Case Management Assistant

Job Description We are offering a contract to permanent employment opportunity for a Case Management Assistant in San Leandro, California. This role is within the healthcare industry and is primarily non‑clinical. As a Case Management Assistant, you will work closely with the Care Management staff, providing key administrative support and managing patient information. Responsibilities: Collaborate with Care Management staff to provide specific clinical information for initial and concurrent utilization review. Ensure certification/approval of in‑patient and post‑discharge services. Act as a key point of contact between Care Management staff, admissions, and payers. Coordinate and track all communication, including but not limited to Important Message letters, Denial Letters, and patient choice forms. Regularly update the Care Management team on the status of these communications. Coordinate and obtain authorizations for admissions and document all information in the AHS financial system. Work closely with Revenue Cycle to ensure each inpatient encounter is accurate. Coordinate all reviews and inquiries with the payors. Maintain a current database of existing and potential referral sources and communicate with them about bed availability, new products, and services. Manage multiple inquiries and present referrals based on location and services provided, providing appropriate follow‑up on active or pending inquiries. Use Epic Software and other Electronic Medical Record (EMR) systems for case management tasks. Assist with patient transfers and work closely with the Non‑clinical and Acute care teams for seamless operations. Conduct Utilization review and Utilization management tasks as needed. Proficiency in communication skills to effectively interact with patients, medical professionals, and insurance companies. Proficient with database management for maintaining patient records and other relevant data. Knowledge of medical coverage policies and procedures. Familiarity with clinical trial operations for patient management. Experience in processing referrals and authorizations. Understanding of health care systems and case management principles. Proficiency in Epic Software for maintaining electronic health records. Knowledge of payer systems and electronic medical record management. Experience in inpatient care and EHR systems. Understanding of health plan coordination and financial systems in healthcare. Knowledge of revenue cycle processes. Familiarity with 3M health information systems. Experience in non‑clinical tasks such as photocopying and scanning documents. Knowledge of acute care management. Experience in QA management for healthcare processes. Proficiency in managing patient transfers. Familiarity with utilization review and management. Ability to handle confidential information in a sensitive and ethical manner. #J-18808-Ljbffr 6AM City, LLC