- Supports all non-clinical functions throughout the Continuum.
- Facilitates discharge planning for members across the Continuum.
- Answers phones to respond to all inquiries made by patients, vendors, and other healthcare recipients. Must be able to handle at least calls per day.
- Must be able to work in a call centric environment and meet daily metrics.
- Must be able to work in a productivity driven environment to meet the need of members and providers.
- Enters authorization/referral data into required applications for all levels of care, ensuring the correct admitting, principal, and discharge diagnoses, bed types, discharge date, and other applicable fields.
- Ensures accuracy of Tapestry Census Reports by reviewing/updating authorizations daily and attending case management rounds to update diagnoses or other information as needed or indicated.
- Documents outside medical services and enters referrals into Tapestry for all applicable levels of care.
- Ascertains eligibility and benefits for all admissions and every 7 days thereafter (or other designated time frame).
- Ascertains admission status via physician order for weekend retro admissions, enters authorization, and sends to CM/UM for review.
- Coordinates data and reporting needs, data collection process, and data processing issues; provides timely utilization data and analytic support.
- Collaborates with other organizational units and outside facilities to obtain, verify, and/or provide information, e.g. works with KP Claims and external vendors to reconcile billed charges.
- Answers inquiries and educates members, physicians, and hospitals on covered benefits and other related topics.
- Provides information and assistance to members during claims review process and coordinators authorized and non-authorized claims review.
- Coordinates and supervises air and ground transportation and authorization review for said services.
- Coordinates durable medical equipment for members.
- Maintain the consistency and integrity of all applicable utilization tracking management systems.
- Schedules member appointments and coordinates care as needed.
- Determine admission status via MD order for weekend retro admissions, enter authorization & forward to ICM for review.
- Work pended claims in Tapestry pool, forwards to appropriate Continuum staff for investigation as needed and pend back to claims pool when completed.
- Run, print, and make copies of Tapestry census for rounds. Attend case rounds with Continuum staff & Physicians.
- Copy required sections of members charts for referrals to all levels of care and place on front of chart as requested by Case Manager/Utilization Reviewer.
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Rn Care Coordinator-continuity of Care As-needed
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Northwestern Medicine DeKalb, United StatesThe **RN Care Coordinator** reflects the mission, vision, and values of NM, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards. · The R ...
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Care Lync Georgia Lawrenceville, United States**About Us** · Care Lync is a Social Services agency focused on providing Support Coordination (Service Coordination/Case Management) services to adults diagnosed with Intellectual, Developmental and Physical Disabilities and Autism Spectrum Disorder who are enrolled in the Depar ...
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Ascend Medical, Inc. Atlanta, United StatesJob Type · Full-time · Description · The Care Coordinator at Ascend Medical plays a pivotal role, ensuring comprehensive care between the patient and care team. This role involves one-on-one interactions that significantly impact individuals' lives by introducing them to a new ...
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Care Coordinator
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Ascend Medical, Inc. Atlanta, United StatesJob Type Full-timeDescriptionThe Care Coordinator at Ascend Medical plays a pivotal role, ensuring comprehensive care between the patient and care team. This role involves one-on-one interactions that significantly impact individuals' lives by introducing them to a new approach t ...
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Endo Patient Care Coordinator- Stone Mountain
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Coast Dental and Orthodontics Stone Mountain, United States· • · • · • · • · • · • · • · • · • · • · • · • · • · • · • · • · • · • · • · • · • · • · • · • · • · • · • · • · • · • · • · • · • · o · • · • · • · • · Revised March 2012 · Page 2 · Revised March 2012 · Page 3 ...
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The Buckeye Ranch Whitehall, United StatesSalary Range: · HS Diploma/ Associates: $36,843 - $46,054 (based on education and relevant work experience) · Bachelors/ Masters: $41,684 - $52,106 (based on education and relevant work experience) · Learn about The Buckeye Ranch – Care Management Entity · The Buckeye Ranch i ...
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Whitefoord Health Center Atlanta, United StatesJob Description · Job DescriptionReviewed January 2023 · Job Title: Care Coordinator, RN · Department: Medical · Supervisor: Manager, Clinical Operations · Employment/FLSA Status: Full-time, Exempt · The Care Coordinator works closely with identified high-risk and complex patient ...
