Case Management Coordinator

4 days ago


Alexandria, Virginia, United States Inova Full time
Job Description

The Case Management Specialist plays a vital role in coordinating and performing administrative activities to support the Case Management department. This includes participating in the annual and ongoing budget processes, arranging services for assigned patient populations, and communicating and documenting accurate clinical/financial information.

Key Responsibilities
  • Service Arrangements: Conduct timely arrangements of services to meet customer requirements.
  • Issue Resolution: Addresses and solves provider and payor issues quickly with support from Case Management staff.
  • Regulatory Compliance: Distributes and documents delivery of mandated Observation and Medicare IMM/HINN letters as directed.
  • Communication: Communicates financial and clinical information to clinicians, patients, families, care team members, and external customers.
  • Documentation: Documents clinical and financial patient information to assist with discharge, planning, and access to continuing care services.
  • Payor Communication: Communicates with payor and documents detailed instructions on billing, authorization, and utilization of services.
  • Form Completion: Completes state and federal forms related to patient level of care, according to regulatory standards, to assist with patient transition.
  • Financial Management: Manages and maintains state required UAI filings as well as all accounts receivable/payable functions for the department to ensure timely payments.
  • System Management: Maintains and monitors the system Case Management program, including reimbursement of all negotiated vendor contracts.
  • Support and Review: Provides support to the strategic planning and business development initiatives of the department, reviews and approves time/attendance for department staff, and performs periodic reviews to track employee time and attendance.
  • Record Keeping: Maintains records of all system Case Management files and acts as liaison to Foundation, auxiliary, and external vendors.
  • Budget Management: Assists in monitoring the operational budget, in collaboration with department Director, related to funds disbursement and reconciliation.
  • Accounting: Tracks and monitors accounting for budgets, capital requests, travel funds, and business expenses.
Requirements

Certification: N/A

Licensure: N/A

Experience: 2 years of relevant experience

Education: High School or GED



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