Case Management Assistant - Case Management - Full Time / Nights - Req#2030315774

Antelope Valley Medical CenterLancaster, CA, US

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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

Abilities

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.