The Case Manager Assistant under the direct supervision of the Registered Nurse Case Manager will perform clerical duties to include but not be limited to: issuance of regulatory letters, monitoring of Sfax for authorizations and denials, transference of Medicare primary insurance information to ACM, obtaining insurance authorizations telephonically, answering incoming calls to the department.
- Issue regulatory letters to include: Discharge Important Message from Medicare, MOON, and HOON with documentation of such in AllScripts. Notify RN Case Manager if further explanation to the patient is needed.
- Monitor Sfax for insurance authorizations. Transfer fax to the appropriate RN Case Manager’s Sfax folder.
- Monitor Sfax for insurance denials. Transfer fax to the appropriate RN Case Manager’s Sfax folder and notify that RN Case Manager of the denial verbally or telephonically.
- Transfer PFM Medicare eligibility note from PFM to ACM
- Verify initial Important Message from Medicare, HOON, or MOON are properly scanned into SCM and document such in the ACM note.
- Obtain current and retrospective insurance authorizations telephonically and notify the appropriate RN Case Manager
- Answer incoming calls to the department. Transfer calls to the appropriate RN Case Manager’s or Care Coordinator’s phone.
- All other duties as assigned by department