Case Management Assistant - Eisenhower Medical Center

• Job Objective: A brief overview of the position.
  • The position is responsible to provide clerical support to Case Managers, Social Workers and other members of the department in order to maintain efficient discharge planning processes and department operations.
• Reports to
  • Manager, Case Management
• Supervises
  • N/A
• Ages of Patients
  • N/A
• Blood Borne Pathogens
  • Minimal/ No Potential
• Qualifications
  • Education
    • Required: High School Diploma, GED or Higher Level Degree
    • Preferred: AA degree or higher
  • Licensure/Certification
    • Preferred: Medical Assistant, Certified Nursing Assistant, Medical Terminology or other health related certification
  • Experience
    • Required: 2-3 years of experience working in healthcare, preferably inpatient or SNF
    • Preferred: CNA, Front/back Office Assisting, Patient Financial Services
• Essential Responsibilities
  • Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns; reports suspected violations, particularly in the area of HIPAA/privacy.
  • Per direction of Case Managers (CM) and Social Workers (SW), assists in referring and faxing of discharge referrals to outside agencies (skilled nursing, sub-acute and acute care facilities, transitional care, rehab services, home health agencies, DME companies and other providers).
  • Assists CM/SW in facilitating acquisition of appropriate insurance information and authorization prior to discharge.
  • Assists CM/SW in insuring completion of all necessary post discharge paperwork and sends to provider as directed.
  • Confirms agency/facility acceptance and time of transfer; makes transportation arrangements per direction of CM/SW; routinely and timely communicates this information via email and/or verbally to appropriate CM/SW.
  • Performs phone calls and faxes information to complete Medi-Cal 10-bed call list and other bed searches; documents bed search information in medical record.
  • Communicates results of Medi-Cal 10-bed search and other bed searches to CM/SW; informs CM/SW of barriers to acceptance and potential accepting facilities in order for CM/SW to communicate to patient/family and facility as needed.
  • Per direction of CM/SW, assists in preparing patient packets when needed, i.e., by copying medical records, printing reports from computer, collating required information and preparing transfer envelope.
  • Communicates directly with Manager and/or Case Management Director when issues or needs for process changes are identified.
  • Maintains community resource list.
  • Assists in the distribution of Medicare IMM letters and in obtaining signatures.
  • Under the direction of the CM, assists with Medicare appeals by gathering all information, faxing to the QIO, confirming that information was received, completing log, following up on outcome and communicating with CM team.
  • Assists CM/SW in making PCP post discharge appointments of high risk patients as needed to prevent readmissions.
  • Assists CM and UM Secretaries in taking-off and communicating voice mail messages.
  • Asks for help when necessary and willingly assists co-workers when necessary to promote efficiency and to provide quality service.
  • Determines priority in workload; is able to complete a typical day’s assigned workload within the scheduled shift.
  • Maintains current knowledge and awareness of payer reimbursement practices and regulations impacting the patients plan for care and discharge plan.
  • Other duties as assigned.

PI239567264