Care Management Coordinator

				Responsibilities:

* Management of all Clinical Review Patient Work Queues including DNB and report out progress on weekly CFB call.
* Management of Livanta Appeal process.
* Assist in denial mitigation and concurrent denials overturned dept goal.
* Collaboration with HCA team to ensure accurate insurance verification and timely notice of admissions.
* Management of daily discharge and maternity communication to payers.
* Accessing and managing insurance portals: Navinet, Availity, PEAR, etc. 
* Management of Epic Payer Communication information.  
* Processing of daily insurance logs. 
* Delivery of Medicare Compliance forms as needed.
* Timely management of insurance approvals and denials. 
* Scheduling and management of physician peer to peers.
* Trouble shoot delays in inpatient determinations. 
* Manage of all incoming correspondence including efax, fax, phone, voice mail, and email communications. 
* Accurate EPIC care Management Module data input, staff Epic training, and identification of process improvements.
* Maintain and update department lists, grids, educational materials, and shared drive.
* Field incoming calls and direct to appropriate staff members.
* Additional Administrative duties for the department as assigned: AMION, Kronos.
* Assist with Utilization Management Committee agenda, attendance, and minutes

Qualifications:

Care Management/Case Management/Discharge Planning/UR experience preferred.
			

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Cooper University Health Care

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