Case Manager Associate

M-F, on-site

8:00am - 4:30pm

No weekends or holidays

Benefits:

We pride ourselves in retaining our top talent by offering work environments that support professional development and personal success. In addition to our robust healthcare and retirement plans, we offer:

• Onsite children's care centers (Infant through Pre-K)
• Tuition reimbursement
• Payactiv- earned wage benefit-work today get paid tomorrow
• Career advancement opportunities
• Competitive pay and Benefits package

Job Overview:

• Demonstrates knowledge and skills to provide clerical and supportive assistance of a specialized, administrative, and/or complex nature to Case Management Services Department and customers.
• Demonstrates ability to be patient focused and willing to interact with patients, clinical staff, physicians, and the public in the inpatient hospital rooms and units.
• Employee must be able to successfully demonstrate the staff requirements as specified in the Case Management Scope of Service, and complete the Case Management Department's specific competencies, and meet/exceed the standards as identified in the criteria-based performance appraisal.

Essential Functions and Responsibilities:

• Job Duties include the following: other duties may be assigned:
• Supports Hospital Regulatory Compliance and Departmental Clerical Support (40%)
• Prepares Regulatory Notices for patients, delivers and explains documents, obtains signatures from patients and processes accordingly. This is patient facing; includes coming in contact with sick individuals, requires critical thinking and sensitivity to circumstances, as well as attentiveness to needs of others. No clinical or personal patient care will be completed by the individual but must be comfortable being in the clinical environment.
• Collaborates with the floor care team to ensure timely delivery of regulatory notices. Demonstrating persistence and ability to act autonomously to ensure the job is completed.
• Provides clerical and receptionist support for Case Management Department and customers.
• Operates and performs simple maintenance on office equipment.
• Delegates assignments to others appropriately.
• Coordinates special projects as required.
• Coordinates on call schedule
• Performs time keeping duties as assigned
• Case Records (40%)
• Transmits data via phone, fax, electronic portal, or mail in HIPAA Compliant fashion.
• Ensures the patients right to privacy and appropriate confidentiality when information is released to others.
• Assists Utilization Management staff in processing approvals, denials and insurance documents as necessary.
• Interacts with Payor portals to follow up on authorizations and document in electronic medical record.
• Participates on departmental and/or hospital committees and performance improvements as appropriate.
• Participates on department and/or hospital committees and performance improvements as appropriate.
• Telephone Services (20%)
• Screens calls and routes to appropriate person
• Records messages accurately and delivers to appropriate person promptly
• Utilizes denial prevention technology i.e. recorded, monitored and automated calls, and documents tracking numbers. Verifies faxes are received and retrieves and processes voicemail in timely manner.

Required: Certifications/Licenses/Education:

• Education and Experience

• High school diploma or general education degree (GED); three to six months related clerical experience; or one-year clerical training from college or technical school. CMA or Nursing Assistant experience and/or training is preferable.

• Language Skills

• Ability to read and interpret documents such as patient charts, safety rules, operating/maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to effectively present written or verbal information to customers, clients, and other employees of the organization.

• Mathematical Skills

• Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fraction, and decimals.

• Reasoning Ability

• Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form and to establish priorities. Ability to deal with problems involving several concrete variables in standardized situations.

• Computer Skills

• This job requires computer and system competency in the following areas: Enters data; retrieves data; uses and analyzes data. Ability to learn and use the provided electronic medical record system within three months of attaining position. Must have basic keyboard skills and ability to utilize various methods to relay necessary information via electronic medical record, internet, phone, and fax.

• Other skills, ability or knowledge

• Speaks clearly and persuasively in positive and negative situations. Listens and gets clarification. Writes clearly and informatively. Edits work for spelling and grammar. Able to read and interpret written information.

• Manages difficult or emotional customer situations, Responds promptly to customer needs. Treats people with respect and consideration regardless of their status or position.

• Consistently at work and on time. Ensures work responsibilities are covered when absent. Arrives at meeting and appointments on time. Follows instructions. Completes tasks on time or notifies appropriate person with an alternate plan.

• Communication

• Customer Service

• Attendance/Punctuality/Dependability