Case Management Coordinator

Description

Pay Range: $22.38 - $28.38

We expect those hired into this job to be paid within this range; however, certain circumstances may allow us to pay outside of this range.

ScionHealth is committed to a culture of service excellence, demonstrated by our employees' adherence to principles such as Pride, Teamwork, Compassion, Integrity, Respect, Fun, Professionalism, and Responsibility.

As our most acute level of care, our specialty hospitals provide critical care similar to traditional hospitals or ICUs, but for an extended recovery period. Our clinicians play a vital role in the recovery of chronic, critically ill, and medically complex patients.

Job Summary

Under the supervision of the Director of Case Management (DCM) or designee, this role enhances the efficiency of the Case Management Department and supports daily functions of the Case Managers. It involves securing discharge transition and post-acute services, monitoring insurance verifications, managing authorizations, and assisting with denials and appeals. The position acts as a liaison between the department, payers, post-acute providers, and other entities.

Essential Functions

• Assisting the Case Management staff with referral packets, records organization, calls, signatures, and other tasks.
• Scheduling family conferences.
• Arranging post-discharge follow-up care.
• Serving as the point of contact for clinical insurance review issues.
• Forwarding patient information for insurance reviews and tracking responses.
• Monitoring hospital certified days and communicating with relevant staff.
• Initiating and completing insurance pre-certification and communicating outcomes.
• Preparing clerical elements for meetings.

Knowledge/Skills/Abilities/Expectations

• Fluent in reading, writing, and speaking English.
• Good attendance.
• Ability to learn insurance verification, case management, and discharge planning.
• Clinical knowledge for interpreting medical records.
• Knowledge of Medicare, insurance processes, and contracts.
• Understanding of accreditation standards and compliance.
• Effective communication skills to collaborate with hospital leadership, physicians, payers, and external customers.
• Ability to work under stress and multitask.
• Other duties as assigned.
• Travel: 0%

Qualifications

Education

• College degree in a healthcare-related field preferred.

Licenses/Certification

• None required.

Experience

• At least 1 year in a healthcare setting.