews 100% of denial spreadsheets disseminated by the Revenue Cycle Manager. Researches source of denial, provides requested information, notifies supervisor, and monitors/tracks status of the denial(s) weekly until resolved. Assists Revenue Cycle Manager with identifying charges to be excluded or written off.
25% Surveys and Community Resources
- Generates and completes ongoing Therapist Adherence Measure Surveys (TAMS) required for the randomly identified program participants per national MST program monitoring guidelines. Makes three phone call attempts to reach family within the specified time frame created. Notifies MST program supervisor of any families unable to be contacted.
- Tracks Quality of Care (QOC) surveys. Enters survey information into the TELESAGE system and service recipient charts, and tracks trends of survey response data. Provides monthly status of collection rates and trends identified to supervisors.
- Manages and organizes the Office of Behavioral Health (OBH) Ces’t Bon survey process in the community with the OBH surveyors. Identifies individuals to be surveyed and assists staff with scheduling of appointments. Ensures enough appointments are scheduled to meet survey number requirements.
- Acts as the community resources coordinator and housing resources coordinator for the BHCS division. Researches and validates an ongoing and updated list of parish/ community resources for program supervisors to access.
- Maintains SSI/SSDI Outreach, Access, and Recovery (SOAR) certification and assists any eligible individuals with the application process.
Acts as secondary Child & Adolescent Functional Assessment Screening (CAPAS) screener for the Flexible Family Fund program.
10% Electronic Health Record (EHR) Training/Payment Plans
- Acts as the division’s EHR super-user for the Patient Administration module, Check-in module, Clinical Console module, and Charge Entry module. Sets up new users into the EHR system, including user preferences, schedules and billing codes.
- Trains new and existing employees and contractors on the usage of the EHR in all modules necessary for their workflow (e.g. how to check-in an individual, how to access a progress note, how to submit a Superbill). Trains employees/ contractors on the appropriate encounter reasons to select for each type of progress note and on proper process for claim submission. Provides ongoing support and assistance to EHR users.
- Assists service recipients with completion of a financial assessment and discount fee application, as needed. Gathers and documents required information received from individuals into the EHR.
- Tracks 100% of National Voter Registration Act (NVRA) declaration forms for division, updates monthly NVRA tracking spreadsheet, attends all NVRA trainings designated by the NVRA site coordinator, and ensures appropriate and necessary training updates are distributed.
- Serves as designated Records Manager for BHCS division.
- Ensures proper, secure storage of service recipient files and records containing protected health information in accordance with Policies (Records Management; Privacy of Individuals Served; Release of Information).
- Manages the organization and placement of open, closed, and archived files.
- Maintains online records database for tracking and managing closed files to ensure retention schedule is maintained.
- Acts as secondary file manager to division designated file manager when file manager is out of the office.
- Participates in all required JPHSA agency in-service training listed in Relias Learning on or before established due dates and all JPHSA agency in-service trainings/professional meetings conducted in real time to enhance skill development, program effectiveness, procedural/ policy compliance, and maintenance of an environment that ensures a recovery focused approach.
- Participates in regularly scheduled supervisory sessions per JPHSA Staff Development & Supervision Guidelines.
- Performs other duties as assigned to meet Division and/or Authority needs.
About Jefferson Parish Human Services Authority
Jefferson Parish Human Services Authority (JPHSA) envisions a Jefferson Parish in which individuals and families affected by Mental Illness, Addictive Disorders, and/or Developmental Disabilities shall live full, healthy, independent and productive lives to the greatest extent possible for available resources.