Case Coordinator

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Primary liaison between marketing liaisons, facilities admissions and MCO Case Management for new referrals and readmissions.
• Communicates and maintains effective working relationships with marketing teams, facility contacts, and case management team as relates to referral process.
• Performs review of referral requests for completeness of information and determines when ready to move to a case manager for preauthorization.
• Performs benefit verifications on all referrals adhering to appropriate processes.
• Able to hold facilities accountable to adhere to the process for referrals to case management of MCO cases.
• Maintain / Close out Manage Care Referral Log.
• Assistant to Case Management Consultant - Obtaining Auth, communication with communities, and communication with insurance companies.

QUALIFICATIONS

• College Degree is Preferred
• Experience working in a skilled nursing facility
• Understanding of how claims are paid under Commercial and Medicare Advantage plans for skilled services
• 2 years working with MCO insurance experience is preferred
• Self-Starter and results orientated personality
• Strong organizational, planning and problem-solving skills
• Able to work multiple tasks before a task is completed
• Understanding of the differences in types of insurance that is taken at a skilled nursing facility
• Working understanding of Medicare rules as it is applied to a skilled nursing facility