Quick overview
Job description
The individual in this position works under the direction of the RN and/or Social Worker to complete referrals for post-acute services for patients, and assists with tasks that do not require a clinical license or degree. The individual’s responsibilities include the following activities:
a) arrange post-discharge services;
b) create and follow up on electronic referrals using the Tenet Case Management system;
c) review patient choice letters with patients/families for required signatures;
d) provide follow up Important Message to Medicare patients prior to discharge;
e) communicate with patients, families and other members of the care team;
(f) complete tasks assigned by Case Manager and Social Work staff;
g) make copies, send faxes and complete phone calls;
h) complete process reviews or audits as requested;
Validates patient’s demographic and payer information with patient/family and notifies Patient Access immediately if any corrections are needed within 24 hours of admission
Validates that all commercial/managed care discharge have an authorization for status and level of care provided and notifies Director of Case Management (DCM) or designee of variances
Escalates discharged cases at end of the day that have no authorization or notification or dispute is provided by payor.
Ensures, on a concurrent basis, that all clinical needed by payors and updates are provided by alerting Case Manager assigned to case and escalating to DCM if not complete timely
Trends dispute/denial potential to DCM or designee by failure points to revenue cycle
MINIMUM EDUCATION: High School diploma or equivalent
PREFERRED EDUCATION: Associate’s or Bachelor’s Degree from an accredited college
MINIMUM EXPERIENCE: 2 years of experience in clerical or healthcare field. Possesses excellent organizational,
verbal/ written communication skills, problems solving and computer literacy skills. Data Analytics skills.
PREFERRED EXPERIENCE: Acute hospital experience
REQUIRED CERTIFICATIONS/LICENSURE: NA
PREFERRED CERTIFICATIONS/LICENSURE: Paramedic, EMT or Nursing Assistant certifications.
REQUIRED COURSES/ COMPLETIONS (e.g., CPR): NA
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