Administrative Outpatient Case Manager-Work From Home Job Vacancy in Confidential-Healthcare Services Los Angeles County, CA – Latest Jobs in Los Angeles County, CA – updated today

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Company Name : Confidential-Healthcare Services
Location : Los Angeles County, CA
Position : Administrative Outpatient Case Manager-Work From Home

Job Description : Compensation: Negotiable Based On Experience Employment type: full-time Telecommuting okay and encouraged
CASE MANAGER- Work From Home (LA Metro)
Compensation: Negotiable Based On Experience Employment type: full-time Telecommuting okay and encouraged
ESSENTIAL DUTIES AND RESPONSIBILITIES include but are not limited to being responsible for assessing, preparing and properly finalizing referral cases for surgery in a timely manner and in accordance with the practice timelines.
QUALIFICATIONS: 5+ Years of Experience in Medical administrative work intake/preauthorizations, knowledge of the full revenue cycle
Specific duties include assessing and processing cases by checking medical benefits, obtaining current eligibilities, contacting patients/parents/guardians for case information, following up on submitted authorizations, preparing, sending and obtaining pre-admit forms for review and signature, uploading documents to accounts, reviewing and processing authorization replies, researching in-network options while filing grievances with members and their insurance, collecting deposits and cash payments, scheduling approved cases accordingly, discussing case issues with your team and/or designated referral staff to resolve these patient issues, maintaining live schedules on-line with Google Sheets in cooperation with the referral offices, analyzing and resolving insurance or financial issues, running and submitting reports
Maintaining a daily tracking record of case progress summaries and statuses, releasing case status to client upon request and attending case management conference calls or meetings
Assess daily referral paperwork for completeness and accuracy, request and obtain missing information in a timely manner
Set up cases to track their progress until properly finalized and approved to be scheduled
Pre-vet cases by phone with patients, guardians, conservators, and/or social workers including but not limited to conducting a demographic intake, completing a full medical history and discussing our program attributes via patient orientation
Contact insurance companies to obtain benefits and perform a thorough insurance verification process for the benefits
Conduct monthly eligibility checks on the 1st of every month for all active cases
Request authorization submission to team members and confirm submission to insurance payors
Follow up on authorization submission with health plans and IPAs until received
Prepare, send and obtain pre-admit forms to patients for signature prior to date of surgery
Upload documents to accounts such as signed forms, insurance card, letters of guardianship, notices, correspondence accordingly to case files etc.
Review authorization replies to ensure CPT codes were authorized properly. If denied, determine approach and strategy for timely implementation
Research in-network options for care, track data and file grievances with the member and their health plan, document details in the case notes
Collect deposits for PPO/HMO/EPO cases, document in the notes and upload receipts
Collect cash payments for cases without a benefit option based
Insert notes into EMR for each case with details related to progress on finalizing the case, status updates, follow up calls, contact details
Assign reason codes to each case based on the status of the case at any given step of the way; indicate case status notes including reference numbers, contact name and phone number
Assist referral office team and schedule approved cases on the LIVE schedule by date of service
Participate in team conference calls to discuss case issues and analyze outcomes for case strategy
Contact designated referral office staff to assist in the processing of their referred cases
Run weekly reports for case status to share with the referral office for their reference and scheduling; review case status and work report to finalize cases
Maintain daily case status log for tracking progress and quantifying tasks completed each day for the practice
Meet or exceed timelines associated with finalizing cases properly for scheduling
Communicate effectively and often with client, administrator and team about issues with cases and provide solutions
Be readily available via phone, text or email to discuss case situations, challenges or problems
Accept and learn from constructive direction and criticism with regards to decision making and case processing
Interact with patient/parent/guardian for the good of establishing a relationship to promote and ensure the program requirements are maintained
Please respond by sending your resume with relevant experience in Medical Administrative/Intake/Preauthorizations/Billing with contact information so that a phone and personal interview can be conducted. Spanish and Arabic speaking is a plus.
Job Types: Full-time, Contract
Pay: Up to $30.00 per hour
Schedule:

Monday to Friday
Weekend availability

COVID-19 considerations:Remote position
Experience:

healthcare: 5 years (Preferred)
Administrative: 5 years (Preferred)

Language:

Spanish or Arabic (Preferred)

Work Location: Remote

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Post Tags : , Los Angeles County, CA, jobs in Los Angeles County, CA, Administrative Outpatient Case Manager-Work From Home jobs in Los Angeles County, CA

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