Case Management Support Specialist

4 days ago

Melbourne, Florida, United States Health First Full time
Job Summary

The Case Management Support Specialist position at Health First is responsible for providing quality care and support to patients and families. This role involves working closely with case managers, social workers, and other healthcare professionals to ensure that patients receive the best possible care. The ideal candidate will have excellent communication and organizational skills, as well as the ability to work autonomously and as part of a team.

Key Responsibilities

* Gather information from social workers, utilization review nurses, case managers, or patients to assist in the validation of demographics, insurance information, and facilitation of assigned case management tasks, relating to reimbursement, discharge planning, and regulatory requirements.
* Ensure proper infection control practices while meeting with patients and families to coordinate discharge plan details in patient care areas.
* Assist in referral functions which may include sending documents, calling, and producing letters needed to be sent to community providers and/or regulatory agencies.
* Receive requests and send clinical information to third-party payers, post-acute agencies/services, and/or regulatory agencies as assigned by Utilization Review Nurses, Case Managers and Social Workers for the purpose of referrals for post-acute care and reimbursement.
* Complete delegated paperwork required for the execution of the discharge plan and delivery of regulatory forms.
* Proactively follow up with patients, families, third-party payers, or community agencies, as delegated, to determine needs and provide information to facilitate discharge, reimbursement, or authorization of stay-making documentation.
* Utilize various communication methods to relay information and ensure timely receipt and transfer of voice mail messages.
* Maintain a positive attitude and positive working relationship with patients, families, and all levels within the organization.
* Document approved authorization/denial information from payers and provide clear and accurate communication on all accounts to ensure accurate and timely billing.
* Recognize and communicate any service delays to the Case Manager, Social Worker, and/or Utilization Review Nurse.
* Utilize department policies, procedures, and organizational initiatives to proactively complete work assignments, while maintaining the confidentiality of all protected health information.

Requirements

* High school diploma or equivalent.
* AHA BLS if the position is hospital based. Not required for remote positions.
* Previous customer service experience working in a face-to-face environment.
* Knowledge/Skills/Abilities o Proficient in Microsoft Office – Outlook, Word, Excel. o Ability to work autonomously with minimal supervision. o Strong critical thinking skills. o Strong communication skills demonstrated both verbally and in writing, with a strong professional presence. o Ability to maintain composure in a stressful office environment. o Able to work flexible hours and days, including weekends to meet departmental needs. o Able to work directly with patients and families in patient care areas and via telephone.

Preferred Qualifications

* Associate degree.
* Medical, acute care, insurance, or social work experience. o One year of customer service experience working in a face-to-face environment.
* Strong organizational skills.

Physical Requirements
Majority of time involves sitting or standing; occasional walking, bending, stooping.
Long periods of computer time or at a workstation.
Light work that may include lifting or moving objects up to 20 pounds with or without assistance.
May be exposed to inside environments with varying temperatures, air quality, lighting, and/or low to moderate noise.
Communicating with others to exchange information.
Visual acuity and hand-eye coordination to perform tasks.
Workspace may vary from open to confined, on-site or remote.
May require travel to various facilities within and beyond county perimeter; may require use of personal vehicle.

Job Title: Case Management Support Specialist - Per Diem

Location: Florida - Brevard County-Melbourne

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