Case Management Assistant

Eisenhower Health•Rancho Mirage, CA

3d•$20 - $30

About The Position

The Case Management Assistant provides clerical support to Case Managers, Social Workers, and other department members to help maintain efficient discharge planning and department operations. The role assists with referrals, insurance information and authorizations, post-discharge paperwork, transfers, bed searches, patient packets, Medicare-related processes, and post-discharge appointments. The assistant communicates timely updates and identified barriers to the appropriate care team, maintains community resource information, prioritizes assigned work, and supports colleagues in providing quality service.

Requirements

High school diploma, GED, or higher degree.
Two years of experience working in healthcare.
Ability to communicate effectively in a positive and professional manner.
Ability to use Microsoft Office Suite, including Word, Excel, Outlook, and PowerPoint, and other relevant software applications.
Knowledge of payer types, including Medicare, SR HMO, Medi-Cal, and private payers.
Problem-solving skills to identify issues and formulate effective solutions.
Self-starter with the drive to take action without prompting.
Written and verbal communication skills.

Nice To Haves

Associate's degree.
Medical Assistant, Certified Nursing Assistant, Medical Terminology, or other health-related certification.
Experience as a front- or back-office assistant or in Patient Financial Services.

Responsibilities

Comply with the Code of Conduct and compliance policies, address compliance questions or concerns, and report suspected violations.
Assist with referring and faxing discharge referrals to outside agencies and providers, including skilled nursing, sub-acute and acute care facilities, transitional care, rehabilitation services, home health agencies, and durable medical equipment companies.
Assist in obtaining appropriate insurance information and authorization before discharge.
Help ensure completion of necessary post-discharge paperwork and send it to providers as directed.
Confirm agency or facility acceptance and transfer time, arrange transportation as directed, and promptly communicate updates to the appropriate Case Manager, Social Worker, or Nurse Navigator.
Make phone calls and fax information for Medi-Cal 10-bed and other bed searches, and document search information in the medical record.
Communicate bed-search results, acceptance barriers, and potentially accepting facilities to the appropriate care team.
Prepare patient packets as needed by copying medical records, printing computer reports, collating required information, and preparing transfer envelopes.
Communicate identified issues and potential process changes to leadership.
Maintain the community resource list.
Assist with distributing Medicare IMM letters and obtaining signatures, when applicable.
Assist with Medicare appeals by gathering information, faxing it to the QIO, confirming receipt, completing the log, following up on outcomes, and communicating with the appropriate team, when applicable.
Assist with arranging post-discharge primary care appointments for high-risk patients as needed to help prevent readmissions.
Take off and communicate voicemail messages.
Ask for help when necessary and assist coworkers as needed to promote efficiency and quality service.
Prioritize workload and complete a typical day's assigned work within the scheduled shift.
Maintain current knowledge of payer reimbursement practices and regulations that affect patients' care and discharge plans.
Perform other duties as assigned.