Case Management Assistant
Broken Arrow, Oklahoma Facility Cornerstone Specialty Hospitals Broken Arrow
Req ID 513218 Post Date 06 / 27 / 2024
Description
Schedule : Monday - Friday 8am-5pm, must be willing to work 3 days in Muskogee and 2 days in Broken Arrow
JOB SUMMARY :
Underthe supervision of the Lead Case Manager, or Director of Quality,thisrolecompletesvariousduties to enhance the efficiencyof the CaseManagementDepartment, as well as support the dailyfunctionsofthecasemanagers.
Thisroleassistsinsecuringarrangements for the dischargetransitionandpost-acuteservices. While monitoring the revenuecycle process related to insurancecertifications,insuranceverification,peer-to-peercompletion,anddenial / appealtracking,thispositionserves as a liaisonbetween the CaseManagementDepartment,payers,andadditionalentities.
ESSENTIAL FUNCTIONS :
- Providesassistanceto the case managementstaff,includingbutnotlimitedto,creatingandsendingreferralpackets,organizingadmissionanddischargepatientrecords,makingphonecalls,obtainingsignatures,oranyother assistanceneededdetermined by the CM team.
- Assiststhe casemanagement teaminschedulingfamilyconferences.
- Assiststhe case managementteam by makingnecessaryarrangementsforpost-dischargefollow up care.
- Functionsas the pointofcontactandliaison for the hospitalCaseManagementDepartmentstaff regardingclinical insurancereviewcompletionand / orissues.
- Forwardsthe necessarypatientclinicalinformation for alladmission,concurrent,andretrospectiveinsurance reviews to payers for the completionof medical necessityreviews.
- Monitors,follow-up,documents,andtrackspayerresponses / requestsofcompletedclinicalreviews,includingapprovals,appeals,anddenials,andcommunicatestheseto the appropriatepersonnel hospitalstaff,physician,DCM,CaseManager,ClinicalDenialManagement,andCentralizedBusinessOffice(CBO) .
- Monitorsandtracksthe total hospitalcertifieddays of the patient for payers(commercial,managedcare,andMedicaid)andcommunicatesmissingcertifications to the Lead CM / DQ and Case Manager
- Organizesandprepares the necessaryclerical elements for the weeklyInterdisciplinaryTeamMeeting to functiontimelyandefficiently
- Enter DME needs per order sheet specifications
- Prepare Discharge IMM for delivery
- Deliver Advance Directive packets
- Assist with Rehab tracker sign ups
- Abilityto maintainconfidentiality of allpatient and / or employeeinformation to assurepatientand / or employeerights areprotected.
- Abilityto interface on alllevels of the organization by demonstratingexcellentinterpersonalskills.
- Abilityto communicateeffectively,both in writing andverbally.
- Abilityto workcooperativelyandcollaboratively as a memberof a team.
- Abilityto workunderstressand to respondquicklyinemergencysituations.
- Musthave good and regularattendance.
- Performsother relateddutiesas assigned.
Qualifications
QUALIFICATIONS :
- College degree in healthcare related field preferred
- LPN or social work degree preferred but not required
- Minimum of 1 year hospital or post-acute healthcare experience with preference in case management or clinical department.
Proficient with WORD and EXCEL software, keyboard typing, and general office equipment.
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