Case Management Regulatory Clerk (Full-Time, Days)

Enloe Health • Chico, CA

7d • Onsite

About The Position

The Case Management Regulatory Clerk (CMRC) functions as a member of the Case Management department. The primary role of the CMRC will be to support Case Management specific compliance with Centers for Medicare and Medicaid Service (CMS) (including Condition of Participation) and Joint Commission in completing the following clerical tasks: One, as per CMS, ensure timely, accurate delivery and documentation of the Admission and Discharge Important Message from Medicare (IMM) letter to all inpatient Medicare and Medicare Advantage Beneficiaries. Two, as per CMS, ensure timely, accurate delivery and documentation of the Medicare Outpatient Observation Notice (MOON) to all outpatient Medicare and Medicare Advantage Beneficiaries. Three, support the CMS hospital Conditions of Participation (CoP) and the Joint Commission requirements that hospitals address regarding patient decisions about care, treatment, and services received at the end of life or if incapacitated by patient screening. The CMRC will possess strong knowledge of regulatory compliance related to delivery of IMM letters, MOONs. and screening for Advanced Directives. In addition, the CMRC will support other Case Management (CM) compliance related matters such as audits for patient choice and timely CM patient assessments. Finally The CMRA will support the clerical needs of the department such as maintaining the department phone line, faxing, emailing, data collection, file management, photocopying, and support the Case Management Assistant (CMA) with any outstanding clerical/regulatory duties.

Requirements

• Two-year computer experience including Microsoft Office.
• One-year experience in health care/medical setting OR 2-year degree in human service or healthcare related field.
• One-year experience working in an office environment performing general clerical duties to include data collection, data entry, typing, customer relations and filing.
• One year experience in a customer service role.
• Working knowledge of medical terminology.
• Strong skills in confidentiality and maintain all protected patient information in strict confidence.
• Positive, professional, and effective interpersonal relations with patients, public, physicians, and staff.
• Ability to work in a multidisciplinary team environment.
• Ability to communicate with patients and families during time of emotional and physical stress.
• Excellent analytical, grammatical, punctuation, spelling, and formatting skills.
• Self-motivated, flexible, and detail oriented.
• Knowledge of regulatory requirements as outlined by the Centers for Medicare and Medicaid Service (CMS).
• High ethical standards.
• Ability to fulfill the essential functions of the position.

Nice To Haves

• Previous experience in healthcare regulatory compliance or another field.
• Experience in EPIC software system.

Responsibilities

• Ensure timely, accurate delivery and documentation of the Admission and Discharge Important Message from Medicare (IMM) letter to all inpatient Medicare and Medicare Advantage Beneficiaries.
• Ensure timely, accurate delivery and documentation of the Medicare Outpatient Observation Notice (MOON) to all outpatient Medicare and Medicare Advantage Beneficiaries.
• Support CMS hospital Conditions of Participation (CoP) and Joint Commission requirements regarding patient decisions about care, treatment, and services received at the end of life or if incapacitated by patient screening.
• Support other Case Management (CM) compliance related matters such as audits for patient choice and timely CM patient assessments.
• Maintain the department phone line, faxing, emailing, data collection, file management, and photocopying.
• Support the Case Management Assistant (CMA) with any outstanding clerical/regulatory duties.

Benefits

• $0 premium medical plan to include vision insurance
• Prescription and dental group insurance
• Retirement with employer match
• Generous paid time off (PTO) plan that starts accruing immediately and can be used as it's earned
• Extended Sick Leave
• Flexible Spending Accounts for unreimbursed medical expenses and dependent care
• Employee Assistance Program
• Educational Assistance

What This Job Offers

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