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Duties & Responsibilities
Provide case management services to patients/families including;
Provide exploration and updating of community resources and procedures, and the dissemination of this information to the Health Social Work Staff including;
Participate in the departmental Continuous Quality Improvement program. Document clinic outcome data and assist in preparing program activity reports.
Assists in assembling data as required during audits.
Function as a clerical support person to other Health Social Work Staff as needed.
Upgrades to all appropriate encounters for patients whom applications are were (Self Pay to Approved Insurance).
Generate unofficial bills for purpose of Financial applications or when SW/UM staff request to submit on a letter of financial responsibility.
Process Community Discount upon request with collaboration from Patient Accounts.
Assist with Redetermination applications.
Maintain appropriate and required records, such as documentation in EMR and monthly departmental statistics.
Using a knowledge of Medicare and Medicaid government regulations, completes statistical and financial modeling to produce cost reports to ensure all possible reimbursement enhancements or opportunities are captured
Completes analysis of new developments and/or proposals in the reimbursement field to determine the financial impact on the health care facility
Gathers data and completes required analysis at the request of outside audit staff during audits by Medicare, Medicaid, and Blue Cross and reports the impact of audit adjustments to management
Assists management in the analysis and development of third party contractual allowances, using financial and statistical modeling
Assists management in the analysis and development of bad debt projections, using financial modeling, for budget forecasting
Assists more senior staff members in the review of existing operating procedures and makes recommendations for the development of settlement data to maximize reimbursement from third party payers
Recommends improvements and modifications to departmental operating procedures to maximize operating efficiency and reimbursement
Completes review and analysis of prior years outstanding cost reports to resolve outstanding issues in conformance with regulations and within the time frame imposed by the federal governments statute of limitations
Provides assistance, by reviewing current and prior years data and other necessary variance explanations, in coordinating the annual financial audit of the health care facility by outside audit firms.
Attends Revenue or Financial Entitlement Committee meetings, conferences, Insurance verification webinar/seminars as instructed and other planning/organizational meetings as requested.
Participates in quality improvement initiatives and assists Director
Other
$78k-100k (estimate)
02/29/2024
05/25/2024
galaxydrill.com
Morristown, NJ
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