Care Coordination Support Specialist (Case Management)

Loma Linda University Health; Loma Linda (CA); On-site; USD 52,000 - 76,000; Full time

Job summary

The Case Management Assistant (CMA) collaborates with Case Managers and Social Workers to support the continuum of care and discharge planning. Communicates clinical information, referrals and coordination of insurance review.

Collaborates with the PBO to identify payer sources, completes TARs, and supports reimbursement, denials and appeals; coordinates patient placements and care transitions. Associate's degree preferred with at least three years in a medical setting.

Qualifications

• Associate's degree preferred; minimum three years experience in medical groups, managed care, hospital admitting or medical nursing unit required.
• Hospital and/or insurance experience preferred.

Responsibilities

• Collaborate with Case Managers and Social Workers to support continuum of care and discharge planning.
• Communicate clinical information, referrals and insurance coordination.
• Assist PBO in identifying payer sources, eligibility, or indigent programs; prepare TARs for county offices.
• Support on-site reviewer functions, reimbursement, and denial/appeals processes.
• Coordinate patient placements, durable medical equipment, and care transitions.

Skills

English communication

Customer service

Attention to detail

Education

Associate's degree

Job description

The Case Management Assistant (CMA) collaborates with Case Managers and Social Workers to support the continuum of care and discharge planning. Communicates clinical information, referrals and coordination of insurance review.

Collaborates with the PBO to identify payer sources, completes TARs, and supports reimbursement, denials and appeals; coordinates patient placements and care transitions. Associate's degree preferred with at least three years in a medical setting.