San Juan Regional Medical Center

Creating Life Better Here starts with you. At San Juan Regional Medical Center, we're more than a healthcare provider—we're a values-driven organization dedicated to delivering exceptional care. As a team member, you help fulfill our mission to make life better here for our community.

The Case Management Assistant is entrusted to provide excellent service and set a positive tone for every customer while serving as the liaison between the Case Management team and post-hospital care agencies.

Required Behaviors:

• As you go about fulfilling this mission, your work habits and work relationships should embody SJRMC's values. These values are our culture, our identity as an organization: Sacred Trust, Personal Reverence, Thoughtful Anticipation, Team Accountability and Creative Vitality ask more of us than merely completing some list of tasks. Our values ask for a deeper level of commitment, and what is asked of us we freely give because we believe in our mission.

Required Qualifications:

• High School diploma or equivalent
• Self-motivated and accountable
• Team-oriented
• Flexibility in schedule to accommodate the needs of SJRMC and the department
• Ability to set and maintain priorities when dealing with multiple demands and interruptions
• Effective communication skills
• Excellent customer service skills and phone etiquette
• Ability to function autonomously
• Experienced in computer programs including Excel and Office

Preferred Qualifications:

• One (1) year experience in healthcare and/or insurance
• Knowledge of insurance and billing requirements
• Understanding of diagnostic and procedural CPT coding
• Medical Terminology

Duties and Responsibilities:

• Arrange post-hospital appointments, including obtaining prior authorization when applicable
• Create and provide calendar itinerary of all post-hospital care appointments and services
• Provide and document CMS forms including but not limited to the Important Message from Medicare, MOON and Patient Choice forms as directed by the RN Case Manager, Social Workers and Case Workers
• Arrange transportation home when necessary and a covered benefit from insurance provider
• Send electronic referrals for post-hospital services and equipment as directed by RN Case Manager
• Verify accurate patient phone numbers to ensure appropriate follow up
• Document actions according to hospital and department standards
• Provide excellent customer service by appropriately greeting and responding to inquiries from teammates, SJRMC staff, physicians' office staff and insurance companies in a timely manner
• Use personal judgement and initiative to develop effective and constructive solutions per established guidelines and policies
• Advocate for patients
• Communicate with the RN Case Manager/Social Worker any barriers encountered to executing the discharge plan
• Maintain knowledge of changing insurance requirements through internal/external training and/or communication
• Complete assigned tasks in a timely manner
• Each employee is responsible for implementing SJRMC’s Service Standards into their daily work:

Safety, Courtesy, Effectiveness, and Stewardship

• Other duties as assigned

Physical Demands and Environmental Work Conditions:

Physical Activities:

• Extended sitting
• Extended talking
• Extended reading
• Extended listening
• Extensive repetitive motions of both hands, such as: wrist/hand movements, grasping, finger dexterity (i.e., typing, writing, faxing, filing, etc.)
• Ability to lift up to fifty (50) pounds

Work Environment:

• The typical noise level will vary from quiet to very loud
• Occasional mild variance in room temperature

Sensory Requirements:

The employee will need adequate ability to:

• See both close and distant objects
• Adjust visual focus

The employee will need adequate ability to hear:

• Human speech, primarily telephone communication
• Verbal instructions