Care Management Assistant - Case Management York Hospital - Days

Duties and Responsibilities

Essential Functions:

• Assists with clerical functions (e.g., filing, copying, scanning, emailing, telephone, taking minutes)
• Determines patient health insurance benefit information as requested by CMRN/CMSW.
• Reviews payor logs and enters authorization information into EMR/patient record.
• Receives denial information and records in EMR/patient record; forwarding same to assigned CMRN.
• Initiates SNF authorizations as requested by CMSW/CMRN; followed by documentation of payor determination in EMR/patient record.
• Completes discharge notification to varied insurance payors.
• Assists CM team with IMM notices to patient.
• Assists with medication pricing as requested by CMRN/CMSW.
• Coordinates after care issues with the appropriate team members.
• Supports the CM team by coordinating follow up PCP appointments.
• Compiles data for and prepares regularly scheduled or special reports, analysis, and statements.
• Reviews daily patient discharge list, routes incomplete VNA orders, identifies incomplete auth information, reviews final disposition Epic navigator for accuracy and completeness.
• Works and maintains Incomplete Auth work queue; obtains delinquent authorizations and records in EMR.

Common Expectations:

• Maintains Downtime computer terminal/ associated logs.
• Enhances professional growth and development through participation in educational programs, current literature, in-service meetings, and workshops.
• Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.