Genesis is one of the leading providers of healthcare services from short-term to long-term care and a wide variety of living options and professional clinical services. We are changing how care is delivered by bringing together people like you -- passionate, highly skilled and motivated to make a difference.
Combine your clinical interest and administrative skills as a Clinical Reimbursement Administrative Assistant. In this role, you will coordinate case management in a nursing center. This includes telephone, fax and e-mail communication, typing, data entry, and electronic submission of records to the various managed care organizations.
Position Highlights *Collaborate with the clinical team to obtain information necessary to ensure timely submission of concurrent reviews and subsequent authorizations for all managed care patients. *Review Pre-Admission Review (PAR) and IRM Pre-Authorization assessment to identify costly treatments, supplies or services. *Confer with the clinical team to negotiate appropriate continuation of length of stay or extension of services and appropriate Level of Care (what is covered/what is not covered) and associated rates. *Obtain payor authorization for recommended treatments, procedures, supplies, equipment and medications and all exclusions. *Communicate contract terms for patient's stay to the interdisciplinary team to include the level of care, length of service, utilization of services, inclusions and exclusions, revenue per day, network providers and rehabilitation treatments. *Monitor patient cases throughout stay to ensure utilization of services are in accordance with plan of care and minimize financial risk to patient and center. *Identify overuse of resources such as rehabilitation therapy, diagnostic studies, non- formulary medications and medical supplies. *Alert the interdisciplinary team regarding the last covered day of service for patients/residents. *Assist the interdisciplinary team with patient/resident discharge/transition by ensuring network providers are known and securing all appropriate authorizations. *Manage relationships with third party payers ensuring timely responses.
Why Genesis? We improve the lives we touch through the delivery of high-quality healthcare and everyday compassion!

• We Care Deeply about YOU! Guided by our Core Values, Code of Conduct and Ethics program, we foster a culture of care and compassion. We focus on improving the quality of care through creativity and innovation, honesty and integrity in all we do. *We Develop YOU! We provide career ladders, education and training opportunities so you can build a long and successful career with Genesis. *We Appreciate YOU! We value your contributions to the Genesis mission and vision and instill an environment of teamwork and enjoyment in working together. We recognize and celebrate our shared successes. *We are Committed to YOU! We know you are the vital link between Genesis, our patients and residents! We inspire you to be your best self.

SHAREAACR
Qualifications: *High school degree with college/business school coursework is required. *Experience with medical terminology is preferred. *Prior experience in utilization review, case management or discharge planning is required. *Must be proficient in Microsoft office products. *Strong organization skills are required. To protect the health and safety of our patients, residents, employees, family members, and the communities we serve, Genesis has implemented a universal COVID-19 vaccination requirement for employees, care partners and onsite vendors.
Position Type: Full Time
Requisition Number: 436448
Pay Target:
High School Degree Required