Care Management Assistant - Outpatient Services
LCMC Health, New Orleans, LA, United States
Your job is more than a job. As a Care Management Assistant, you support the care management team with the utilization review process such as intake, transmission, and tracking of clinical reviews to payors, coordination of post‑hospital care and service arrangements, and ensuring that documentation, communication and information required to facilitate patient discharge is complete.
Responsibilities
Participate in discharge planning activities as needed to ensure appropriate referrals to post‑acute providers and timely patient discharges.
Assist in the research for available preferred providers for post‑acute care to meet the patient’s needs for discharge.
Contact post‑acute care providers and transmit information needed for the referral process and provide follow‑up to ensure identification and communication of available resources.
Collect, copy, and transmit pertinent patient demographic and clinical information required to complete arrangements for post‑acute care and/or placement.
Transmit transition of care documents to primary care physicians and post‑acute providers.
Facilitate timely transmission of reviews to the payers in coordination with the case management team.
Communicate pertinent information received from payers to relevant stakeholders.
Support and assist with concurrent insurance denials and appeals processes and provide denial and non‑certified day information to the appropriate stakeholders to reduce potential denials.
Collaborate with other departments to ensure accuracy of patient and payer information.
Assist the department leadership in data management.
Maintain accurate payer contact information and update it in the software system to ensure accuracy in review submission.
Validate and update vendor information.
Qualifications
Combination of appropriate education and work experience.
High school diploma/GED and at least 2 years of office/clerical experience in a healthcare setting.
Four years of experience in a healthcare setting is required in lieu of education.
Work Shift
Days (United States of America)
Equal Opportunity Employer
LCMC Health is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law. The above job summary is intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary.
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Responsibilities
Participate in discharge planning activities as needed to ensure appropriate referrals to post‑acute providers and timely patient discharges.
Assist in the research for available preferred providers for post‑acute care to meet the patient’s needs for discharge.
Contact post‑acute care providers and transmit information needed for the referral process and provide follow‑up to ensure identification and communication of available resources.
Collect, copy, and transmit pertinent patient demographic and clinical information required to complete arrangements for post‑acute care and/or placement.
Transmit transition of care documents to primary care physicians and post‑acute providers.
Facilitate timely transmission of reviews to the payers in coordination with the case management team.
Communicate pertinent information received from payers to relevant stakeholders.
Support and assist with concurrent insurance denials and appeals processes and provide denial and non‑certified day information to the appropriate stakeholders to reduce potential denials.
Collaborate with other departments to ensure accuracy of patient and payer information.
Assist the department leadership in data management.
Maintain accurate payer contact information and update it in the software system to ensure accuracy in review submission.
Validate and update vendor information.
Qualifications
Combination of appropriate education and work experience.
High school diploma/GED and at least 2 years of office/clerical experience in a healthcare setting.
Four years of experience in a healthcare setting is required in lieu of education.
Work Shift
Days (United States of America)
Equal Opportunity Employer
LCMC Health is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law. The above job summary is intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary.
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