Job Description & Responsibilities:
The Care Management Representative assists the Care Management team with accurate and timely initiation and completion of payer specific information and communications flow to facilitate appropriate LOS and payer reimbursement. Primary responsibilities include obtaining insurance certification, functioning as a liaison with third party payers, communicating clinical information to the insurance companies as requested, and notifying the Care Management team of any actual or potential denials. GENERAL REQUIREMENTS Adheres to the hospital and departmental attendance and punctuality guidelines. Performs all job responsibilities in alignment with the core values, mission and vision of the organization. Performs other duties as required and completes all job functions as per departmental policies and procedures. Maintains current knowledge in present areas of responsibility (i.e., self education, attends ongoing educational programs). Attends staff meetings and completes mandatory in-services and requirements and competency evaluations on time. Demonstrates competency at all levels in providing care to all patients based on age, sex, weight, and demonstrated needs. For non-clinical areas, has attended training and demonstrates usage of age- specific customer service skills. Wears protective clothing and equipment as appropriate.
Qualifications
High School Diploma or GED (Required). 2 year / Associate Degree in Business or related field (Preferred). EXPERIENCE REQUIREMENTS: 1 - 2 years insurance, utilization review, or medical terminology preferably in a Healthcare organization (Required). 1 - 2 years Proficient with computer applications like Microsoft Word and Excel and just in general use of the computer and typing information, experience with Midas would be a plus (Preferred).
How To Apply:
Salary:
Depending on Experience
Contact:
Employer: Phoebe Putney Health System
Location: Albany, GA
Link: https://careers.phoebehealth.com/Search/JobDetails/care-management-representative/c97972a9-20cd-48dc-84e3-ad7c6e0daf58