What are the responsibilities and job description for the Case Management Assistant - Case Management - Full Time/Days - Req#2047101408 position at Antelope Valley Medical Center?
Job Objective:
Under the direction of the Director of Case Management, or designee, the Case Management Assistant supports the functions of the Patient Care Coordination department by performing a wide variety of administrative duties.
Essential Duties and Responsibilities:
A. Case Management Assistance
- Facilitates communication to department team members from internal and external sources by coordinating telephone calls and messages
- Utilizes and documents in the computer systems to facilitate case management workflow and communication
- Monitors computer system for admission and continued stay insurance authorizations notifying the Case Manager when a clinical update is needed
- Submits clinical reviews to appropriate review agencies and documents in the computer system
- Follows up with review agency for authorized days and documents in the computer system
- Coordinates the retroactive utilization process by tracking accounts needing reviews, ordering medical records, submitting completed reviews and documenting authorizations or denials
- Coordinates the insurance authorization process with appropriate hospital departments.
- Assists with referrals to other facilities, home health agencies, and DME agencies
- Arranges ambulance, as well as other forms of medical and taxi transportation
- Provides support to the discharge coordination process
B. Clerical Duties
- Answers telephone calls and greets customers in the department with the highest level of customer service
- Provides taxi vouchers
- Coordinates mailing of department documentation
- Assists the department director with payroll reporting and processing
- Establishes and maintains an accurate detailed record for the department billing and payment of vendor claims
- Prepares and records department check requests and purchase orders
- Efficiently and cost effectively orders and organizes office supplies
- Prepares letter, memos, and other documents
- Assists with scheduling of meetings and provides clerical support as needed
- Sorts and distributes office mail
- Maintains department patient information files
- Maintains department records for regulatory compliance purposes as indicated.
- Other duties as assigned within skill sets and abilities.
Non-Essential Duties:
- Assist with other duties as assigned, within skill sets and abilities
Knowledge, Skills and Abilities:
Knowledge
- Familiar with Government, State, HMO, PPO, Commercial, and Workers Compensation authorization and billing guidelines
- Working knowledge of Microsoft Office applications
- Knowledge of medical terminology
Skills
- Knowledge of basic personal computers
- Proficient in the operation of scanners, copiers, fax machines Good oral and written communication skills Good interpersonal skills and customer focus
- Ability to handle stress
- Ability to manage a heavy caseload in an organized and efficient manner
- Ability to maintain a working relationship with other departments within the organization
- Ability to document account information at time of account follow-up
- Ability to run case management related reports as needed
Core Competencies: All AVH employees will effectively demonstrate these behaviors:
Accountability
Action Oriented
Customer Focused
Compassion
Effective Communication
Teamwork
Ethics & Values
Integrity & Trust
Education and Experience: Education
- High School graduate or equivalent
Experience
- Minimum 2-years healthcare related office experience, preferably in an acute care setting
Required Licensure and/or Certifications:
- None
AVH Conduct/Compliance Expectations:
- Ability to adhere with AVH Leaves of Absence Policy
- Ability to adhere with AVH Paid Time Off (PTO) Policy
- Ability to adhere with AVH Recording of Hours Worked Policy
- Ability to adhere to the department dress code
- Ability to organize work and establish priorities
- Ability to expand on own initiative in performance of duties
- Skill and ability to follow the telephone etiquette/standards
- Conforms to AVH Standards of Excellence
- Ability to function effectively under pressure and meet time parameters
- Ability to communicate effectively while maintaining good working relationships with coworkers, managers and other hospital staff
- Ability to adhere to the normal standards of courtesy and conduct as defined under the rules of hospitality at AVH
- Ability to maintain the confidentiality of patient, hospital and department information
- Ability to adhere to safety rules and regulations
- Safely and effectively uses all equipment necessary to carry out duties
- Ability to interpret and function under hospital and department policies and procedures
- Conforms with required and appropriate Joint Commission requirements
- Conforms with and supports hospital quality assurance and improvement guidelines
- Ability to participate effectively in department and hospital staff education
- Display a willingness to work as a team player
- Ability to give and support the highest level of patient/customer satisfaction at all times
- Supports and adheres to the values and mission statement established by the AVH Board of Directors
Ability to demonstrate knowledge and understanding of Corporate Compliance rules and regulations, complies with duty to report behavior standard, demonstrates understanding of purpose for Corporate Compliance hotline and importance of seeking guidance from a supervisor when in doubt regarding a possible corporate compliance issue
Key Physical Requirements and Working Conditions:
- Primarily works in a climate-controlled area
- Sitting 80% of time on duty
- Tolerate repetitive arm and hand movements
A detailed description of the physical requirements of this job is maintained in the Employee Health Department.
Education and Experience: Education
- High School graduate or equivalent
Experience
- Minimum 2-years healthcare related office experience, preferably in an acute care setting
Required Licensure and/or Certifications:
- None
