Clinical Case Coordinator

Overview

Summary:The Clinical Case Coordinator assists the Director of Rehabilitation (DOR) for each location in an assigned area with obtaining insurance verification and authorization for treatment of patients. The Clinical Case Coordinator receives patient therapy information from the therapy team and then contacts the insurance companies to receive authorization for therapy services. This position may be a remote position or on-site at the facility reporting to an operations manager as assigned (various by region).

Responsibilities

Essential Duties and Responsibilities:

• Receive patient information and treatment details for patients receiving therapy services not under skilled Medicare A and/or Managed Care A services from therapy team members at assigned locations.
• Contact insurance company either through online sources or by phone to obtain treatment authorization.
• Input insurance details and authorization into the clinical system to ensure proper patient billing.
• Communicate daily with manager and support area to ensure all billing authorization and insurance documentation is completed and entered appropriately.
• Maintain professional customer service relationships with customer employees and therapy team members. Upload completed and continued authorization to the patients’ individual charts in the clinical system (NetHealth, PCC, etc.)
• Maintain appropriate patient records as directed by Reliant’s management of records or electronic files policy.
• Maintain confidentiality of Reliant Rehabilitation, facility, and patient information.
• Must be able to work remotely, when indicated, with minimal supervision and complete all tasks in a timely manner.
• Must conduct self in an ethical, legal, and responsible manner at all times.
• Must adhere to the policies, principles, and guidance within the Team Member Handbook and Code of Conduct.
• Must be able to work scheduled hours as appropriate.
• Attend all mandatory meetings, trainings, and assignments as delegated.
• Perform other duties and responsibilities as assigned.

Qualifications

Competency:To perform the job successfully, an individual should demonstrate the following competencies:

• Strong verbal & written communication skills
• Strong ability to communicate effectively over the phone in a professional manner
• Ability to build strong working relationships with a diverse population.
• Ability to read, write, speak, and comprehend in English: instructions, correspondence, memos, and reports
• Ability to work in a fast-paced, productive work environment.
• Completion of on-the-job training.Education/Experience:
• High School Diploma, GED, or equivalentComputer Skills:
• Proficient knowledge of Microsoft Office (Outlook, Word, Excel, Power Point, etc.)
• Basic Internet navigation skills