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