Case Management Assistant

Harboroaks; Millerton (PA); On-site; USD 32,000 - 45,000; Full time

Job summary

Harboroaks seeks an Insurance Coordination Assistant to support the care management team in delivering seamless continuity of care in a behavioral health setting. The role focuses on coordinating communications between insurers, care teams, and the finance department, and assisting with discharge planning and record requests.

Ideal candidates have a high school diploma, 1+ year of behavioral health experience, and a preference for an associate degree or case management exposure.

Qualifications

• 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.

Responsibilities

• 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.
• Perform other functions and tasks as assigned.

Skills

Customer service

Communication skills

Phone etiquette

Education

Associate's degree preferred

Job description

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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