Case Management Coordinator

Job Purpose The Case Management Coordinator supports the operations within required timeframes and collaborates well with all team members in alignment with the organization’s mission and goals. The Case Management Coordinator will perform audits, consolidations, and standardizations of Charge Data Masters (CDM/CGT) and Revenue Integrity workflows. In addition, the Case Management Coordinator will work to improve charge capture accuracy through workflow assessments, coordinating coding reviews, process improvements, and report generation.

Duties & Responsibilities Communicate information thoroughly and compose and distribute daily, weekly, and monthly reporting as needed

Input data into the computer systems accurately relevant to all Case Management activities, Utilization Review and other items managed by the Case Management department

Maintain electronic and manual files of all Case Management activities, process improvement initiatives and results

Forward information to other departments as indicated

Utilize various systems to track and report on departmental activity

Coordinate and provide reports as requested

Manage and review accounts for accuracy and completeness without compromising quality in entering area specific information

Adhere to required timeframes and deadlines for reporting and work requirements

Effectively identify and communicate barriers preventing accurate data entry and report generation to leadership

Manage the Case Management tracking system(s) and reporting functions

Request medical records for retrospective review from Health Information Management

Other duties as assigned

Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards

Understand and comply with Information Security and HIPAA policies and procedures at all times

Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties

Qualifications Highs School diploma or equivalent required

2 years of experience with databases and other spreadsheet reporting software preferred

Experience with Case Management software desired (CarePort/Wellsky/MCG/etc)

Advanced level of Excel proficiency and experience in financial modeling and analysis

Advanced Microsoft PowerPoint and Word skills

Ability to complete tasks with a high degree of accuracy

Strong analytical and problem-solving abilities, with a data-driven approach to decision-making and a focus on continuous improvement

Ability to adapt to a fast-paced and changing environment, managing multiple priorities and deadlines effectively

Proficiency in Microsoft Office Suite

Strong interpersonal skills, ability to communicate well at all levels of the organization

Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses

High level of integrity and dependability with a strong sense of urgency and results oriented

Excellent written and verbal communication skills required

Gracious and welcoming personality for customer service interaction

Working Conditions Occasional travel may be required

May need to work outside of normal business hours on occasion

Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes.

Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.

Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.

Work Environment: The noise level in the work environment is usually minimal.

Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.

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