Non-Clinical - Administrative - Administrative Coordinator

Coordinator Administrative Onsite Part-Time

Provides clerical support for Case Management team, assisting team with problem solving and facilitating inpatient and post hospitalization care.

Specific Skills Needed:

• Basic computer knowledge
• Medical terminology
• Strong verbal and written communication skills
• Critical thinking skills

Education/Experience/Training Required:

• High School diploma or equivalent
• LA City Fire Card within 6 months of employment (PHGSH only)
• Previous experience in a medical setting

Preferred:

• Bachelor's degree

Duties and Responsibilities:

• Safeguards and preserves the confidentiality of patient's protected health information in accordance with State and Federal (HIPAA) regulatory requirements, hospital and departmental policies.
• Ensures a safe patient environment and adherence to safety practices per policy.
• With consideration to age, employee utilizes the approved process to resolve biophysical, psychological, educational and environmental needs of patient/significant other when administering care.
• Actively participates in daily Case Management team meetings.
• Follows up with phone calls and necessary paperwork to ensure seamless referrals to outside agencies.
• Collects information to facilitate assessment of financial resources available for post-acute care.
• Make arrangements for procuring and delivering DME and medications for post discharge care.
• Arranges timely transportation for discharge according to plan.
• Performs all clerical functions, such as, faxing, copying and telephoning as necessary to expedite patient discharge.
• Ensures all discharge plans are followed through to resolution or requests assistance as needed.
• Ensures insurance verification and obtains benefits to ensure adequate coverage to meet the need of the discharge plan.
• Refers patients to financial counselors for information and/or to implement financial assistance forms.
• Maintains knowledge of common reimbursement methods.
• Communicates reimbursement information to patients and families as directed.
• Works collaboratively with RN and SW Case Manager to issue continued stay documents and denial information.
• Initiates disability applications.
• Accesses computer system to obtain updated financial information and benefits.
• Completes MAC paperwork and assists with county transfers.
• Maintains awareness of payor / reimbursement practices and regulations that may impact patients' plan of care.
• Completes mandated legal reporting as appropriate.
• Reports all observations/information to the Case Management team.
• Screens all cases for advanced directives documentation.
• Assist patient's families with education or completing paperwork for healthcare decisions under the direction of the SW/RN Case Manager.
• Helps ensure appropriate test results are available in a timely manner for physician review.
• Assists with coordination of Case Management paperwork for admissions, transfers and discharges.
• Monitors patients for frequent admissions and alerts Case Managers.
• Follows up on pre-certification activities.
• Coordinates admission notifications to third party payors with Admitting department.
• Maintains awareness of current managed care contract requirements for UR.
• Communicates pertinent information received from payors to Case Managers.
• Facilitates timely transmissions of concurrent and retroactive utilization reviews with insurance companies in coordination with RN Case Manager.
• Assists with Medi-Cal review process, copying patient records and assists with TAR completion.
• Supports process for insurance denials and appeal processes.
• Collects and enters data on avoidable delays/days.