Case Mgmt Support Specialist- Case Management

• Ensures proper infection control practices while meeting with patients and families to coordinate discharge plan details in patient care areas.
• Assists in referral functions which may include sending documents, calling, and producing letters needed to be sent to community providers and/or regulatory agencies.
• Receives requests and sends clinical information to third-party payers, post-acute agencies/services, and/or regulatory agencies as assigned by Utilization Review Nurses, Case Managers and Social Workers for the purpose of referrals for post-acute care and reimbursement.
• Completes delegated paperwork required for the execution of the discharge plan and delivery of regulatory forms.
• Proactively follows up with patients, families, third-party payers, or community agencies, as delegated, to determine needs and provide information to facilitate discharge, reimbursement, or authorization of stay-making documentation.
• Utilizes various communication methods to relay information and ensure timely receipt and transfer of voice mail messages.
• Maintains a positive attitude and positive working relationship with patients, families, and all levels within the organization.
• Documents approved authorization/denial information from payers and provides clear and accurate communication on all accounts to ensure accurate and timely billing.
• Recognizes and communicate any service delays to the Case Manager, Social Worker and/or Utilization Review Nurse.
• Utilizes department policies, procedures, and organizational initiatives to proactively complete work assignments, while maintaining the confidentiality of all protected health information.

• Education: High school diploma or equivalent.
• Certification: AHA BLS
• Work Experience: Previous customer service experience working in a face-to-face environment.
• Knowledge/Skills/Abilities:
• Proficient in Microsoft Office – Outlook, Word, Excel.
• Ability to work autonomously with minimal supervision.
• Strong critical thinking skills.
• Strong communication skills demonstrated both verbally and in writing, with a strong professional presence.
• Ability to maintain composure in a stressful office environment.
• Able to work flexible hours and days, including weekends to meet departmental needs.
• Able to work directly with patients and families in patient care areas and via telephone.

• Education: Associate degree.
• Work Experience:
• Medical, acute care, insurance, or social work experience.
• One year of customer service experience working in a face-to-face environment.

• Knowledge/Skills/Abilities: Strong organizational skills.

• Majority of time involves sitting or standing; occasional walking, bending, stooping.
• Long periods of computer time or at a workstation.
• Light work that may include lifting or moving objects up to 20 pounds with or without assistance.
• May be exposed to inside environments with varying temperatures, air quality, lighting, and/or low to moderate noise.
• Communicating with others to exchange information.
• Visual acuity and hand-eye coordination to perform tasks.
• Workspace may vary from open to confined.
• May require travel to various facilities within and beyond county perimeter; may require use of personal vehicle.

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