Case Management Assistant

Lifepoint Health • Las Cruces, NM

8d • Onsite

About The Position

Memorial Medical Center is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Case Management Assistant joining our team, you’re embracing a vital mission dedicated to making communities healthier ®. Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve.
A Case Management Assistant who excels in this role completes various duties to enhance the efficiency of the Case Management Department and supports the daily functions of the case managers. This role assists in securing arrangements for the discharge transition and post-acute services and monitors the revenue cycle process related to insurance certifications, insurance verification, peer-to-peer completion, and denial/appeal tracking. This position also serves as a liaison between the Case Management Department, payers, and additional entities.

Requirements

• Minimum of one year of hospital or post-acute healthcare experience
• Preference in case management or a clinical department
• College degree in a healthcare related field preferred
• LPN or social work degree preferred but not required

Responsibilities

• Aids the case management staff, including but not limited to, creating and sending referral packets, organizing admission and discharge patient records, making phone calls, obtaining signatures, or any other assistance needed determined by the CM team.
• Organizes and prepares the necessary clerical elements for the weekly interdisciplinary team meeting to function timely and efficiently.
• Schedules family conferences and by makes necessary arrangements for post-discharge follow-up care.
• Functions as the point of contact and liaison for the hospital Case Management Department staff regarding clinical insurance review completion and/or issues.
• Forwards the necessary patient clinical information for all admission, concurrent, and retrospective insurance reviews to payers for the completion of medical necessity reviews.
• Monitors, follows up on, documents, and tracks payer responses/requests of completed clinical reviews, including approvals, appeals, and denials, and communicates these to the appropriate personnel (hospital staff, physician, Case Manager, clinical denial management, and Centralized Business Office).
• Monitors and tracks the total hospital certified days of the patient for payers (commercial, managed care, and Medicaid) and communicates missing certifications to the Case Manager.
• Enters DME orders, prepares discharge IMM for delivery, delivers Advance Directive packets and assists with Rehabtracker sign-ups.

Benefits

• Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
• Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.
• Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.
• Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).
• Ongoing learning and career advancement opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree