Care Management Representative #11
2 months ago
Who We Are:
St. John’s Episcopal Hospital is the only hospital providing emergency and ambulatory care to the densely populated, culturally and economically diverse, and medically underserved populations of the Rockaways and Five Towns in southern Queens County and southwestern Nassau County, New York. Celebrating over 110 years of community care, the 257-bed facility provides people of all faiths with comprehensive preventive, diagnostic treatment and rehabilitative services, regardless of ability to pay.
Come Grow With Us
Type: Full-Time (75 hours biweekly)
Shift: Days
Pay: $26.36 - $27.73 per hour
Job Description:
The Care Management Representative performs a variety of supportive services with the focus on facilitating effective communication and sharing of information between departmental staff and external customers and other departments. Customers include (but not limited to) Access Care, Business Office, Insurance payors, Insurance Case managers and Medical Directors, Post-Acute care facilities, as well as other internal financial departments and the Revenue Cycle Team. The Care Management Representative acts as a facilitator between the payors and case managers. Ensures that case certification, case denials and approvals are appropriately recorded and communicated.
Requirements/Skills:
BA/BS Degree Required. 3+ years of experience in Healthcare office setting preferred. Experience working with health insurances managed care Payors required. Bilingual in English and Spanish preferred. Must be customer focused with excellent telephone etiquette. Working knowledge of managing Clinical Denials. Must be able to problem solve and apply critical thinking skills during all situations. Must be computer literate; experienced with Microsoft office especially Excel. Must be able to work with multiple computer programs.-
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