Case Management Assistant: Care Coordination & Payer Liaison

North Mississippi Health Services; Pontotoc (MS); On-site; USD 32,000 - 42,000; Full time

Job summary

The Case Management Assistant at North Mississippi Health Services is responsible for maintaining and facilitating communication and documentation regarding patient stay, insurance, and the case management area function. This includes coordinating on clinical appeals, payer notifications and authorizations, electronic census, and payer requests and reviews.

This role engages strong organizational and communication skills to maintain accurate and organized documentation and interface with

Qualifications

• Maintain required annual education and competency requirements.

Responsibilities

• Notify insurance companies and third-party payors of patient hospital admissions
• Coordinate retrieval and submission of medical records to support reimbursement and authorization processes?
• Track, record, and communicate payor requests and authorization statuses?
• Retrieves requested medical information and submits to insurance company/3rd party payor for post-acute care coordination (i.e. UM Reviews including clinicals, Discharge Plan).
• Maintain Blue Cross/Blue Shield of Mississippi and other electronic census reports?
• Generate chart audit reports and distribute to appropriate personnel?
• Reconcile discharge dispositions and meet regulatory documentation requirements?
• Manages, documents, and tracks Medicaid TAN requests.
• Completes electronic submission of Medicaid reviews for certification as required.
• Communicate effectively with staff, patients, families, vendors, and leadership; provide accurate information and guidance to patients, visitors, and staff; support department operations to ensure a positive patient experience?
• Maintain required annual education and competency requirements?

Job description

The Case Management Assistant at North Mississippi Health Services is responsible for maintaining and facilitating communication and documentation regarding patient stay, insurance, and the case management area function. This includes coordinating on clinical appeals, payer notifications and authorizations, electronic census, and payer requests and reviews.

This role engages strong organizational and communication skills to maintain accurate and organized documentation and interface with