About The Position

Provides clerical support for the Case Management team, assisting the team with problem-solving and facilitating inpatient and post-hospitalization care. The role requires the candidate to complete orientation and training during the week until done and must be available Monday-Friday until training is completed. The position is part-time, working weekends (Saturday and Sunday), with a possibility of some weekdays if the employee is available.

Requirements

  • High School diploma or equivalent
  • LA City Fire Card within 6 months of employment (PHGSH only)
  • Previous experience in a medical setting
  • Basic computer knowledge
  • Medical terminology
  • Strong verbal and written communication skills
  • Critical thinking skills

Nice To Haves

  • Bachelor’s degree preferred

Responsibilities

  • Safeguards and preserves the confidentiality of patient’s protected health information in accordance with State and Federal (HIPAA) regulatory requirements, hospital and departmental policies.
  • Ensures a safe patient environment and adherence to safety practices per policy.
  • With consideration to age, employee utilizes the approved process to resolve biophysical, psychological, educational and environmental needs of patient/significant other when administering care.
  • Actively participates in daily Case Management team meetings.
  • Follows up with phone calls and necessary paperwork to ensure seamless referrals to outside agencies.
  • Collects information to facilitate assessment of financial resources available for post-acute care.
  • Make arrangements for procuring and delivering DME and medications for post discharge care.
  • Arranges timely transportation for discharge according to plan.
  • Performs all clerical functions, such as, faxing, copying and telephoning as necessary to expedite patient discharge.
  • Ensures all discharge plans are followed through to resolution or requests assistance as needed.
  • Ensures insurance verification and obtains benefits to ensure adequate coverage to meet the need of the discharge plan.
  • Refers patients to financial counselors for information and/or to implement financial assistance forms.
  • Maintains knowledge of common reimbursement methods.
  • Communicates reimbursement information to patients and families as directed.
  • Works collaboratively with RN and SW Case Manager to issue continued stay documents and denial information.
  • Initiates disability applications.
  • Accesses computer system to obtain updated financial information and benefits.
  • Completes MAC paperwork and assists with county transfers.
  • Maintains awareness of payor / reimbursement practices and regulations that may impact patients’ plan of care.
  • Completes mandated legal reporting as appropriate.
  • Reports all observations/information to the Case Management team.
  • Screens all cases for advanced directives documentation.
  • Assist patient’s families with education or completing paperwork for healthcare decisions under the direction of the SW/RN Case Manager.
  • Helps ensure appropriate test results are available in a timely manner for physician review.
  • Assists with coordination of Case Management paperwork for admissions, transfers and discharges.
  • Monitors patients for frequent admissions and alerts Case Managers.
  • Assists with obtaining appropriate resources as directed.
  • Follows up on pre-certification activities.
  • Coordinates admission notifications to third party payors with Admitting department.
  • Maintains awareness of current managed care contract requirements for UR.
  • Communicates pertinent information received from payors to Case Managers.
  • Facilitates timely transmissions of concurrent and retroactive utilization reviews with insurance companies in coordination with RN Case Manager.
  • Assists with Medi-Cal review process, copying patient records and assists with TAR completion.
  • Supports process for insurance denials and appeal processes.
  • Collects and enters data on avoidable delays/days.
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