What are the responsibilities and job description for the Social Services Case Manager position at Excel Care?
Position Overview
Excelcare Health Management is seeking a detail-oriented and reliable Admissions and Insurance Coordinator, to support our skilled nursing facility’s case management operations. This position is vital to coordinating and organizing documentation for insurance updates, appeals, and authorizations. The role requires frequent interaction with the PointClickCare (PCC) system and secure file transmission through eFax.
Benefits:
Health, Dental and Vision Insurance
401k with up to 5% matching
Paid Time Off
Employee-only discounts and perks
Key Responsibilities
Coordinate and facilitate UR for managed care cases
Serve as the point of contact for the insurance companies
Handle, process and follow up on NOMNCS & Appeals
LTC2E/B
Medication carveout requests
VOB & Prior Authorization
Authorization follow up
Daily census audit to ensure correct insurance is selected
Oversee custodial authorizations that are handled by BOM
Submit admit & discharge notice to insurance
Combine files as needed to create complete packets for insurance purposes (PCC & Net Health) - Recurring reviews for NRD
Send documents securely via eFax for updates, appeals, and authorizations
Confirm transmission and follow up on fax deliveries when required
Communicate with insurance representatives and internal staff to clarify and obtain documentation
Maintain compliance with HIPAA and other privacy regulations
Assist with administrative support tasks such as scanning, scheduling, data entry, and filing
Organize and update resident case files with new authorization or insurance materials via outlook shared calendar
Collaborate with interdisciplinary teams to ensure timely and accurate documentation
Qualifications
High school diploma or equivalent required; associate degree preferred
Experience in healthcare administration or case management preferred
Familiarity with PointClickCare (PCC), eFax, and HIPAA-compliant document handling
Strong organizational skills and attention to detail
Ability to manage multiple priorities efficiently
Proficient in Microsoft Office and healthcare-related software
Excellent communication and teamwork skills
About Excelcare Health Management
Excelcare Health Management is committed to delivering high-quality care to our residents and supporting our staff with efficient systems and compassionate leadership. This position plays a critical role in ensuring that residents receive timely access to the services they need through proper documentation and insurance coordination.