Job Overview
The Case Management Associate provides clerical and administrative support to the Case Management Department. This position works closely with patients, physicians, clinical staff, and the public and requires strong communication, organization, attention to detail, and customer service skills.
This is a patient-facing administrative position. The employee will interact with patients in inpatient hospital rooms and units and must be comfortable working in a clinical environment. No clinical or personal patient care is required.
The employee is expected to complete all department-specific training and competencies and meet established performance standards.
Essential Functions & Responsibilities
- Prepare, deliver, and explain required regulatory notices to patients.
- Obtain patient signatures and process documentation appropriately.
- Work with clinical and floor care teams to ensure notices are delivered accurately and on time.
- Use patience, good judgment, and sensitivity when interacting with patients and families.
- Work independently and follow through to ensure assigned tasks are completed.
- Provide clerical and receptionist support to the Case Management Department.
- Operate and perform basic maintenance on office equipment.
- Assist with special projects and assignments as needed.
- Coordinate the department's on-call schedule.
- Perform timekeeping duties as assigned.
- Delegate tasks appropriately when needed.
Case Records & Insurance Support
- Transmit patient information by phone, fax, electronic portal, or mail while maintaining HIPAA compliance.
- Protect patient privacy and maintain confidentiality when handling or releasing information.
- Assist Utilization Management staff with insurance approvals, denials, and related documentation.
- Access insurance payor portals to follow up on authorizations.
- Accurately document authorization information in the electronic medical record.
- Participate in department or hospital committees and performance improvement activities as assigned.
Telephone Services
- Answer, screen, and route incoming calls to the appropriate person.
- Accurately record and promptly deliver messages.
- Retrieve and process voicemail in a timely manner.
- Verify that faxes have been received and process them appropriately.
- Use denial-prevention technology, including recorded, monitored, and automated calls.
- Document tracking numbers and related information accurately.
Required Education & Experience
- High school diploma or GED required.
- Three to six months of related clerical experience or one year of clerical training from a college or technical school.
- CMA or Nursing Assistant experience and/or training is preferred.
Skills & Qualifications
Communication
- Communicates clearly and professionally with patients, families, physicians, staff, and the public.
- Listens carefully, asks questions, and seeks clarification when needed.
- Communicates effectively in both routine and challenging situations.
- Writes clearly and accurately and reviews work for spelling and grammar.
- Reads and interprets patient charts, policies, procedures, safety guidelines, and other written information.
Customer Service
- Provides respectful, compassionate, and professional service.
- Responds promptly to customer needs.
- Remains calm and professional when handling difficult or emotional situations.
- Treats all patients, families, coworkers, and visitors with dignity and respect.
Organization & Critical Thinking
- Follows written, verbal, and visual instructions.
- Establishes priorities and manages multiple responsibilities.
- Uses sound judgment and common sense to resolve routine problems.
- Works independently and follows through on assignments.
- Completes tasks accurately and on time.
- Communicates promptly when a deadline cannot be met and provides an appropriate alternative plan.
Computer & Technology Skills
- Basic computer and keyboarding skills required.
- Ability to enter, retrieve, and review information accurately.
- Ability to learn and use the electronic medical record system within three months of starting the position.
- Comfortable using electronic medical records, internet-based systems, telephone, fax, and insurance payor portals.
Dependability
- Maintains consistent attendance and punctuality.
- Arrives on time for work, meetings, and appointments.
- Follows through on assigned responsibilities.
- Ensures appropriate coverage when absent.
- Demonstrates reliability and professionalism in all aspects of the role.