At Kindred It Starts With Me.

Our commitment is to deliver excellence and an empathetic human experience to every patient, every family member, every employee, every time. We do this through our Core Values which help in guiding our work every day.

Job Summary: Under the supervision of the Director of Case Management (DCM) or designee, the Case Management Coordinator completes various duties to enhance the efficiency of the Case Management Department, as well as support the daily functions of the case managers. This role assists in securing arrangements for the discharge transition and post-acute services. Works with the case management team to monitor and obtain insurance verifications and concurrent authorizations. Assist with denial prevention and management as requested, aiding with the peer-to-peer coordination, and denials/appeals tracking. This positition serves as a liaison between the Case Management Department, payers, post-acute providers, and various other entities.

Essential Functions:

• Provides assistance to the case management staff, including but not limited to, creating and sending referral packets, organizing admission and discharge patient records, making phone calls, obtaining signatures, or any other assistance needed determined by the DCM.
• Assists the case management team in scheduling family conferences.
• Assists the case management team by making necessary arrangement for post-discharge follow up care.
• Functions as the point of contact and liaison for the hospital Case Management Department staff regarding clinical insurance review completion and/or issues.
• Forwards the necessary patient clinical information for all admission, concurrent, and retrospective insurance reviews to payers for the completion of medical necessity reviews.
• Monitors, follow-up, documents, and tracks payer responses/requests of completed clinical reviews, including approvals, appeals, and denials, and communicates these to the appropriate personnel [hospital staff, physician, DCM, Case Manager, Clinical Denial Management, and Centralized Business Office (CBO)]
• Monitors and tracks the total hospital certified days of the patient for payers (commercial, managed care, and Medicaid) and communicates missing certifications to the DCM, Case Manager, and CBO.
• Initiates and completes insurance pre-certification for patients lacking certification. Communicates pre-authorization outcomes to appropriate personnel (hospital and CBO).
• Organizes and prepares the necessary clerical elements for the weekly Interdisciplinary Team Meeting and other Case Management meetings.

Education:

• College degree in healthcare related field a plus

Experience:

• 1 year in a healthcare setting