Case Management Assistant - Ft | Jupiter

Case Management Assistant
The Case Management Assistant (CMA) completes various duties to enhance the efficiency of the Case Management Department, as well as support the daily functions of the case managers. The CMA assists in securing arrangements for the discharge transition and post-acute services and serves as the liaison between the Case Management Department, payers, and additional entities.
Responsibilities

• Forwards necessary patient clinical information for all admission, concurrent, and retrospective insurance reviews to payers for the completion of medical necessity reviews
• Assists the Case Management team by making necessary arrangements for post-discharge follow-up care
• Functions as the point of contact and liaison for the facility Case Management team regarding clinical insurance review completion, and/or issues
• Assists the Case Management team in scheduling family conferences
• Performs other assigned duties as designated
• Monitors, documents, and tracks payer responses/requests of complete clinical reviews, including approvals, appeals, and denials, and communicates these to the appropriate personnel as directed by the DCM (Physician, CBO, Admissions)
• Monitors and tracks the HMS documentation of total hospital certified days of the patient for payers (Commercial, Managed Care, and Medicaid) and communicates missing certifications and/or documentation to the DCM
• Performs additional duties to assist the Case Management team, support revenue cycle, and subsidize the discharge planning processes as necessary and assigned
• Organizes and prepares the necessary clerical elements for the Interdisciplinary Team meetings to function timely and efficiently
• Performs general daily operational tasks/clerical support (i.e. phone calls, emails, faxes, copies, etc.) for the Case Management team and as determined by the DCM
• Provides assistance to the Case Management team, including but not limited to, creating and faxing referral packets, organizing admission and discharge patient records, making phone calls, obtaining signatures (Important Message from Medicare, Freedom of Choice, etc.), or any other assistance needed determined by the DCM
• Initiates and completes insurance pre-certification for patients with anticipated out of hospital procedures or diagnostics; Communicates pre-authorization outcomes to the DCM
• Performs, monitors and documents the 30,60 and 90 day post-discharge follow-up calls; Communicates outcomes to the DCM

Qualifications
Education and Training: High School Diploma or equivalent
Minimum Work Experience: Previous experience in healthcare setting; Medical terminology knowledge preferred
Required Knowledge, Skills, and Abilities:

• Ability to function with minimal supervision
• Ability to work in a collaborative model with all members of the interdisciplinary team, both internal and external
• Use of discretion in handling sensitive information
• Must be able to read and write in English
• Strong interpersonal skills to include negotiation
• Ability to meet deadlines
• Self-motivated and able to motivate others
• Effective written and verbal communication skills
• Organizational and time management skills, as evidenced by capacity to prioritize multiple tasks
• Highly functional knowledge of and comfort level with computer applications such as Microsoft Word, Excel, and Outlook
• Effective decision making skills
• Exemplary written and verbal communication skills
• Exceptional telephone etiquette required
• Ability to work in an unstructured setting and to handle multiple tasks concurrently

About Us
PAM HEALTH (PAM) based in Enola, Pennsylvania, provides specialty healthcare services through more than 70 long-term acute care hospitals and physical medicine and rehabilitation hospitals, as well as wound clinics and outpatient physical therapy locations, in 17 states. PAM Health is committed to providing high-quality patient care and outstanding customer service, coupled with the loyalty and dedication of highly trained staff, to be the most trusted source for post-acute services in every community it serves. Its mission is to serve people by providing compassionate, expert care, and to support recovery through education and research.
Joining our PAMily allows you to work in a collaborative environment with colleagues and leadership with exposure to a variety of patient care levels. Aside from our competitive pay, generous paid benefit time, and excellent insurance options, you will also have opportunities for professional growth through our Education Advancement Program.
We are excited to learn more about you and hope that you consider joining us on a shared mission to improve the lives of others by being an integral part of our We Care Program. Please take a moment to visit us online at www.PAMHealth.com for a comprehensive look at how we're able to positively impact our local communities.
PAM Health does not discriminate and does not permit discrimination, including, without limitation, bullying, abuse or harassment, on the basis of actual or perceived race, color, religion, national origin, ancestry, age, gender, physical or mental disability, sexual orientation, gender identity or expression or HIV status, or based on association with another person on account of that person's actual or perceived race, color, religion, national origin, ancestry, age, gender, physical or mental disability, sexual orientation, gender identity or expression or HIV status.