Assistant Case Manager
Aperion Care · Newport, RI · 2 days ago
On-siteFull-time
Job Summary
Responsibilities
- Schedule and attend resident care plan meetings and send out invitations to family members
- Schedule and attend teleconference meetings with family members of skilled residents, if requested
- Follow up with interdisciplinary team members on non-completed sections of evaluations and forms required for insurance updates
- Retrieve and fax or upload to managed care portal medical records to managed care companies for utilization review purposes
- Track and schedule all certifications and recertification needed for skilled care
- Coordinate with Social Services to issue Medicare Advantage denial letters
- Retrieve and upload medical records to QIO website for any requested appeals
- Assist with compiling medical records and preparing for submission with subsequent level appeals to QIC, ALJ, etc.
- Track and submit all managed care documentation on review dates
- Monitor daily any change in resident status that would impact skilled level of care or discharge and assure managed care company is notified of changes in next review
- Track and submit all managed care documentation on review dates
- Update weekly UR board and attend weekly UR meeting
- Consult with Regional RN Case Manager as needed
- Assist with compiling medical records or other documentation as requested by Curis ADR department
- Scan and upload to PCC all Certs, NOMNCs and SNF ABNs
Qualifications
- Certified nursing assistant or certified Medication tech
- At least 1 year experience in long term care
- Experienced with electronic medical records such as PCC
- Basic knowledge of Microsoft Word and Excel
- Proficient with email and downloading/uploading documents