Case Management Assistant
Varied start times, will work some week days, weekends and holidays based on operational needs.
Job Summary : The Case Management Assistant (CMA) collaborates with Case Managers and Social Workers in assisting with the continuum of care and discharge planning.
Communicates clinical information, referrals and coordination of insurance review. Collaborates with the PBO (Patient Business Office) for identification of payer sources, eligibility, or indigent programs;
completes TAR's (Treatment Authorization Requests) for submission to the county field offices for medical authorization, supports medical on-site reviewer functions, assists with reimbursement, authorization contracts, and supports the denials and appeals process.
Functions under the direction of a Case Manager with minimal supervision, takes responsibility for professional growth, and assists in the coordination of patient placements, ordering of durable medical equipment and coordinating care transitions.
Performs other duties as needed.
Education and Experience : High School Diploma or GED required. Associate's Degree in related field preferred. Minimum three years experience with a medical group, managed care organization, utilization management, hospital admitting, or medical nursing unit required.
Hospital and / or insurance experience preferred.
- Knowledge and Skills : Acquires and maintains working knowledge of Medi-Cal, CCS, CMS and commercial regulations and managed care;
- Knowledge of state managed health plans and contracting. Able to read; write legibly; speak in English with professional quality;
use computer and software programs necessary to the position; Operate / troubleshoot basic office equipment required for the position.
- Able to relate and communicate positively, effectively, and professionally with others; able to demonstrate positive customer service skills;
- work calmly and respond courteously when under pressure; lead, supervise, teach, and collaborate; accept direction. Able to communicate effectively in English in person, in writing, and on the telephone;
- think critically; work independently with minimal supervision; perform basic math functions; manage multiple assignments effectively;
- work well under pressure; problem solve; organize and prioritize workload; recall information with accuracy; pay close attention to detail;
- maintain confidential records and correspondence. Able to distinguish colors as necessary; hear sufficiently for general conversation in person and on the telephone;
identify and distinguish various sounds associated with the work place; see adequately to read computer screens, medical records, and written documents necessary to position.
Licensures and Certifications : Medical Assistant Certification preferred.
Our mission is to continue the teaching and healing ministry of Jesus Christ. Our core values are compassion, excellence, humility, integrity, justice, teamwork and wholeness.
Case Management Assistant
The Case Management Assistant (CMA) collaborates with Case Managers and Social Workers in assisting with the continuum of care and discharge planning. University Hospital: Case Management (Unscheduled, Day Shift) -. Functions under the direction of a Case Manager with minimal supervision, takes resp...
Case Management Assistant
The Case Management Assistant (CMA) collaborates with Case Managers and Social Workers in assisting with the continuum of care and discharge planning. Medical Center: Social Work and Case Mgmt (Unscheduled, Day Shift) - . Functions under the direction of a Case Manager with minimal supervision, take...
Back Office Medical Assistant with Ophthalmology experience
Tayani Institute is seeking a dynamic, energetic, high level and knowledgeable Back Office Ophthalmic Medical Assistant to join our growing and thriving Ophthalmology practice in Southern California. We have Medical Assistant positions available in Santa Ana, Laguna Hills, and San Clemente. Answer a...
Care Coordinator - (ECM) Inland Empire
The Enhanced Care Management (ECM) Care Coordinator (CC) is responsible for care coordination, improving health outcomes, enhancing satisfaction, and reducing unnecessary healthcare utilization. Collaborates on Student care issues with other ECM Care Team Members, participating in weekly system...
Holiday Asst. Location Manager- Galleria at Tyler
Cherry Hill Programs brings the magic to every experience by capturing moments that last a lifetime. In partnership with retail locations, tourist attractions, and destinations across North America, Cherry Hill Programs contributes millions of holiday and souvenir experiences for children and famili...
Care Coordinator
We are seeking a dynamic Care Coordinator to be an integral part of our treatment team at our adolescent residential treatment programs. The primary purpose of the Care Coordinator is to provide structure, supervision and direction to our clients, promote accountability, and ensure their safety and ...
Assistant General Manager
The Assistant General Manager (AGM) is responsible for the Front and Back of the House operations of a single business location with the General Manager and whenever s/he is offsite. Assistant General Manager Position Summary: . ...
Registered Nurse (Oncology Care Coordinator)
The Care Coordinator assists Veterans, family members, and caregivers with receiving the most appropriate options and services to meet their complex health care needs. The RN Care Coordinator addresses psychosocial, as well as nursing and medical needs of patients and their families/caregivers, thro...
Administrative Assistant for Rehab / Medical Office (Pacific Time)
As an Administrative Assistant for Recover, you’ll be responsible for providing a professional, caring, and supportive outward face for the company. You will handle standard clerical front office tasks and ensure that our patients have a smooth experience along their recovery journey. ...
Medical Social Worker MSW-PRN
Provides counseling to patients and families in areas such as family problems, coping with illness, trauma, loss of function and grief* You will be participating as part of the multidisciplinary team in case and family conferences to assist in formulating overall patient care plans, interprets psych...