Job Summary: To work in a close relationship with discharge planning specialists, insurance verification/authorization team, medical records, and all insurance payors to ensure post-hospital facility placements receive authorization in a timely manner. Serves as a liaison between discharge planners, facilities, third-party payors, Providers, and Families/Legal Guardians. Supports the expedited appeal with insurance payers for post-acute authorization as needed. Functions as the facilitator and support staff for prompt discharge planning with complex and long-stay patients to include as-needed meetings with all stakeholders. Supports discharge planners, facilities, third-party payors, providers, and families/legal guardians while maintaining a clinical/administrative office environment. Update case management leadership and appropriate parties daily regarding progress, delays, and barriers to discharge. Provide disposition information and/or needed documentation to insurance, staff, and physicians on an ongoing basis to include but not limited to entering and tracking authorizations through the entire process with charting in EPIC, and other duties as assigned. Fields questions and serves as a resource to onsite staff, leadership, and physicians. This position is responsible for managing sensitive private patient information in a manner that meets HIPAA standards/requirements.
Qualifications: Requires a 2-year college degree. Two years of healthcare experience are required, but six or more years of healthcare experience are preferred working in community facilities, medical group practice, or hospital setting. Proficient with Epic, MS Office, and Windows environment. Experience with Managed Care, Medicare, Medicaid Admissions, Insurance, Discharge, business office procedures required. Advanced skills in dealing tactfully with internal and external customers, as well as, State, Federal, and community facilities and agencies. BLS required. Strong critical thinking, problem-solving, and analytical skills are required. Autonomous time management, exemplary verbal and written communication skills are required. Ability to work effectively within a team office environment. Ability to maintain CaroMont Cares Values daily.
EOE AA M/F/Vet/Disability
