Case Coordinator Discharge Planner

Springhillmedicalcenter; Mobile (AL); On-site; USD 52,000 - 76,000; Full time

Job summary

Springhill Medical Center is seeking a qualified RN/LPN or Social Worker to influence outcomes for a designated caseload and to manage appeals per payer rules. The role requires timely entry and follow-up on discharge planning and appeals, with letters addressing denial reasons supported by clinical data.

Applicants must be licensed in Alabama (RN or LPN) or as a Social Worker; BSN preferred for nurses. At least one year of case management or discharge planning experience and proficient MS

Qualifications

• Must be an LPN/RN or Social Worker.
• Nurse requirements: nursing degree, LPN/RN license, Alabama licensure, BSN preferred.
• Social Worker: SW degree and Alabama licensure.

Responsibilities

• Influence clinical and financial outcomes for a caseload.
• Manage entry, follow-up and appeals per payer rules.
• Write appeal letters with clinical data to support denial.
• Communicate with BO, Case Management, Payers, HIM about denials.

Skills

Case Management

Discharge Planning

Critical Thinking

Microsoft Office

Decision Making

Education

LPN/RN

Social Worker Degree

Job description

Pre-Employment Requirements:

• We are a drug free facility. Passing a pre-employment drug screening is required.
• Responsible for influencing positive clinical and financial outcomes of a designated caseload of patients.
• Responsible for timely entry, follow-up and management of appeals according to payer rules.
• Writes appeal letters addressing the reason for denial with clinical data to support appeal.
• Communicates with all parties involved in the denial process, including but not limited to, BO, Case Management, Payers, HIM.

Education Requirements:

Applicant must be an LPN/RN or Social Worker.

• Nurse Requirements:
  • Graduate from an accredited school of nursing.
  • LPN or RN license required.
  • Current licensure in the State of Alabama is required.
  • Bachelors of Science in Nursing preferred.
• Social Worker Requirements:
  • Graduate from an accredited school of Social Work.
  • Current licensure in the State of Alabama required.

Experience:

• Minimum of one year of Case Management and/or Discharge Planning experience required.
• Must demonstrate critical thinking skills and decision-making ability.
• Demonstrates the ability to carry out detailed written or verbal instructions independently.
• Working Knowledge of Microsoft Office (Word, Excel, and PowerPoint)

Qualifications

Licenses & Certifications

Required

SOCIAL WORKER

RN LICENSE

Equal Opportunity Employer
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