Discharge Assistant - Care Management

Job Title: Discharge Assistant - Care Management

Description Employment Status:
Full time Shift: Day (United States of America) Facility: 1906 Belleview Ave SE - Roanoke CP01 Carilion Medical Center. Requisition Number: R158321 Discharge Assistant - Care Management (Open). How You'll Help Transform Healthcare:
This is Carilion Clinic – an organization where innovation happens, collaboration is expected, and ideas are valued. A not-for-profit, mission-driven health system built on progress and partnerships, a courageous team that is always learning, never discouraged and forever curious. Headquartered in Roanoke, Va., you will find a robust system of award-winning hospitals, Level 1 and 3 trauma centers, Level 3 NICU, Institute of Orthopedics and Neurosciences, multi-specialty physician practices, and The Virginia Tech Carilion School of Medicine and Research Institute.

Carilion is where you can make your own path, make new discoveries and, most importantly, make a difference. Here, in a place where the air is clean, people are kind and life is good. Make your tomorrow with us.

Hours:

Monday - Thursday, 8 am-6:30 pm

• Prioritizes work to maintain workflow functions as needed. Fields faxes, voicemails, written correspondences, categorizes and disseminates mail.

• Arranges and documents P2P requests, post P2P determinations, denial, and approval information from payors; provides missing or updated demographic/clinical information needed for authorization determinations; on front line of appeals process, communicates with payors, Carilion billing department and UM team for appeals case submissions; explores inquiries regarding benefits, coverage, and insurance questions. Assists Central Resource Center (CRC) staff with certain workflows, e.g., regulatory letters and Virginia MLTSS (UAI) approval process as needed.

• Maintains databases and spreadsheet files, ensuring accuracy, production, and distribution; manages Epic work queues with appeals, denials and P2
  
  Ps and tracks related data.

• Researches and resolves issues and concerns ensuring a timely turnaround to facilitate throughput.

• Supports regulatory tasks that are federally mandated, such as the Medicare Important Message (IM), Lifetime Reserve (LTR) Day and Status Change letters.

• Aids in completion of demographic information to facilitate delivery of in person letters to patients (IM, observation to IP, LTR, and Code 44, etc.).

• Collaborates with team and Carilion billing to verify and add LTR day information to letters for delivery.

• Receives Notice of Medicare Non-Coverage (NOMNC) letters for patients that are in swing beds and disseminates to all Care Management team members in a timely manner.

• Documents delivery in patient's electronic medical record and notifies billing department as appropriate.

• Provides letter delivery at regional facilities as needed.

• Processes health plan specific referral requirements including prior authorizations and assists with denial/appeal resolutions, as well as P2P initiations related to admission and throughput needs.

• Resource/liaison to payors, billing, staff, patients and providers. Answers phone calls re: pricing, benefits, coverage, approvals, denials, and insurance questions.

• Facilitates timely collection of paperwork, signatures, and other correspondence from the Care Management team and external agencies required to facilitate a timely discharge.

• Assists medical and nursing staff as needed.

• Travels between regional facilities to support and facilitate timely patient progression/ throughput needs.

Education: Associate degree or 2 years of experience can be considered in lieu of degree.

Experience: 2 years of experience in data collection and analysis and/or advanced administrative support required.

Licensure, certification, and/or registration: Virginia MLTSS (UAI) Certification required.

Other

Minimum Qualifications:

Advanced computer skills with knowledge of a variety of software programs, including Microsoft Word, Excel, Access, word processing, spreadsheets and presentation or database software. Excellent communications and organizational skills required.

This job description…