- Must be familiarized with Managed Care providers to ensure proper processing of all required documents ie. Appendix A, LocadtrMaintain
- E-mail distribution daily
- Ensure that documents are submitted to Managed Care providers within the required timeline,
Within 24-48hrs from point of admission - Ensure Discharge/Con-Current review documentation are completed within a timely manner. Complete follow-up call to ensure documents have been received/reviewed
- Must confer with Medical Director when Doc to Doc review are being requested by manage care providers as well as CASAC managing the case
- Track Re-Admissions trends to avoid denial by manage care providers
- Communicate all appeal request to Unit Clerk to ensure charts are submitted to our finance dept. for processing within appropriate timeline
- Assist clients to resolve any problems and answer questions about their Manage Care benefits.
- Educate eligible partner staff and prospective clients about benefits and how to access those benefits.
- Ensure that all program outcomes are properly documented in an accurate and timely manner through program reporting systems
- Work with leadership staff to use program performance data to drive improvements to the program design and implementation
- Participate in all required trainings and meetings; maintain a strong and current expertise in public benefits eligibility, application and enrollment, as well as community resources
- Perform other duties as required
REQUIREMENTS: Experience and Special Requirements High School diploma required; CASAC 2 and/or Bachelor's Degree in relevant field preferred. Relevant experience with special need population facing strong barriers towards benefits. Bilingual Spanish preferred. Excellent communication and computer skills. Comfortable working closely with others in a stressful environment. Bilingual, Spanish and English, ability to work independently, Familiarity with database and case noting |