Care Management Coordinator - PRN

At Cooper University Health Care , our commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols. We have a commitment to our employees to provide competitive rates and compensation programs. Cooper offers full and part-time employees a comprehensive benefits program, including health, dental, vision, life, disability, and retirement. We also provide attractive working conditions and opportunities for career growth through professional development.

Discover why Cooper University Health Care is the employer of choice in South Jersey.

• Management of all Clinical Review Patient Work Queues including DNB and report out progress on weekly CFB call.
• Management of Livanta Appeal process.
• Assist in denial mitigation and concurrent denials overturned dept goal.
• Collaboration with HCA team to ensure accurate insurance verification and timely notice of admissions.
• Management of daily discharge and maternity communication to payers.
• Accessing and managing insurance portals: Navinet, Availity, PEAR, etc.
• Management of Epic Payer Communication information.
• Processing of daily insurance logs.
• Delivery of Medicare Compliance forms as needed
• Timely management of insurance approvals and denials.
• Scheduling and management of physician peer to peers.
• Trouble shoot delays in inpatient determinations.
• Manage of all incoming correspondence including efax, fax, phone, voice mail, and email communications.
• Accurate EPIC care Management Module data input, staff Epic training, and identification of process improvements.
• Maintain and update department lists, grids, educational materials, and shared drive.
• Field incoming calls and direct to appropriate staff members.
• Additional Administrative duties for the department as assigned: AMION, Kronos.
• Assist with Utilization Management Committee agenda, attendance, and minutes.

0-2 years' experience required.

High School/GED required

Care Management/Case Management/Discharge Planning/UR experience preferred.

Communication Ability to communicate with patients, visitors and coworkers required.

Epic and/or Insurance Portals preferred.