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Job CategoryPatient Services
Job FamilyPatient Support
DepartmentRCH Care Management
Scheduled Weekly Hours40
Job SummarySupports the Case Management/Social Work functions related to payer pre-authorizations/notifications, utilization review submissions, education of patients and families regarding required regulatory notices, assists with patient discharge arrangements, specialized administrative assistance, record keeping and general care-coordination tasks as assigned by Case Management/Social Work partners.
- Collaborates with the healthcare team, patients/families, payers, physician offices and other community agencies ensuring a team environment. Demonstrates excellent customer service skills in all interactions to provide a smooth and efficient department operation allowing for maximum comfort and confidentiality for the customer. Prioritizes workflow and knows when to ask for help.
- Verifies and obtains benefits levels from insurance carriers and employers when applicable and maintains appropriate and accurate documentation, both written and electronically. Maintains working knowledge of procedures and insurance requirements.
- Responsible to obtain the necessary knowledge and experience to perform job tasks in compliance with federal, state, and local laws, regulations and guidelines. Maintains compliance with all department policies and procedures. Completes Medicare Message follow up letter and Medicare Outpatient Observation Notices as identified by department process.
- Educates patients and families on coverage and coordination progress as directed by Case Management/ Utilization Management team.
- Coordinates, under direction of the nurse Case Manager/Social Worker and in collaboration with the healthcare team, patient care transitions which may include faxing information, arranging authorization and transportation, confirming arrangements, obtaining clothing, durable medical equipment etc.
- Supports comprehensive coordination of medical services including intake, screening and supporting the implementation of care plans to promote effective utilization of healthcare services.
- May assist in providing transportation as directed.
- Participate in staff meetings, training and/or in-services and on-going educational groups.
- Contributes to documentation of coordinated functions in appropriate computer systems and the patient’s electronic medical record.
- All other duties as assigned.
Education - High School Diploma/GED Equivalent in General Studies
Experience - 1+ years of Medical Terminology Experience
Certification - State drivers license
Certification - Certified Nurse Aide (CNA) - South Dakota Board of Nursing
Experience - 1+ years of Clerical Experience
Sedentary work - Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time.10 Monument Health Rapid City Hospital, Inc.
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Monument Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.Apply