Optalis Health & Rehabilitation Centers

Case Manager

Optalis Health & Rehabilitation Centers  •  Southfield, MI (Onsite)  •  5 hours ago
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Job Description

 
Insurance Advocate Coordinators "Case Managers" are responsible for retrieving and inputting data from the facility IDT team documentation and submitting it to managed care insurance companies to advocate for continued stay coverage. The Case Manager is additionally responsible for submission of reports, excel spread sheet development, auditing records and communication both internally and externally for the facility.

Essential Job Functions:
  • Retrieve medical information from Patient EMR and submit continued stay authorizations via various portals and fax processing formats.
  • Verify insurance, summarize authorizations, communicate with IDT team via phone and email and input medical information into Point Click Care
  • Provide information to nurse liaisons for medical evaluation/review
  • Correspond with care coordinators from all managed care entities requesting clarification or additional information.
  • Perform clerical responsibilities which may include notice of authorizations or issuance of NOMNCs.

Performance Requirements:
  • Communication and "people" skills
  • Must be polite and cooperative at all times to patients, family and fellow staff members
  • Organized, detailed oriented and able to time manage multiple tasks
  • Be able to maintain composer during challenging situations
  • Computer, scan, portal usage proficient
  • Self-starter and can function with little direction
  • Medical knowledge and terminology
  • Knowledge of various insurance companies and the role of managed care in the facility
  • Appreciates the importance of maintaining confidentiality of resident and facility information
  • Demonstrates honesty and integrity at all times in the care and use of resident and facility property
  • Able to interact effectively with multidisciplinary team, insurance providers, patients and family members.
 
Minimum Qualification Standards:
  • Successful completion of High School Education requirements.
  • Preferred Social Worker or Nurse
  • Able to carry out the essential functions of this job.
  • Able to maintain a clean and well-groomed personal appearance.
Optalis Health & Rehabilitation Centers

About Optalis Health & Rehabilitation Centers

As you plan your post-hospital care, it’s good to know the most advanced medical treatment, comfort and compassion can be found in one place—at an Optalis Health & Rehabilitation Center. No matter which of our convenient locations you choose – expect unrivaled access to the expertise, experience, and resources unlike anywhere else.

Industry
Healthcare & Social Services
Company Size
501-1,000 employees
Headquarters
Novi, Michigan
Year Founded
Unknown
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