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Case Management Assistant

Company: Cleveland Clinic
Location: Canton
Posted on: November 22, 2021

Job Description:

The Case Management Assistant functions with peers and other care providers and physicians for problem solving and facilitating in-patient and post hospitalization care. Position Requirements * Coordinates, oversees, records, and transmits information pertinent to the resource management of patients. * Assists the CM team in transition (discharge) planning and coordination. * Follows up with phone calls and necessary paperwork to assure seamless referrals to outside facilities (Acute care, SNF, Home Health, etc) as directed by the Case Management team. * Performs all clerical functions, such as faxing, copying, and telephoning as necessary to expedite patient progress. Essential Functions * Works collaboratively as directed with continued stay documents and denial information. * Maintains awareness of payer/reimbursement practices and regulations that may impact patient's plan of care. * Communicates with Business office regarding any financial arrangements. * Collects data for use in performance improvement as directed. * Assists with compliance for regulatory agencies. * Transmits admission reviews to third party payers as necessary. * Transmits continued stay reviews, tracks authorization, and assists with denial letter process. * Communicates any pertinent information received from payers to RN care managers. * Supports and assists with insurance denials and appeals process. * Facilitates timely transmission of concurrent and retroactive utilization reviews with insurance companies in coordination with the team. Physical Demands Light Work: Exert up to 20lbs force occasionally; and/or up to 10lbs frequently. Educational, Licensure, & Experience Requirements * High School diploma or equivalent required with previous medical education, such as Licensed Practical Nurse, or a medical related degree or training. * Previous medical and healthcare reimbursement experience required if no formal medical related training or education. * Prior experience in hospital case management, medical staff services office, or similar background preferred. * Working knowledge of medical terminology. Keywords: Case Manager Assistant, Case Management, Case Manager, Case Worker, Case Worker Assistant The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our employees and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. Job offers will be rescinded for candidates for employment who test positive for nicotine. Candidates for employment who are impacted by Cleveland Clinic Health System's Smoking Policy will be permitted to reapply for open positions after 90 days. Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility. Please review the

Keywords: Cleveland Clinic, Canton , Case Management Assistant, Executive , Canton, Ohio

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