Flex Case Management Assistant
US-ID-Boise
careers
Req #: 103088
Type: Flex
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Overview: At St. Luke's, our dedicated team of Case Managers are critical in providing exceptional, patient-centered care. We strive to foster an environment that embraces our employees' unique strengths, experiences and perspectives which ultimately drives our exceptional, patient-centered care. Join our team as a Case Management Assistant! What You Can Expect From This Role: * Provides support to the RN Case Managers, Social Workers and Utilization Reviewers * Assists with all aspects of case and/or utilization management functions, which may include activities such as prioritization and assignment of patients, authorizations and referrals, verification of patient information, benefit review, intake and screening, and coordination of services * Prepares and faxes necessary documentation/information to facilitate authorizations and referrals * As needed, variable day schedule, including weekend coverage Qualifications: * Education: Associate degree or 2 additional years of experience in lieu of degree. * Experience: 2 years' experience Responsibilities: The Case Management Assistant is responsible for providing accurate and timely administrative and technical support to the case and/or utilization management teams, helping ensure a positive patient experience and effective coordination of care and utilization review processes. * Provides support to the RN Case Managers, Social Workers and Utilization Reviewers. Assists with all aspects of case and/or utilization management functions, which may include activities such as prioritization and assignment of patients, authorizations and referrals, verification of patient information, benefit review, intake and screening, and coordination of services. * Prepares and faxes necessary documentation/information to facilitate authorizations and referrals. Follows-up on authorizations and referrals by phone to ensure receipt and ensure all necessary information/documentation was provided. Receives and documents authorizations requested. Contacts insurance companies/payers/medical groups to acquire authorizations. * Coordinates, generates and tracks both incoming and outgoing correspondence and faxes. Receives calls, faxes and portal submissions regarding authorization requests, process inquiries, and eligibility verifications; coordinating and communicating with providers and payers for plan members to facilitate receipt of information, and/or records for prompt review and response. * Documents all relevant information in the electronic medical record according to policy and departmental guidelines. Assists department leadership in data management. Runs scheduled and ad hoc reports, as requested. * Identifies potential issues in coordination or reimbursement of care, notifies appropriate personnel, and assists in resolution efforts. * Performs job duties and coordinates with other members of the healthcare team to ensure appropriate compliance with state, federal, HIPAA, and Joint Commission regulations and requirements. * Other duties and responsibilities as assigned. Qualifications: * Education: Associate degree or 2 additional years of experience in lieu of degree. * Experience: 2 years' experience * Licenses/Certifications: None
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