Case Management Assistant

San Juan Regional Medical Center•Farmington, NM

13d•Onsite

About The Position

Creating Life Better Here starts with you. At San Juan Regional Medical Center, we're more than a healthcare provider—we're a values-driven organization dedicated to delivering exceptional care. As a team member, you help fulfill our mission to make life better here for our community. 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.

Requirements

High School diploma or equivalent
Self-motivated and accountable
Team-oriented
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
Effective communication skills
Excellent customer service skills and phone etiquette
Ability to function autonomously
Experienced in computer programs including Excel and Office

Nice To Haves

One (1) year experience in healthcare and/or insurance
Knowledge of insurance and billing requirements
Understanding of diagnostic and procedural CPT coding
Medical Terminology

Responsibilities

Arrange post-hospital appointments, including obtaining prior authorization when applicable
Create and provide calendar itinerary of all post-hospital care appointments and services
Provide and document CMS forms including but not limited to the Important Message from Medicare, MOON and Patient Choice forms as directed by the RN Case Manager, Social Workers and Case Workers
Arrange transportation home when necessary and a covered benefit from insurance provider
Send electronic referrals for post-hospital services and equipment as directed by RN Case Manager
Verify accurate patient phone numbers to ensure appropriate follow up
Document actions according to hospital and department standards
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 judgement and initiative to develop effective and constructive solutions per established guidelines and policies
Advocate for patients
Communicate with the RN Case Manager/Social Worker any barriers encountered to executing the discharge plan
Maintain knowledge of changing insurance requirements through internal/external training and/or communication
Complete assigned tasks in a timely manner
Each employee is responsible for implementing SJRMC’s Service Standards into their daily work: Safety, Courtesy, Effectiveness, and Stewardship
Other duties as assigned