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Your Job
The Case Manager will have an innate ability to provide outstanding customer service to both the patients, families and referral sources. You will be responsible for part B authorizations.
Your Qualifications
• Experience in long-term or acute.
• Experience in case management or disease management.
Your Responsibilities
•Responsible for the management of therapy Part B authorizations
•Responsible for ensuring the continuity of care utilizing the appropriate resources within the parameters of established contracts and resident health plan benefits
•Attains prior authorization for Part B therapy services as directed
•Alert appropriate management team members regarding late or missing documents required for authorization approval
•Provide excellent customer service to patients, families and referral sources
•Ensure the members are receiving treatment from the therapy department that is clinically appropriate
•Direct line of communication to external insurance Case Managers
•Complete daily tracking log with updated status of authorization through approval
•Continued follow up with the Insurance/Medicaid representatives until request approved/denied
•Request and obtain continued authorizations while member is receiving therapy
•Submit initial therapy evaluations, doctor’s order and therapy notes to external Insurance/Medicaid providers within 24 hours
•Communication of authorization approvals and denials to management team
•Adhere to professional standards as outlined by protocols, rules and regulations
•Performs any miscellaneous work assignments as may be required
•Able to analyze various types of data reports
Outfield Healthcare Partners provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
Full Time
$80k-97k (estimate)
05/27/2023
05/03/2024
opcoca.com
Los Angeles, CA
<25
The job skills required for Case Manager include Case Management, Customer Service, etc. Having related job skills and expertise will give you an advantage when applying to be a Case Manager. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Case Manager. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Case Manager positions, which can be used as a reference in future career path planning. As a Case Manager, it can be promoted into senior positions as a Case Management Director that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Case Manager. You can explore the career advancement for a Case Manager below and select your interested title to get hiring information.