Case Management Assistant SJRMC Hospital/en-US/SJRMC/job/SJRMC-Hospital/Case-Management-Assistant_R0000915/apply Love what you do; Love where you live Position Summary: The Case Management Assistant is entrusted to provide excellent service and set a positive tone for every customer while serving as the liaison between the Case Management team and post-hospital care agencies. Required Behaviors: As you go about fulfilling this mission, your work habits and work relationships should embody SJRMC's values. These values are our culture, our identity as an organization. Sacred Trust, Personal Reverence, Thoughtful Anticipation, Team Accountability and Creative Vitality ask more of us than merely completing some list of tasks. Our values ask for a deeper level of commitment, and what is asked of us we freely give because we believe in our mission Required Qualifications: High School diploma/GED is required. Strong communication skills: verbal and listening, primarily in telephone conversation, and written Excellent interpersonal skills and the ability to communicate clearly and effectively in English. Ability to work with minimal supervision Demonstrates ability to deliver quality work within tight deadlines. Independent decision making and discretion. Ability to operate a computer; including email and other office equipment (copy machines, scanners, faxnbsp;nbsp;nbsp;nbsp; machines, etc.). Ability to work effectively with team members, staff, and insurance co personnel of varying personalities and culture. Flexibility in schedule to accommodate the needs of SJRMC and the department. Ability to set and maintain priorities when dealing with multiple demands and interruptions. Preferred Qualifications: 1 year experience in healthcare and or insurance Knowledge of insurance and billing requirements Understanding of diagnostic and procedural CPT coding Medical Terminology Duties and Responsibilities: As assigned, provide support to the RN Case Managers and Social Workers in completing routine post-acute care arrangements. This includes setting up routine post-acute services according to physician orders, keeping the case manager or social worker informed. Assist the RN Case Managers and Social Workers in providing patients with the Important Message from Medicare, MOON and Patient Choice forms. Prepare and electronically send referral packets for transfers to Skilled Nursing Facility, Home Health agencies, Hospices, Durable Medical Equipment companies and transfers to higher level of care. Prepare and fax necessary documentation/information to facilitate prior authorization of off-formulary drugs for home use. Arrange post-hospital appointments, including obtaining prior authorization when applicable. Obtain prior authorization as necessary for patients in the hospital receiving observation services. Arrange medical transportation when required, including receiving insurance authorization. Follow up on above referrals by phone to ensure receipt of referral to intended company/facility and ensure all necessary information/documentation was provided. Document accordingly. Verify patient personal information and service address for home care post-acute providers. Document actions according to hospital and department standards. Places follow up phone calls to discharged patients as determined appropriate by Case Management RN and SW. Provide excellent customer service by appropriately greeting and responding to inquiries from teammates, SJRMC staff, physicians office staff and insurance companies in a timely manner. Use personal judgment and initiative to develop effective and constructive solutions per established guidelines and policies. Advocate for the patient Maintain knowledge of changing insurance requirements through internal/external training and/or communication * nbsp;Each employee is responsible for implementing SJRMCs Service Standards into their daily work. Safety _ Courtesy _ Effectiveness_ Stewardship * Other duties as assigned Physical Demands and Environmental Work Conditions: Physical Activities: Extended sitting Extended talking Extended reading Extended listening Extensive repetitive motions of both hands, such as: wrist/hand movements, grasping, finger dexterity as in typing, writing, faxing, filing, etc.) Ability to lift up to 50 pounds Work Environment: The typical noise level will vary from quiet to very loud Occasional mild variance in room temperature Sensory Requirements: The employee will need adequate ability to: See both close and distant objects Adjust visual focus The employee will need adequate ability to: Hear human speech, primarily telephone communication Hear verbal instructions Posted 2 Days AgoFull timeR0000915 As you go about fulfilling this mission, your work habits and work relationships should embody SJRMC's values. These values are our culture, our identity as an organization. Sacred Trust, Personal Reverence, Thoughtful Anticipation, Team Accountability and Creative Vitality ask more of us than merely completing some list of tasks. Our values ask for a deeper level of commitment, and what is asked of us we freely give because we believe in our mission. To learn more, visit us at http://www.sanjuanregional.com.