Case Management AssistantChandler, Arizona
Dignity Health East Valley Rehabilitation Hospital is a joint venture operation and free-standing Post-Acute Inpatient Rehabilitation Hospital between Dignity Health and Kindred Healthcare. Our two-story, 58,000-square-foot facility includes a stroke unit, therapy gym and 50 beds to serve patients recovering from significant neurological injury, illness and trauma and similar medical conditions.
Under the supervision of the Lead Case Manager, or Director of Quality,thisrolecompletesvariousduties to enhance the efficiencyof the CaseManagementDepartment, as well as support the dailyfunctionsofthecasemanagers.Thisroleassistsinsecuringarrangements for the dischargetransitionandpost-acuteservices. While monitoring the revenuecycle process related to insurancecertifications,insuranceverification,peer-to-peercompletion,anddenial/appealtracking,thispositionserves as a liaisonbetween the CaseManagementDepartment,payers,andadditionalentities.
- Providesassistanceto the case managementstaff,includingbutnotlimitedto,creatingandsendingreferralpackets,organizingadmissionanddischargepatientrecords,makingphonecalls,obtainingsignatures,oranyother assistanceneededdetermined by the CM team.
- Assiststhe casemanagement teaminschedulingfamilyconferences.
- Assiststhe case managementteam by makingnecessaryarrangementsforpost-dischargefollow up care.
- Functionsas the pointofcontactandliaison for the hospitalCaseManagementDepartmentstaff regardingclinical insurancereviewcompletionand/orissues.
- Forwardsthe necessarypatientclinicalinformation for alladmission,concurrent,andretrospectiveinsurance reviews to payers for the completionof medical necessityreviews.
- Monitors,follow-up,documents,andtrackspayerresponses/requestsofcompletedclinicalreviews,includingapprovals,appeals,anddenials,andcommunicatestheseto the appropriatepersonnel[hospitalstaff,physician,DCM,CaseManager,ClinicalDenialManagement,andCentralizedBusinessOffice(CBO)].
- Monitorsandtracksthe total hospitalcertifieddays of the patient for payers(commercial,managedcare,andMedicaid)andcommunicatesmissingcertifications to the Lead CM/DQ and Case Manager.
- Organizesandprepares the necessaryclerical elements for the weeklyInterdisciplinaryTeamMeeting to functiontimelyandefficiently.
- Enter DME needs per order sheet specifications.
- Prepare Discharge IMM for delivery.
- Deliver Advance Directive packets.
- Assist with Rehabtracker sign ups.
- Abilityto maintainconfidentiality of allpatient and/or employeeinformation to assurepatientand/or employeerights areprotected.
- Abilityto interface on alllevels of the organization by demonstratingexcellentinterpersonalskills.
- Abilityto communicateeffectively,both in writing andverbally.
- Abilityto workcooperativelyandcollaboratively as a memberof a team.
- Abilityto workunderstressand to respondquicklyinemergencysituations.
- Musthave good and regularattendance.
- Performsother relateddutiesas assigned.
- College degree in healthcare related field preferred
- LPN or social work degree preferred but not required
- Minimum of 1 year hospital or post-acute healthcare experience with preference in case management or clinical department. Proficient with WORD and EXCEL software, keyboard typing, and general office equipment.
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