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ResCare Community Living · 15 hours ago

Case Manager - Finance Float

Tukwila, WA

Full-time

Onsite

Entry, Mid Level

$32/hr - $32/hr

2+ years exp

ResCare Community Living is a company focused on providing quality care to clients in need. The Case Manager - Finance Float will be responsible for managing referrals, overseeing pre-screening assessments, and ensuring compliance with company policies while maintaining relationships with referral sources and third-party payers.

Assisted LivingChild CareHealth CareSocial

Diversity & Inclusion

Responsibilities

Receives/responds to incoming calls from referral sources/potential clients and exchanges information to identify the clients' needs and consults with Director of Clinical Management to determine the Company's ability to meet them

Completes all viable referrals by setting up and carrying out pre-screening assessments, completion of pre-screening reports, and preparation of case proposals and other related pre-admission paperwork (i.e., obtains authorization for payment, coordinates availability of an appropriate treatment team)

Oversees, directs and supervises field staff assigned in assisting with pre-screening process

Accesses national/state/company account information, including the account names and terms of contracts or other past payer agreements, as appropriate

Consults with third party representatives regarding client benefit coverage, client financial responsibility, company service authorization and specific reimbursement procedures. Presents company’s services, interprets potential reimbursement options and negotiates reimbursement levels with third party payer

Contacts referral sources to advise them of case acceptance and provides information on the clinical team responsible for client's case

Develops/maintains a working knowledge of all services/resources provided by the Company and services available within the community. Assists in identifying alternative community service sources when company solutions are not appropriate or available

Maintains relationships with standard referral sources and payer case managers. Contacts identified referral sources and seeks referrals as appropriate. Records outcome of calls and keeps the SAR informed

Monitors/tracks referral sources' satisfaction levels, tracks/reports on conversion ratios and provides summary reports to management at requested intervals

Implements/maintains, with the up line management, operational processes to ensure compliance with Company policies, requirements and regulatory mandates

Adheres to and participates in Company’s mandatory HIPAA privacy program/practices and Business Ethics and Compliance programs

Participates in quarterly growth planning meetings/activities including discussions around staffing and recruitment needs

Participates in special projects and performs other duties as assigned