Case Management Assistant

Job Description

Job Description

Job Description :

Provides clerical and administrative support to the Case Management team to facilitate care coordination, discharge planning, and utilization review. This may include but is not limited to : Tracking dates that concurrent reviews are due to third party payors; Obtaining updated clinical information from the EMR / Chart or the managed care forms filled out by case managers, and faxing to third party payors; Obtaining fax confirmation and making follow up calls to verify concurrent review information was received; Obtaining authorizations and documenting these with accuracy in the HMS financial system. After receiving training may assist with issuing the Medicare Important Message. Assists with initial post discharge referrals and makes follow up calls to providers regarding referrals and acceptance. Assists with arrangement of post-acute care services such as Home Health, Durable Medical Equipment, Outpatient Dialysis, Outpatient Infusion and Wound Care Centers, and post discharge transportation. Assists with preparation and completeness of discharge packets that accompany patients to Skilled Nursing, Subacute, and Acute Rehab Facilities. Assists in arranging post discharge physician appointments with primary care physician and specialist. May conduct post discharge calls to patients and providers and refer to appropriate disciplines if additional follow up is needed.

Qualifications / Skills :

• Minimum Qualifications : High school diploma or equivalent required. Knowledge of medical terminology required. Minimum one (1) year of experience as an Administrative Assistant or higher role required. Previous experience in a health care or health insurance setting required. Significant computer / data gathering and processing experience required.
• Additional Qualifications / Skills : One (1) year of college is preferred. Acute Care Hospital experience preferred. Experience working with Third Party Payor’s preferred. Knowledge of reimbursement programs, case management, and discharge planning preferred. Knowledge of federal and state regulatory standards, and Policies and Procedures. Ability to understand and complete work under deadlines. Strong organizational, prioritizing, and analytical skills. Ability to make independent decisions when circumstances warrant. Working knowledge of computer and software applications used in job functions. Ability to project a professional image. Freedom from illegal use of and effects of use of drugs and alcohol in the workplace.

Required licenses and certifications : None