Facilitates arrangements for post-acute services for patient and coordinates requested services for post-discharge.

Education/Experience

• HS Diploma or GED required
• Three (3)+ Hospital and/or Medical Setting experience preferred

Essential Functions

• Participates in daily Care Management Touchpoint with Care Managers, Social Workers, and Utilization Managers.
• Discusses referred cases, including, patient status, barriers to discharge, payer communication, escalations and support needs.
• Reviews insurance coverage updates on all appropriate patients, as assigned.
• Reviews patient census for each service Care Management team, prioritizing communication needs.
• Reviews discharge planning priorities
• Assists Care Management team with administrative support in arranging for discharge of patients including but not limited to durable medical equipment, Home Health, facility referrals and transfers, transportation, and infusions.
• Reviews work list for referrals throughout the day.
• Completes all appropriate documentation for routine referrals and prepares documents for post acute services.
• Documents all discharge planning activities and communications according to department standard
• Provides information required to insurance companies as requested by Utilization Manager or Care Manager or as per policy.
• Communicates and documents authorizations.
• Communicates with Care Manager and Utilization Manager for additional clarification as needed. Determines benefits for post-acute care.
• Completes follow-up on post-acute care authorization.
• Escalates potential barriers to discharge to the Care Manager as identified. Follows escalation process to department leadership.
• Collaborate with Care Manager, Social Worker, and/or utilize estimated discharge report to track discharges. As assigned administers and documents regulatory documents including second Important Message from Medicare (IMM) within two days of discharge , delivers Medicare Outpatient Observation Notice, and Condition Code 44 .
• Completes identified sections of documents as requested by Care Manager and/or Social Worker.
• Sends completed forms from Care Manager and Social Worker to the state for review.
• Monitors status.
• Documents delivery/completion and notifies Care Manager and Social Worker.

SKILLS/QUALIFICATIONS

• Communicates effectively with patient, families, health care team members, and community providers.
• Maintains cooperative working relationship with patient, family, health care team members, and community providers
• Attends and participates in department staff meetings;
• Assists with other duties as assigned by Care Management leadership. Supports Care Managers, Social Workers, and Utilization
• Managers as needed. Identifies Avoidable Delays and notifies Care Manager and/or Social Worker of delay and root cause.
• Completes and transmits other documents as needed.
• Upholds a professional working relationship at all times and adheres to department rules. Practices teamwork and adheres to
• Standards of Behavior.
• Performs other duties as assigned by management.