- 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.
- Minimum two (2) years of relevant experience.
- High School Diploma or General Education Development (GED) required.
- Certified Professional Coder within 6 months of hire OR Certified Outpatient Coder within 6 months of hire OR Certified Coding Specialist within 6 months of hire
- Able to apply critical thinking, analytic techniques, problem solving, and computer skills to all inpatient and outpatient data.
- Strong analytic and communication skills (written and verbal)
- Expertise with tracking, spreadsheets, and graphic computer systems operating on PC mainframes.
- Knowledge of health plan benefits
- Understanding of medical center operations, complex health systems, with the ability to quickly grasp and apply policies and procedures.
- Data entry experience.
- Working knowledge and use of the most up-to-date ICD manual, as well as CPT/HCPCS codes.
- Understanding of health care payment mechanisms (capitation, fee-for-service, etc.)
- Functional knowledge of computers, fax machines, and copiers.
- Excellent customer service skills.
- Proficient with Microsoft Office Suite (Word, Excel, PowerPoint, etc.).
- Clinical background preferred.
- Medical Terminology Certification preferred.
- Bachelors degree.
-
Patient Care Coordinator
2 days ago
LanceSoft Alpharetta, United StatesTitle: Patient Care CoordinatorLocation: lpharetta GA 30004Duration: 12+ months Description: "Essential Duties and Responsibilities: Process Game Ready Direct orders, completing all required tasks set forth for the Game Ready Direct order management process. Build sustainable rel ...
-
Patient Care Coordinator
2 weeks ago
Tech Providers Alpharetta, United StatesTitle: Patient Care Coordinator · Location: Alpharetta, GA % onsite) · Duration: 12 + Month Contract with the possibility of extension · Job Position · Preferred: · •Spanish (Written and verbal) · •degree or actively pursuing a degree · •Experience with SAP or another ERP s ...
-
Executive Vice President of Care Coordination
3 weeks ago
Jackson Healthcare Alpharetta, United StatesPOSITION SUMMARY: · The Executive Vice President of Care Coordination is a dynamic and visionary nursing leader to provide strategic leadership and direction for Care Coordination services. This leader will be responsible for overseeing all aspects of nursing practice, ensuring t ...
-
patient care coordinator
3 weeks ago
Emory Healthcare , GA, United StatesOverview · Emory University is a leading research university that fosters excellence and attracts world-class talent to innovate today and prepare leaders for the future. We welcome candidates who can contribute to the diversity and excellence of our academic community. · Descrip ...
-
Patient Care Coordinator
4 weeks ago
Tech Providers Alpharetta, United StatesTitle:Patient Care Coordinator · Location: Alpharetta, GA % onsite) · Duration: 12 + Month Contract with the possibility of extension · Job Position · Preferred: · • Spanish (Written and verbal) · • AA degree or actively pursuing a degree · • Experience with SAP or another ...
-
customer care coordinator
3 weeks ago
LocumTenens , GA, United StatesOverview · has been leading the way in a booming healthcare industry since 1995. Locum Tenens is a Latin phrase meaning, to substitute for. When hospitals are understaffed, they rely on us to find them the right temporary physicians to fill in when needed. Every associate at pla ...
-
patient care coordinator
3 weeks ago
Specialty1 Partners Alpharetta, GA, USA, United StatesOur office, Alpharetta Endodontics, is seeking a Patient Care Coordinator to join our busy specialty practice. · Our office is looking for a talented and pleasant patient care coordinator to take on all administrative and front office duties to provide an exceptional experience ...
-
Customer Care Coordinator
4 weeks ago
Jackson Healthcare Family of Companies Alpharetta, United StatesLocum. has been leading the way in a booming healthcare industry since 1995. Locum Tenens is a Latin phrase meaning, to substitute for. When hospitals are understaffed, they rely on us to find them the right temporary physicians to fill Care Coordinator, Customer Care, Coordinat ...
