Medical Assistant

Job Summary Assists in Care Management Team of social workers and nurses with functions such as but not limited to provide census reconciliation, administrative support for care coordination and discharge planning activities, working with the payors, accurate and critical information data entry and tracking, and report creation. Qualifications Preferred Education: Bachelor’s degree in related field. Preferred Experience: Medical Assistant. Required Education: High school diploma or G.E.D. Required Experience: Three years in a health care field or one year in Utilization Management at a Medical Group or Health plan experience; electronic Health Record (EHR) and Case Management applications, e.g. Knowledge, Skills and Abilities Act in an appropriate and professional manner as defined by the company’s Standards of Behavior, Policy and Procedures, and Scope of Services. Correct business English, including spelling, grammar and punctuation. Current office administrative practices and procedures. Demonstrated ability to work effectively in a team-based environment, and collaborate with a broad range of health care professionals. Establish and maintain effective working relationships with a variety of individuals from various socioeconomic, ethnic and cultural backgrounds. Excellent communication skills, both written and verbal. Excellent organizational, prioritization, interpersonal, customer service, problem-solving skills. Role model AHS Standards of Behavior. Strong critical thinking and analytical skills. Use independent judgment and initiative within established policies and procedures. Working knowledge of medical terminology. Collaborates with Case Management staff to provide specific clinical information for the purpose of completing initial and concurrent utilization review to ensure certification/approval of in-patient and post discharge services. Communicates status with Care Management staff and arranges for patient transfer; functions as a key point of contact between Care Management staff, admissions and payers. Coordinate and track any communication, e.g. Important Message letters, Denial Letters, patient choice forms; regularly updates Care Management team. Coordinates and obtains authorizations for admissions; documents all information in the AHS financial system; works closely with Revenue Cycle to ensure each inpatient encounter is accurate; coordinates all reviews and inquires with the payors. Coordinates with referral sources on bed availability, new product and services; maintains current database of existing and potential referral sources. Functions as a key point of contact between clinical case management staff, admissions and payors. Documents all interactions with payors and communicates status with Care Management staff. Manages multiple inquiries and presents referrals based on location and services provided; provides appropriate follow up on active or pending inquires. Per the direction of the Care Management social worker and/or nurse, facilitates, identifies and documents all referrals made to contracted facilities, providers or agencies, makes post discharge appointments for patients and coordinates transportation; expedites discharges by transmitting appropriate documentation to providers for acceptance of patient; documents all interactions with payers and communicates status with appropriate staff. Perform all other duties as assigned. Reconciles census; works with Patient Access and the Care Management team to ensure census is correct in the financial and care management systems; prepares paperwork and updates encounter information for admissions, discharges and transfers of patients; prepares census for the Care Management staff. Supports any audits with coordinating medical records with HIM; prepares statements of diagnosis and treatments, and extracts other information required for the completion of forms received from patients’ insurance carriers. Seniority level Mid-Senior level Employment type Contract Job function Health Care Provider Industries IT Services and IT Consulting Referrals increase your chances of interviewing at SDK Software, Inc. by 2x Sign in to set job alerts for “Medical Assistant” roles. We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI. #J-18808-Ljbffr SDK Software, Inc.