Company :

Job Description :

GENERAL OVERVIEW:

This role is responsible for expediting discharges across AHN hospitals by partnering with case management, nursing and other clinicians. This role is also responsible for validating/verifying insurance status and type for all patients requiring transfer into/around AHN network.

ESSENTIAL RESPONSIBILITIES

• Utilize EPIC tools/dashboards to prioritize patients, review charts and work to eliminate barriers to expedite discharges. (25%)
• Evaluates patient progress and its impact on resource consumption and identifying, intervening and expediting determinants which may adversely affect the appropriate utilization of health care services across the continuum including but limited to working with discharge transport to prioritize patients for discharge. (25%)
• Verify insurance information through payor contacts via telephone, online resources, or electronic verification system. Provides appropriate documentation and follow up to department leaders. (25%)
• Promote transparency of the discharge process, progress to the discharge plan and works to identify improvements to the discharge process ultimately aiming to reduce existing silos. Coordinates open communication lines across campuses, including but not limited to clinicians, families, the Transfer Center and external stakeholders. (25%)
• Additional duties as assigned
  

QUALIFICATIONS:

Minimum

• Associate's Degree in Social Work, Nursing, Care Management, Education, Healthcare Related Field - OR - 3 years of related experience
• People-oriented with excellent communication skills as they will be required to interact daily with diverse people
• Maintain a level of professionalism when interacting with all clients and staff.
• Excellent computer, communication, and organizational skills
  

Preferred

• Bachelor's Degree in Social Work, Nursing, Care Management, Education, Healthcare Related Field
• Experience in an acute hospital setting, home care, skilled facility, rehabilitation facility, or direct discharge planning form a medical setting
• Experience doing discharge planning
• Experience verifying/validating patient medical insurance coverage
• Licensed Social Worker, LPN, or RN
  

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

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