Case Management Assistant

Loma Linda University Health • Redlands, CA

1d • Onsite

About The Position

The Case Management Assistant is responsible for assisting with case management in the daily utilization management functions of authorization, referrals, claims analysis, claims payment, data entry and chart review. Demonstrates working knowledge of managed care contract rates, terms, and conditions and accurately identifies member benefits. Cross covers all key areas of utilization management to ensure compliance with regulations. Functions independently with minimal supervision and takes responsibility for professional growth. Performs other duties as needed.

Requirements

• High School Diploma or GED required.
• Minimum two years of experience with a home care agency, medical group, business office or managed care office required.
• Able to keyboard 40 wpm.
• Able to use a computer, printer, and software programs necessary to the position (e.g., Word, Excel, Outlook, PowerPoint).
• Operate/troubleshoot basic office equipment required for the position.
• Able to work calmly and respond courteously when under pressure.
• Able to collaborate and accept direction.
• Able to think critically.
• Able to manage multiple assignments effectively.
• Able to organize and prioritize workload.
• Able to work well under pressure.
• Able to problem solve.
• Able to recall information with accuracy.
• Able to pay close attention to detail.
• Able to work independently with minimal supervision.
• Able to distinguish colors as necessary.
• Able to hear sufficiently for general conversation in person and on the telephone, and identify and distinguish various sounds associated with the workplace.
• Able to see adequately to read computer screens, and written documents necessary to the position.
• Valid driver's license required at time of hire.

Nice To Haves

• Certificate or degree in business or healthcare field preferred.
• LVN, MA or Managed Care related national certification preferred.

Responsibilities

• Assisting with case management in daily utilization management functions including authorization, referrals, claims analysis, claims payment, data entry, and chart review.
• Demonstrating working knowledge of managed care contract rates, terms, and conditions.
• Accurately identifying member benefits.
• Cross-covering key areas of utilization management to ensure compliance with regulations.
• Functioning independently with minimal supervision.
• Taking responsibility for professional growth.
• Performing other duties as needed.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED