What are the responsibilities and job description for the Case Management Assistant position at Loma Linda University Health?
Job Description
Department: UHC: Managed Care
Job Summary: The Case Management Assistant is responsible for assisting with case management in the daily utilization management functions of authorization, referrals, claims analysis, claims payment, data entry and chart review. Demonstrates working knowledge of managed care contract rates, terms, and conditions and accurately identifies member benefits. Cross covers all key areas of utilization management to ensure compliance with regulations. Functions independently with minimal supervision and takes responsibility for professional growth. Performs other duties as needed.
Education and Experience: High School Diploma or GED required. Certificate or degree in business or healthcare field preferred. Minimum two years of experience with a home care agency, medical group, business office or managed care office required.
Knowledge and Skills: Able to keyboard 40 wpm. Able to use a computer, printer, and software programs necessary to the position (e.g., Word, Excel, Outlook, PowerPoint). Operate/troubleshoot basic office equipment required for the position. Able to work calmly and respond courteously when under pressure; collaborate and accept direction. Able to think critically; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; work independently with minimal supervision. Able to distinguish colors as necessary; hear sufficiently for general conversation in person and on the telephone, and identify and distinguish various sounds associated with the workplace; see adequately to read computer screens, and written documents necessary to the position.
Licensures and Certifications: LVN ,MA or Managed Care related national certification preferred. Valid driver's license required at time of hire.
About Us
Our mission is to continue the teaching and healing ministry of Jesus Christ. Our core values are compassion, excellence, humility, integrity, justice, teamwork and wholeness.
About The Team
Loma Linda University Health is a Seventh-day Adventist, faith and values based Christian institution. Candidates must understand and embrace the mission, purpose, and identity of Loma Linda and its affiliated entities.
We are an equal opportunity employer committed to the principles of diversity. We provide equal opportunities in all aspects of the employment process to every individual, regardless of gender, race, color, age, national origin, ancestry, physical or mental disability, marital or veteran status, genetic information or any other characteristic protected by law. In addition, we will provide reasonable accommodations for otherwise qualified individuals requesting an accommodation due to a disability. If you need accommodation assistance with accessing our job listings or completing an application, or during any other phase of employment with us, please contact Human Resources Management at (909) 651-4001.
Loma Linda University Health Care is a religiously-qualified Equal Opportunity Employer under Title VII of Civil Rights Act of 1964. No question on this application is asked for the purpose of unlawfully limiting or excluding any applicant’s consideration for employment because of race, color, religion, gender, age, national origin, disability, genetic information, or any other status protected by applicable law. If you need a reasonable accommodation in the hiring process, please notify Human Resource Management.
We appreciate your interest in Loma Linda and wish you success in your job search!
Department: UHC: Managed Care
Job Summary: The Case Management Assistant is responsible for assisting with case management in the daily utilization management functions of authorization, referrals, claims analysis, claims payment, data entry and chart review. Demonstrates working knowledge of managed care contract rates, terms, and conditions and accurately identifies member benefits. Cross covers all key areas of utilization management to ensure compliance with regulations. Functions independently with minimal supervision and takes responsibility for professional growth. Performs other duties as needed.
Education and Experience: High School Diploma or GED required. Certificate or degree in business or healthcare field preferred. Minimum two years of experience with a home care agency, medical group, business office or managed care office required.
Knowledge and Skills: Able to keyboard 40 wpm. Able to use a computer, printer, and software programs necessary to the position (e.g., Word, Excel, Outlook, PowerPoint). Operate/troubleshoot basic office equipment required for the position. Able to work calmly and respond courteously when under pressure; collaborate and accept direction. Able to think critically; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; work independently with minimal supervision. Able to distinguish colors as necessary; hear sufficiently for general conversation in person and on the telephone, and identify and distinguish various sounds associated with the workplace; see adequately to read computer screens, and written documents necessary to the position.
Licensures and Certifications: LVN ,MA or Managed Care related national certification preferred. Valid driver's license required at time of hire.
About Us
Our mission is to continue the teaching and healing ministry of Jesus Christ. Our core values are compassion, excellence, humility, integrity, justice, teamwork and wholeness.
About The Team
Loma Linda University Health is a Seventh-day Adventist, faith and values based Christian institution. Candidates must understand and embrace the mission, purpose, and identity of Loma Linda and its affiliated entities.
We are an equal opportunity employer committed to the principles of diversity. We provide equal opportunities in all aspects of the employment process to every individual, regardless of gender, race, color, age, national origin, ancestry, physical or mental disability, marital or veteran status, genetic information or any other characteristic protected by law. In addition, we will provide reasonable accommodations for otherwise qualified individuals requesting an accommodation due to a disability. If you need accommodation assistance with accessing our job listings or completing an application, or during any other phase of employment with us, please contact Human Resources Management at (909) 651-4001.
Loma Linda University Health Care is a religiously-qualified Equal Opportunity Employer under Title VII of Civil Rights Act of 1964. No question on this application is asked for the purpose of unlawfully limiting or excluding any applicant’s consideration for employment because of race, color, religion, gender, age, national origin, disability, genetic information, or any other status protected by applicable law. If you need a reasonable accommodation in the hiring process, please notify Human Resource Management.
We appreciate your interest in Loma Linda and wish you success in your job search!