Job Summary:
Insurance Advocate Coordinators "Case Managers" are responsible for retrieving and inputting data from the facility IDT team documentation and submitting it to managed care insurance companies to advocate for continued stay coverage. The Case Manager is additionally responsible for submission of reports, excel spread sheet development, auditing records and communication both internally and externally for the facility.
Essential Job Functions:
- Retrieve medical information from Patient EMR and submit continued stay authorizations via various portals and fax processing formats.
- Verify insurance, summarize authorizations, communicate with IDT team via phone and email and input medical information into Point Click Care
- Provide information to nurse liaisons for medical evaluation/review
- Correspond with care coordinators from all managed care entities requesting clarification or additional information.
- Perform clerical responsibilities which may include notice of authorizations or issuance of NOMNCs.
Performance Requirements:
- Communication and "people" skills
- Must be polite and cooperative at all times to patients, family and fellow staff members
- Organized, detailed oriented and able to time manage multiple tasks
- Be able to maintain composer during challenging situations
- Computer, scan, portal usage proficient
- Self-starter and can function with little direction
- Medical knowledge and terminology
- Knowledge of various insurance companies and the role of managed care in the facility
- Appreciates the importance of maintaining confidentiality of resident and facility information
- Demonstrates honesty and integrity at all times in the care and use of resident and facility property
- Able to interact effectively with multidisciplinary team, insurance providers, patients and family members.
Minimum Qualification Standards:
- Successful completion of High School Education requirements.
- Preferred Social Worker or Nurse
- Able to carry out the essential functions of this job.
- Able to maintain a clean and well-groomed personal appearance.
