Case Management Assistant

Job Description

Job Description

We are offering a contract to permanent employment opportunity for a Case Management Assistant in San Leandro, California.

This role is within the healthcare industry and is primarily non-clinical. As a Case Management Assistant, you will work closely with the Care Management staff, providing key administrative support and managing patient information.

Responsibilities :

• Collaborate with Care Management staff to provide specific clinical information for initial and concurrent utilization review.
• Ensure certification / approval of in-patient and post-discharge services.
• Act as a key point of contact between Care Management staff, admissions, and payers.
• Coordinate and track all communication, including but not limited to, Important Message letters, Denial Letters, and patient choice forms.
• Regularly update the Care Management team on the status of these communications.
• Coordinate and obtain authorizations for admissions and document all information in the AHS financial system.
• Work closely with Revenue Cycle to ensure each inpatient encounter is accurate.
• Coordinate all reviews and inquiries with the payors.
• Maintain a current database of existing and potential referral sources and communicate with them about bed availability, new products, and services.
• Manage multiple inquiries and present referrals based on location and services provided, providing appropriate follow-up on active or pending inquiries.
• Use Epic Software and other Electronic Medical Record (EMR) systems for case management tasks.
• Assist with patient transfers and work closely with the Non-clinical and Acute care teams for seamless operations.
• Conduct Utilization review and Utilization management tasks as needed.
• Proficiency in communication skills to effectively interact with patients, medical professionals, and insurance companies.
• Proficient with database management for maintaining patient records and other relevant data.
• Knowledge of medical coverage policies and procedures.
• Familiarity with clinical trial operations for patient management.
• Experience in processing referrals and authorizations.
• Understanding of health care systems and case management principles.
• Proficiency in Epic Software for maintaining electronic health records.
• Knowledge of payer systems and electronic medical record management.
• Experience in inpatient care and EHR systems.
• Understanding of health plan coordination and financial systems in healthcare.
• Knowledge of revenue cycle processes.
• Familiarity with 3M health information systems.
• Experience in non-clinical tasks such as photocopying and scanning documents.
• Knowledge of acute care management.
• Experience in QA management for healthcare processes.
• Proficiency in managing patient transfers.
• Familiarity with utilization review and management.
• Ability to handle confidential information in a sensitive and ethical manner.
28 days ago