-
patient care coordinator
3 weeks ago
Emory Healthcare/Emory University , GA, United States**Overview** · Emory University is a leading research university that fosters excellence and attracts world-class talent to innovate today and prepare leaders for the future. We welcome candidates who can contribute to the diversity and excellence of our academic community. · **D ...
-
Customer Care Coordinator
3 weeks ago
Jackson Healthcare Alpharetta, United StatesOverview has been leading the way in a booming healthcare industry since 1995. Locum Tenens is a Latin phrase meaning, 'to substitute for.' When hospitals are understaffed, they rely on us to find them the right temporary physicians to fill in when needed. Every associate at pl ...
-
Patient Care Coordinator
4 weeks ago
LanceSoft Alpharetta, United StatesTitle: Patient Care Coordinator · Location: lpharetta GA 30004 · Duration: 12+ months · Description: · "Essential Duties and Responsibilities:Process Game Ready Direct orders, completing all required tasks set forth for the Game Ready Direct order management process. · Build ...
-
Patient Care Coordinator
2 weeks ago
Sunrise Systems Alpharetta, United StatesOur client, a leading Healthcare Company is looking for Patient Care Coordinator – Intake and This is for an initial duration of 12 Months at Alpharetta, GA · Job Title: Patient Care Coordinator - Intake · Job Id: · Location: Alpharetta, GA · Duration: 12 Months Contract · Posit ...
-
Patient Care Coordinator
2 weeks ago
Integrated Resources Alpharetta, United StatesJob Title: Patient Care Coordinator Intake · Location: Alpharetta GA · Duration: 6 Months · Shift Time: 8:00am to 5:00pm · Essential Duties and Responsibilities: Process Game Ready Direct orders, completing all required tasks set forth for the Game Ready Direct order manage ...
-
Patient Care Coordinator
3 weeks ago
Tech Providers Inc. Alpharetta, GA, United StatesTitle: Patient Care Coordinator · Location: Alpharetta, GA % onsite) · Duration: 12 + Month Contract with the possibility of extension · Job Position · Preferred: · • Spanish (Written and verbal) · • AA degree or actively pursuing a degree · • Experience with SAP or another ...
-
Patient Care Coordinator
1 week ago
Tech Providers Alpharetta, United StatesTitle: Patient Care CoordinatorLocation: Alpharetta, GA % onsite)Duration: 12 + Month Contract with the possibility of extension Job PositionPreferred: · •Spanish (Written and verbal) · •degree or actively pursuing a degree · •Experience with SAP or another ERP software · •Experi ...
-
Patient Care Coordinator
3 weeks ago
Sunrise Systems Alpharetta, United StatesThis resource will be speaking directly with the patients on getting the equipment shipped, trained on, etc. · *Your qualifications * · *Required: * · * 2 years minimum experience in Customer Service or direct to Patient Service · * Proven customer or patient support experienc ...
-
Patient Care Coordinator
3 weeks ago
Sunrise Systems, Inc Alpharetta, United StatesThis resource will be speaking directly with the patients on getting the equipment shipped, trained on, etc. · Your qualifications · Required: · 2 years minimum experience in Customer Service or direct to Patient Service · Proven customer or patient support experience or experie ...
-
skilled inpatient facility care coordinator
3 weeks ago
UnitedHealth Group Inc. , GA, United StatesOptum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - ...
-
skilled nursing facility care coordinator
3 weeks ago
UnitedHealth Group Inc. , GA, United StatesOptum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - ...
-
Director of Nursing
6 days ago
The Mansions at Alpharetta Alpharetta, United States Full time, Part timeThe Mansions at Alpharetta is currently accepting applications for the position of Director of Nursing (Wellness Director) to lead our amazing team of wellness professionals at our beautiful Assisted Living and Memory community located in the Alpharetta, GA area. The Director of ...
continuum care coordinator - , GA, 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:
Basic Qualifications:
Experience
Additional Requirements:
Preferred Qualifications:
COMPANY:
KAISER
TITLE:
Continuum Care Coordinator
LOCATION:
Atlanta, Georgia
REQNUMBER:
External hires must pass a background check/drug screen.
Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.
