Care Management Support Specialist

WVU Medicine; Bridgeport, Northern (WV, KY); Hybrid; USD 36,000 - 54,000; Full time

Job summary

WVU Medicine in Bridgeport, WV, is seeking a Care Management Administrative Support role to assist the Care Management Team in day-to-day operations. You will collaborate with third-party payers and post-acute providers and ensure timely documentation in the EMR.

The position requires a high school diploma and 2 years of administrative experience; associates degree and health care exposure are preferred. Flexible hours and potential weekend shifts are possible.

Qualifications

• High School diploma or equivalent.
• Two years administrative experience.
• Associates or advanced degree.
• Two years’ experience in a health care setting.
• Hospital, home health, or payer relations experience.
• Clerical experience in utilization management, discharge planning or case management.
• One year of ICD9/CPT Coding or Medical Terminology experience.

Responsibilities

• Greets visitors and health care personnel promptly and professionally; screens visitors and telephone calls to determine urgency of contact and to facilitate appropriate routing or referral; representing Care Management in a positive manner.
• Effectively communicates clinical information with payer to obtain authorization for post-acute services/medications and documents interactions in patient’s EMR along with timely communication with Care Management staff.
• Participates in discharge planning activities (e.g. contact of post-acute care facilities, other community resources and transportation) as needed to ensure a timely patient discharge and appropriate linkage with post-acute providers.
• Provides prompt feedback regarding payer determinations to Supervisor/Care Manager, enabling them to evaluate/redirect the current patient plan of care in order to streamline the delivery of service.
• Function as placement specialist, as required ,to include research for preferred providers for HHC/DME/Acute Rehab/SNF/LTACH placement.
• Proactively communicates any change in payer information to Supervisor/Care Manager and documents changes appropriately.
• Verify with patient financial counseling that all payment sources have been explored and updated in the patient’s EMR.
• Participates in reimbursement, certification and authorization related activities (e.g. faxing or copying required information) as required.
• Contacts and coordinates with referral agencies to arrange provision of ordered equipment and associated services when appropriate, as directed by Care Managers.
• Collects copies and transmits pertinent clinical and patient demographic information required to complete arrangements for post-discharge care and/or placement, as directed by the Care Managers.
• Coordinates and arranges transportation and community services, as directed by care managers.
• Provides secretarial and clerical support, including faxing, copying charts, filing, typing and scanning.
• Ensures payer and customer satisfaction through effective communication and positive customer service skills at all times.
• Maintains confidentiality of communications.
• Using independent judgment prioritizes appropriately to ensure efficient utilization of time.
• May serve as back up to the Administrative Assistant for Care Management in their absence.

Skills

Communication skills

Team collaboration

Basic computer skills

Education

High school diploma

Associates degree

Job description

WVU Medicine in Bridgeport, WV, is seeking a Care Management Administrative Support role to assist the Care Management Team in day-to-day operations. You will collaborate with third-party payers and post-acute providers and ensure timely documentation in the EMR.

The position requires a high school diploma and 2 years of administrative experience; associates degree and health care exposure are preferred. Flexible hours and potential weekend shifts are possible.