Discharge Assistant

5 days ago

Roanoke, Virginia, United States Carilion Clinic Full time

About the Role:

We are seeking a highly organized and detail-oriented Discharge Assistant to join our team at Carilion Clinic. As a Discharge Assistant, you will play a critical role in ensuring the smooth transition of patients from our hospital to their next level of care.

Key Responsibilities:

  • Schedule peer-to-peer conversations between Carilion providers and payor liaisons to gather required clinical and demographic data for UM/Appeals cases.
  • Supply payor information to the UM team and document actions taken.
  • Prioritize work to maintain workflow functions as needed, fielding faxes, voicemails, written correspondences, categorizing and disseminating mail.
  • Arrange and document P2P requests, post P2P determinations, denial, and approval information from payors.
  • Provide missing or updated demographical/clinical information needed for authorization determinations.
  • Communicate with payors, Carilion billing department, and UM team for appeals case submissions.
  • Explore inquiries regarding benefits, coverage, and insurance questions.
  • Assist Central Resource Center (CRC) staff with certain workflows, such as regulatory letters and Virginia MLTSS (UAI) approval process as needed.
  • Maintain databases and spreadsheet files, ensuring accuracy, production, and distribution.
  • Manage Epic work queues with appeals, denials, and P2Ps and track related data.
  • Research and resolve issues and concerns ensuring a timely turnaround to facilitate throughput.
  • Support regulatory tasks that are federally mandated, such as the Medicare Important Message (IM), Lifetime Reserve (LTR) Day, and Status Change letters.
  • Aid in completion of demographic information to facilitate delivery of in-person letters to patients.
  • Collaborate with the UM team and Carilion billing to verify and add LTR day information to letters for delivery.
  • Receive Notice of Medicare Non-Coverage (NOMNC) letters for patients that are in swing beds and disseminate to all Care Management team members in a timely manner.
  • Document delivery in patient's electronic medical record and notify billing department as appropriate.
  • Provide letter delivery at regional facilities as needed.
  • Process health plan-specific referral requirements, including prior authorizations, and assist with denial/appeal resolutions and P2P initiations related to admission and throughput needs.
  • Act as a resource/liaison to payors, billing, staff, patients, and providers, answering phone calls regarding pricing, benefits, coverage, approvals, denials, and insurance questions.
  • Facilitate timely collection of paperwork, signatures, and other correspondence from the UM Care Management team and external agencies required to facilitate a timely discharge.
  • Assist UM medical and nursing staff as needed.
  • Travel between regional facilities to support and facilitate timely patient progression/throughput needs.

Requirements:

  • Associate degree or equivalent combination of education or equivalent 2 years of experience.
  • Two years of experience in data collection and analysis and/or advanced secretarial support required.
  • Experience in emergency services or healthcare practice setting preferred.
  • Virginia MLTSS (UAI) Certification required to complete orientation and must be maintained throughout employment.
  • Advanced computer skills with knowledge of a variety of software programs, including Microsoft Word, Excel, Access, word processing, spreadsheets, and presentation or database software.
  • Excellent communications and organizational skills required.

About Carilion Clinic:

Carilion Clinic is a not-for-profit, mission-driven health system built on progress and partnerships. We are an organization where innovation happens, collaboration is expected, and ideas are valued. We are a courageous team that is always learning, never discouraged, and forever curious.

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