Case Management Support Specialist - Case Management

Health First Careers•Brevard County, FL

About The Position

The Case Management Support Specialist provides support to the Case Management department by coordinating communication and documentation with third-party payers to obtain authorization for hospital stays and supporting discharge planning. The role requires flexibility in carrying out various departmental tasks while demonstrating professionalism, organization, communication, and problem-solving skills. The position is part-time and works 8-hour day shifts every Friday, Saturday, and Sunday.

Requirements

High school diploma or equivalent.
AHA BLS certification if the position is hospital-based; not required for remote positions.
Previous face-to-face customer service experience.
Proficiency in Microsoft Office, including Outlook, Word, and Excel.
Ability to work autonomously with minimal supervision.
Strong critical-thinking skills.
Strong verbal and written communication skills and a professional presence.
Ability to maintain composure in a stressful office environment.
Ability to work flexible hours and days, including weekends, to meet departmental needs.
Ability to work directly with patients and families in patient care areas and by telephone.

Nice To Haves

Associate degree.
Medical, acute care, insurance, or social work experience.
One year of face-to-face customer service experience.
Strong organizational skills.

Responsibilities

Gather information from social workers, utilization review nurses, case managers, or patients to help validate demographics and insurance information and facilitate case management tasks related to reimbursement, discharge planning, and regulatory requirements.
Follow infection control practices when meeting with patients and families in patient care areas to coordinate discharge plans.
Assist with referrals, including sending documents, making calls, and preparing letters for community providers or regulatory agencies.
Receive requests and send clinical information to third-party payers, post-acute agencies or services, and regulatory agencies as assigned, for post-acute care referrals and reimbursement.
Complete delegated paperwork needed to carry out discharge plans and deliver regulatory forms.
Follow up with patients, families, third-party payers, or community agencies as delegated to identify needs and provide information that facilitates discharge, reimbursement, or authorization of stay; document follow-up.
Use appropriate communication methods to relay information and ensure timely receipt and transfer of voicemail messages.
Maintain positive working relationships with patients, families, and all levels of the organization.
Document payer authorization or denial information and communicate clearly and accurately on accounts to support accurate, timely billing.
Recognize and communicate service delays to the Case Manager, Social Worker, or Utilization Review Nurse.
Use department policies, procedures, and organizational initiatives to complete assignments proactively while protecting the confidentiality of protected health information.