Administrative Skills, Aftercare, Analysis Skills, Case Management, Computer Maintenance, Computer Terminals, Customer Support/Service, Data Collection, Documentation, Electronic Medical Records, Financial Management, Health Insurance, Hospital Administration, Insurance, Medical Records, Medications, Meeting Minutes, Patient Care Denials, Pricing, Team Player
Duties and Responsibilities
Essential Functions:
- Assists with clerical functions (e.g., filing, copying, scanning, emailing, telephone, taking minutes)
- Determines patient health insurance benefit information as requested by CMRN/CMSW.
- Reviews payor logs and enters authorization information into EMR/patient record.
- Receives denial information and records in EMR/patient record; forwarding same to assigned CMRN.
- Initiates SNF authorizations as requested by CMSW/CMRN; followed by documentation of payor determination in EMR/patient record.
- Completes discharge notification to varied insurance payors.
- Assists CM team with IMM notices to patient.
- Assists with medication pricing as requested by CMRN/CMSW.
- Coordinates after care issues with the appropriate team members.
- Supports the CM team by coordinating follow up PCP appointments.
- Compiles data for and prepares regularly scheduled or special reports, analysis, and statements.
- Reviews daily patient discharge list, routes incomplete VNA orders, identifies incomplete auth information, reviews final disposition Epic navigator for accuracy and completeness.
- Works and maintains Incomplete Auth work queue; obtains delinquent authorizations and records in EMR.
Common Expectations:
- Maintains Downtime computer terminal/ associated logs.
- Enhances professional growth and development through participation in educational programs, current literature, in-service meetings, and workshops.
- Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.