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Care Management Assistant

2 months ago

Patchogue, New York, United States Network ESC Full time
Job Summary

Network ESC is seeking a highly organized and detail-oriented individual to join our team as a Care Management Assistant. In this role, you will play a critical part in ensuring a smooth transition for patients from hospital to post-acute care settings.

Key Responsibilities
  • Transition Planning
    • Collaborate with care managers and social workers to research and identify preferred post-acute care providers that meet patient needs.
    • Communicate with post-acute care providers to ensure timely referrals and follow-up on available resources.
    • Obtain payor certification for post-acute services and collect relevant clinical and patient demographic information.
    • Coordinate transportation, DME, and community services as directed by care managers and social workers.
  • Utilization Management
    • Facilitate timely transmission of reviews to payors in coordination with the care management team.
    • Communicate initial and concurrent clinical review information from case managers to payors via telephone and fax.
    • Support and assist with concurrent insurance denials and appeals process.
    • Document denials by type, payor, and appeal outcome.
Requirements
  • High School Diploma or GED
  • Knowledge of medical terminology
  • Computer skills: Word processing, spreadsheets, email
  • Excellent interpersonal and organizational skills
  • Able to work in a team structure and independently