Case Management Assistant

• Provides support to the RN Case Managers, Social Workers and Utilization Reviewers. Assists with all aspects of case and/or utilization management functions, which may include activities such as prioritization and assignment of patients, authorizations and referrals, verification of patient information, benefit review, intake and screening, and coordination of services.
• Prepares and faxes necessary documentation/information to facilitate authorizations and referrals. Follows-up on authorizations and referrals by phone to ensure receipt and ensure all necessary information/documentation was provided. Receives and documents authorizations requested. Contacts insurance companies/payers/medical groups to acquire authorizations.
• Coordinates, generates and tracks both incoming and outgoing correspondence and faxes. Receives calls, faxes and portal submissions regarding authorization requests, process inquiries, and eligibility verifications; coordinating and communicating with providers and payers for plan members to facilitate receipt of information, and/or records for prompt review and response.
• Documents all relevant information in the electronic medical record according to policy and departmental guidelines. Assists department leadership in data management. Runs scheduled and ad hoc reports, as requested.
• Identifies potential issues in coordination or reimbursement of care, notifies appropriate personnel, and assists in resolution efforts.
• Performs job duties and coordinates with other members of the healthcare team to ensure appropriate compliance with state, federal, HIPAA, and Joint Commission regulations and requirements.
• Other duties and responsibilities as assigned

• Education: Associate degree or 2 additional years of experience in lieu of degree.
• Experience: 2 years' experience

A strong, talented staff is at the heart of St. Luke’s Health System. We are the state’s largest employer with more than 15,000 employees and a medical staff of more than 1,800 physicians and advanced practice providers. We’re proud of our people who deliver skilled, compassionate care every day, and are looking to add dedicated individuals who will continue this same tradition of excellence.

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  St. Luke’s is an equal opportunity employer and does not discriminate against any person on the basis of race, religion, color, gender, gender identity, sexual orientation, age, national origin, disability, veteran status, or any other status or condition protected by law.