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Emory Healthcare/Emory University Case Management Associate in Decatur, Georgia


We are looking for a candidate with insurance experience.


JOB DESCRIPTION: Supports the mission of the Division of Care Coordination which is to provide safe, effective and timely transitions of care. Assists the social workers with discharge planning tasks, referral management and all other clerical tasks necessary to obtain post-acute care services for patients. Communicates with social workers to obtain necessary information to effect timely discharges. Assists with arrangement of post-acute care services which can include: Home Health, Durable Medical Equipment, Sub Acute Rehab, Hospice Outpatient Dialysis, and post discharge transportation. Updates all referral information frequently to ensure provider awareness of patient clinical status. Collaborates with insurance case managers to request authorizations for post-acute services. Assists with preparation of discharge packets that accompany patients to Skilled Nursing, Subacute, and Acute Rehab Facilities. Assists in arranging post discharge calls to patients and providers and refers or escalate to appropriate disciplines if additional follow up is needed. CMS Regulatory requirements include delivery of Medicare Outpatient Observation Notice (MOON) and the Medicare Important Message IMM). In addition, Case Management Associate should be comfortable directly interfacing with physicians, nurses, other members of the care team as well as patient/families. Must be able to work independently and execute good judgment and critical thinking skills while adhering to Department guidelines, policies and procedures.

MINIMUM QUALIFICATIONS: High School diploma or equivalent preferred. Associate or Bachelor's degree is preferred. At least two years experience in a healthcare setting is required. Knowledge of computer applications necessary. Preference will be given to those with prior experience in discharge planning, utilization review or financial services. Proficiency in medical terminology is preferred. Knowledge of post-acute resources such as Nursing Home, Acute Rehab, Home Health, Durable Medical Equipment, etc. Good communication skills with focus on excellent customer service. Skill and ability to handle multiple priorities and deadlines. Ability to work as a member of a team. Skill and ability in Microsoft office applications. Ability to take initiative and follow through.

PHYSICAL REQUIREMENTS (Medium): 20-50 lbs; 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 50 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.

ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste. Chemicals/gases/fumes/vapors Communicable diseases Electrical shock, Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation, Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.

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Division Emory Decatur Hospital

Campus Location Decatur, GA, 30033

Campus Location US-GA-Decatur

Department DEC-Care Management

Job Type Regular Full-Time

Job Number 97463

Job Category Clerical & Administrative

Schedule 8a-4:30p

Standard Hours 40 Hours

Emory Healthcare is an Equal Employment Opportunity employer committed to providing equal opportunity in all of its employment practices and decisions. Emory Healthcare prohibits discrimination, harassment, and retaliation in employment based on race, color, religion, national origin, sex, sexual orientation, gender identity or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services, veteran status or any other classification protected by applicable federal, state, or local law.