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    Case Management Associate - Washington, United States - Medstar

    Medstar
    Medstar Washington, United States

    4 weeks ago

    Default job background
    Description
    Assesses the patient insurance/financial status to facilitate appropriate discharge planning.

    Uses departmental software to update hospital departments re:
    post hospital care referrals, provider contacts, and other related information. Serves as communication liaison between Clinical Case Managers, Social Workers and on-site reviewers. Interacts with Precert, PT/OT and Lombardi social worker/case managers.

    The functions are performed in accordance with all applicable laws and regulations and MedStar Georgetown University Hospital's philosophy, policies, procedures and standards.

    EducationHigh School Diploma or GED required andOn-the
    • Job Training with two years post high school education or technical training, preferably in a health care related field.
    required and Medical Terminology class attendance preferred Experience Previous directly related healthcare experience preferred Knowledge, Skills, and AbilitiesDemonstrable skill with word processing and spreadsheet management.
    Ability to utilize the departmental software to communicate with internal case managers and Hospital Precert/Admissions.
    Excellent verbal and written communication skills.
    Verifies patient insurance/financial status as required for access to posthospital care.
    Places orders for posthospital care and verifies that posthospital care is secured prior to patient discharge.

    Attends multi-disciplinary rounds on the nursing unit floors as scheduledUses software to update the Case Mgmt Dept, PFS and Precert re: post hospital care referrals and provider contacts, and all other discharge arrangements.

    Monitors Utilization Review Line 8 hours daily to communicate that insurance companies need clinical info from the case managers.
    Obtains patient medical records for patient referrals and/or discharge, as requested.
    Faxes referrals and chart copies as necessary.
    Facilitates weekly meetings and performs charge rotation in HR Coordinators/Supervisor's absence.

    Prepares billing confirmation documents for GUH to be responsible for payments of services for indigent patients, signed by the Director of Case Management, as requested.

    Answers the main telephone line, verifies that voice mail has been attended to daily &transfers calls appropriately.
    Serves as communication liaison between Clinical Case Managers, social workers and on-site reviewers.
    Communicates actual or potential problems with posthospital care, patient or provider relations to appropriateClinical Case Manager and supervisor immediately.
    Notifies supervisor if workload requires assistance and/or problems can not be resolved.
    Assumes other duties and responsibilities that are appropriate to the position and area.

    The above responsibilities are a general description of the level and nature of the work assigned to this classification and are not to be considered as all-inclusive.

    ","industry":

    "Healthcare


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