Case Management Assistant

Harboroaks; Center Point (TX); On-site; USD 35,000 - 50,000; Full time

Job summary

Harboroaks in Center Point, Texas, is seeking a dedicated professional to assist the care management team in providing a seamless continuum of care. The candidate will communicate with insurance companies, facilitate appeal processes, and support the treatment team.

A high school diploma is required, with an associate's degree and relevant experience preferred. Certifications in CPR and de-escalation/restraint are necessary, with training provided upon hire.

Qualifications

• High school diploma or equivalent required.
• Experience in a behavioral health setting preferred.
• CPR and de-escalation/restraint certification required.

Responsibilities

• Assist in communication with insurance companies.
• Facilitate the appeal process for insurance denials.
• Provide support to the treatment team regarding insurance status.

Skills

Communication skills

Customer service

Education

High school diploma or equivalent

Associate's degree

Job description

Overview

PURPOSE STATEMENT:

Assist the care management team in providing a seamless continuum of care.

Responsibilities

ESSENTIAL FUNCTIONS:

• Provide assistance in seamless communication between the insurance companies by checking outcomes of precert clinical, concurrent reviews, doctor to doctor and denial results.
• Provide communication with the Finance Department and treatment team on insurance denials and status.
• Facilitate appropriate appeal process, as determined by the insurance provider, in cases of denial in collaboration with patients, families/guarantors and the Finance Department.
• Provide assistance in seamless communication with the Finance Department on insurance status and insurance denials.
• Assist in prompt communication of discharge plans that is required by insurance companies.

• Facilitate appropriate appeal process in cases of denial in collaboration with the guarantor and the Finance Department.
• Make copies of insurance company’s request of patient medical records and send via fax or mail as instructed.
• Assist the department in obtaining supplies and maintaining organization. Provide excellent customer service via phone and in person.

OTHER FUNCTIONS:

• Perform other functions and tasks as assigned.

Qualifications

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:

• High school diploma or equivalent required.
• Associate’s degree preferred. One or more years of experience working in behavioral health setting. Experience with the patient population served by the facility preferred. Previous experience in case management and/or utilization review preferred.

LICENSES/DESIGNATIONS/CERTIFICATIONS:

• CPR and de-escalation/restraint certification required (training available upon hire and offered by facility).

• First aid may be required based on state or facility.

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