We are seeking an experienced and detail-oriented Assistant Case Manager to join our team at AdviniaCare at Vinnin Square in Salem, MA. As a valued member of our team, you will assist the Case Manager in coordinating care for our skilled nursing and rehabilitation residents.
Schedule and attend resident care plan meetings and send out invitations to family members
Schedule and attend teleconference meetings with family members of skilled residents, if requested
Follow up with interdisciplinary team members on non-completed sections of evaluations and forms required for insurance updates
Retrieve and fax or upload to managed care portal medical records to managed care companies for utilization review purposes
Track and schedule all certifications and recertification needed for skilled care
Coordinate with Social Services to issue Medicare Advantage denial letters
Retrieve and upload medical records to QIO website for any requested appeals
Assist with compiling medical records and preparing for submission with subsequent level appeals to QIC, ALJ, etc.
Track and submit all managed care documentation on review dates
Monitor daily any change in resident status that would impact skilled level of care or discharge and assure managed care company is notified of changes in next review
Update weekly UR board and attend weekly UR meeting
Consult with Regional RN Case Manager as needed
Assist with compiling medical records or other documentation as requested by Curis ADR department
Scan and upload to PCC all Certs, NOMNCs and SNF ABNs