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Patient Care Coordinator
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Village Podiatry Centers Atlanta, United StatesJob Description · Job DescriptionAbout Us · Upperline Health is the nation's largest provider dedicated to lower extremity, wound and vascular care. Founded in 2017 with the ambitious goal of changing specialty care, Upperline Health delivers a more efficient path for patients t ...
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Patient Care Coordinator
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Emory Healthcare/Emory University Atlanta, United States· JOB DESCRIPTION: Schedules appointments for new and established patients and serves as the primary point of care for these patients and their families. Additional duties may include: · Scheduling return visits · Scheduling ancillary appointments · Registering or scheduling new ...
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patient care coordinator
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Emory Healthcare/Emory University Dunwoody, GA , USA, United States**Overview** · At Emory Healthcare, we integrate science and caring to change the face of health care. Our team members are courageous individuals who are willing to challenge the status quo and help find solutions to complex problems. We're empowered to influence change for, and ...
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Patient Care Coordinator
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Village Podiatry Centers Atlanta, United StatesJob Description · Job DescriptionAbout Us · Upperline Health is the nation's largest provider dedicated to lower extremity, wound and vascular care. Founded in 2017 with the ambitious goal of changing specialty care, Upperline Health delivers a more efficient path for patients t ...
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Patient Care Coordinator
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Village Podiarty Atlanta, United StatesUpperline Health is the nation's largest provider dedicated to lower extremity, wound and vascular care. Founded in 2017 with the ambitious goal of changing specialty care,Upperline Health delivers a more efficient path for patients to receive consistent and effective treatment f ...
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Patient Care Coordinator
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Village Podiarty Atlanta, United StatesAbout Us · Upperline Health is the nation's largest provider dedicated to lower extremity, wound and vascular care. Founded in 2017 with the ambitious goal of changing specialty care, Upperline Health delivers a more efficient path for patients to receive consistent and effectiv ...
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Emory Healthcare/Emory University Atlanta, United StatesOverview · At Emory Healthcare, we integrate science and caring to change the face of health care. Our team members are courageous individuals who are willing to challenge the status quo and help find solutions to complex problems. We're empowered to influence change for, and wit ...
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patient care coordinator
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Emory Healthcare/Emory University Atlanta, GA , USA, United States**Description** · JOB DESCRIPTION: Schedules appointments for new and established patients and serves as the primary point of care for these patients and their families. Additional duties may include: Scheduling return visits Scheduling ancillary appointments Registering or sched ...
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Patient Care Coordinator
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Emory Healthcare Atlanta, United StatesOverview: · At Emory Healthcare, we integrate science and caring to change the face of health care. Our team members are courageous individuals who are willing to challenge the status quo and help find solutions to complex problems. Were empowered to influence change for, and wit ...
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Patient Care Coordinator
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Patient Care Coordinator
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Emory Healthcare/Emory University Atlanta, United StatesOverview · At Emory Healthcare, we integrate science and caring to change the face of health care. Our team members are courageous individuals who are willing to challenge the status quo and help find solutions to complex problems. We're empowered to influence change for, and wi ...
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Patient Care Coordinator
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Wellbe Senior Medical Atlanta, United StatesJob Summary: · Our Patient Care Coordinator (PCC) are part of a team that provides compassionate care to the frailest elderly who suffer from chronic and acute illnesses or injuries living in their homes. Our PCC is responsible for answering incoming and making outgoing calls, h ...
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Patient Care Coordinator
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Druid Hills Physical Therapy Atlanta, United StatesWere currently seeking a Patient Care Coordinator for our outpatient physical therapy practice in Atlanta, GA. Our company is growing and we are opening a second location · At our newest location, Avondale Physical Therapy, we put patient care first and are looking for someone w ...
Continuum Care Coordinator - Atlanta, United States - Kaiser Permanente
Description
Job Summary:Responsible for supporting all non-clinical functions throughout the Continuum. Supports daily activities of Case Managers and Physicians. Ensures data integrity related to all applicable in-scope inpatient and outpatient services. Coordinates data input, analysis, and reporting for KPGA Continuum utilization management, continuing care services, case management, and outside services management.
Essential Responsibilities:
