Case Management Clerk

POSITION SUMMARY

Responsible for providing advanced clerical support services to the Case Management and/or Social Services Department. The Case Management Clerk performs various clerical duties such as sorting data entry, typing, correspondence, and filing, photo copying, scanning and indexing documents. He or she is also responsible for the correct arrangement of transportation and follow-up/outside tests. The clerk must demonstrate the ability to access and use hospital computer system according to established guidelines. Follows the hospitals policy and procedures as they pertain to all hospital information systems and comply with the hospital’s policies and procedures, including timekeeping, dress code, attendance, and the Standards of Conduct. Expresses and accepts feedback in a professional manner. Assists with special projects and takes initiative during downtime to complete other department related tasks. May assist in orientation of new staff.

POSITION QUALIFICATIONS

• High School Diploma or equivalent, 2 years of Healthcare, business office, or related insurance industry experience is preferred.
• Knowledge of computers and relevant software applications
• Knowledge of customer service principles and practices
• Ability to problem solve and work well as a team member
• Intermediate Microsoft office (Word, Excel)
• Strong interpersonal, verbal, and written communication skills, excellent listening skills, organizational and public relations skills
• Ability to work in fast pace environment
• Must have demonstrated an ability to learn within a short period of time
• Ability to prioritize, manage multiple tasks, and complete daily tasks
• Healthcare terminology
• Data entry and 10-key by touch

DUTIES/ RESPONSIBILITIES

• Demonstrate knowledge of pre-certification and concurrent review processes.
• Ability to send concurrent reviews to designated insurance agencies on a daily basis in a timely manner.
• Keeps Unit Clerks and/or Tele Techs informed of pertinent information related to authorizations, appointments, and transportation time.
• Assures responsibility of approved authorizations and being proactive with follow-up phone calls.
• Must be able to communicate difficult and challenging situations with Case Managers in order to resolve any problems that may arise with Vendors or agencies.
• Knowledge of HIPPA regulations and disclosures for release.
• Assures that the rights of all patients are respected and maintained by allowing for privacy confidentiality and dignity in the provision of service.
• Maintains required applicable education and in-service requirements and participates in departmental staff meetings (through attendance or reading meeting minutes).
• Performs all other duties as assigned.