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Form of workThe Case Management Assistant provides support services to ensure pre-certification, authorization and payment for inpatient services, and acquisition of equipment in order to facilitate continuum of care for patients.
This position is M-F 830-5pm ,100% onsite with some holidays/weekends
This position impacts the efficiency of the administration, revenue acquisition, documentation and delivery of patient care services.
Essential Job Functions Provides support services to ensure pre-certification, authorization and payment for inpatient services and facilitates continuum of care for patients. Coordinates the acquisition of equipment between the insurance company, vendor, health care teams and patient/family member(s). Reviews patient medical records to provide clinical information to insurance payor for services. Review patient medical record to obtain authorization for continued inpatient hospitalization. Responsible for completeness of certificates of medical necessity (CMN's) - ICD-9 codes, diagnosis, medical transcription notes, length of need, etc to meet insurance qualifications for prescribed equipment. Documents information to facilitate appeals for denied services, verification of insurance and benefits to facilitate the discharge process. Obtains missing insurance information from patients as appropriate. Provides copies of Medicare notices for Medicare patients for regulatory purposes as directed. Communicates insurance or Medicare issues with patients, access centers, members of the Interdisciplinary Team and all other departments involved in providing care or services to patients. Reconciles and maintains task lists to assign and reassign utilization reviews. Utilizes CARE, Maxsys, InterQual and CARE templates for documentation. Maintains DME vendor relationships.
Other duties as assigned.
Education Required: Associate's degree in Business Administration, Healthcare Administration or related field.
Experience Required: Three years of administrative experience in healthcare, insurance or related field. With preferred degree, one year of related experience. May substitute required education degree with additional years of equivalent experience on a one to one basis
It is the policy of The University of Texas MD Anderson Cancer Center to provide equal employment opportunity without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, disability, protected veteran status, genetic information, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. http://www.mdanderson.org/about-us/legal-and-policy/legal-statements/eeo-affirmative-action.html
Additional Information
#LI-Onsite
This position is M-F 830-5pm ,100% onsite with some holidays/weekends
This position impacts the efficiency of the administration, revenue acquisition, documentation and delivery of patient care services.
Essential Job Functions Provides support services to ensure pre-certification, authorization and payment for inpatient services and facilitates continuum of care for patients. Coordinates the acquisition of equipment between the insurance company, vendor, health care teams and patient/family member(s). Reviews patient medical records to provide clinical information to insurance payor for services. Review patient medical record to obtain authorization for continued inpatient hospitalization. Responsible for completeness of certificates of medical necessity (CMN's) - ICD-9 codes, diagnosis, medical transcription notes, length of need, etc to meet insurance qualifications for prescribed equipment. Documents information to facilitate appeals for denied services, verification of insurance and benefits to facilitate the discharge process. Obtains missing insurance information from patients as appropriate. Provides copies of Medicare notices for Medicare patients for regulatory purposes as directed. Communicates insurance or Medicare issues with patients, access centers, members of the Interdisciplinary Team and all other departments involved in providing care or services to patients. Reconciles and maintains task lists to assign and reassign utilization reviews. Utilizes CARE, Maxsys, InterQual and CARE templates for documentation. Maintains DME vendor relationships.
Other duties as assigned.
Education Required: Associate's degree in Business Administration, Healthcare Administration or related field.
Experience Required: Three years of administrative experience in healthcare, insurance or related field. With preferred degree, one year of related experience. May substitute required education degree with additional years of equivalent experience on a one to one basis
It is the policy of The University of Texas MD Anderson Cancer Center to provide equal employment opportunity without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, disability, protected veteran status, genetic information, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. http://www.mdanderson.org/about-us/legal-and-policy/legal-statements/eeo-affirmative-action.html
Additional Information
- Requisition ID: 165128
- Employment Status: Full-Time
- Employee Status: Regular
- Work Week: Day/Evening
- Minimum Salary: US Dollar (USD) 39,000
- Midpoint Salary: US Dollar (USD) 48,500
- Maximum Salary : US Dollar (USD) 58,000
- FLSA: non-exempt and eligible for overtime pay
- Fund Type: Hard
- Work Location: Onsite
- Pivotal Position: No
- Referral Bonus Available?: No
- Relocation Assistance Available?: No
- Science Jobs: No
#LI-Onsite
