JOB DESCRIPTION:
- Case Manager/Business Office Assistant
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- -Act as the liaison between the clinical staff and the Health Plan Case Managers
- -Verify HMO coverage and benefits to ensure proper reimbursement
- - Obtain and following up on authorization from HMO plans
- -Sends updated clinical records to concurrent review nurses
- -Communicate patient status, changes in functions and care plans between Clinical staff and Health Plan
- Case managers
- -Ensures that NOMNC/denial letters are issued on a timely manner
- -Assist in obtaining Durable Medical Equipment for HMO patients
- -Authorization request for Long Term and Bedhold
- -Re-authorization Request for Long Term patients
- -Checking claims payment status
- -Claims Collection calls – Follow up
- -Assist Business Office Manager with the Month End Process
- -Assist in Medical Application
- -Run and Review Medicare and Medical Eligibility
QUALIFICATIONS
- Excellent organizational skills with a detail orientation towards documentation and follow-up.
- Professional telephone skills with the ability to handle referral calls effectively and efficiently, meeting the needs of the referral sources and families.
- Professional appearance.
- Enthusiastic, motivated attitude.
- Experience and knowledge with Medicare, Managed Care, VA, and Medi-Cal guidelines preferred.
CONSUMER SERVICE
- Presents professional image to consumers through dress, behavior and speech.
- Adheres to Company standards for resolving consumer concerns.
- Ensures that all patient/resident rights are protected.
Job Type: Full-time
Pay: $25.00 - $28.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Experience level:
Schedule:
Education:
- High school or equivalent (Preferred)
Experience:
- Case management: 1 year (Required)
Work Location: In person