City/State
Virginia Beach, VA
Work Shift
First (Days)
Overview:
Sentara Health Corporate Office is hiring an Inpatient Case Management Authorization Technician!
Status: Full-Time, permanent position (40 hours)
Standard working hours: 8:00 AM – 5:00 PM EST, Monday–Friday, with rotating weekends (Saturday or Sunday) every 6 weeks. A weekday off is provided when working a weekend day so hours do not exceed 40 per week. With weekend differential. Closed on the 6 major holidays.
Location: Remote in Virginia. There is an available option to report to the office at Sentara Park 1330 in Virginia Beach, VA, if preferred.
Job responsibilities:
The Inpatient Case Management Technician is responsible for assisting the Inpatient Case Manager RN/MSW with required tasks for obtaining pre-authorizations for nursing facilities and inpatient rehab. The ICM Authorization Technician will prepare documents, and referral packets for submission to post-acute facilities and agencies. Submits clinical information electronically using approved software or faxes as necessary for post-acute consideration.
Competencies/Job Duties:
- Provides assistance to the Inpatient Case Management team under the direction of the ICM RN/MSW, or other team member to coordinate referrals and recommendations for post-acute level of care to expedite care.
- Acts as an extension of the ICM RN/MSW, or AA to facilitate referrals for the purpose of expediting patient care to include authorizations.
- Contacts insurance companies to identify in-network agencies to support patient post-acute needs.
- Gathers, takes action on, and maintains Case Management documentation such as referrals, authorizations, Epic lists, etc.
- Provides appropriate communication and ensures all pertinent information is documented in accordance with departmental and regulatory requirements.
Posting Process and Review:
- Demonstrates knowledge of required health information necessary for post-acute consideration.
- Demonstrates knowledge of regulatory considerations related to post-acute placement.
- Demonstrates knowledge of regulatory considerations related to post-acute placement and required delivery timeframes.
- Medical terminology knowledge and insurance/payor experience preferred.
- Strong written and verbal communication skills required.
- Excel and work proficiency preferred.
- Cross-collaboration with interdisciplinary teams at the division level to obtain timely clinical information required for authorization submission.
Education:
- HS – High School Grad or Equivalent REQUIRED
Certification/Licensure:
- None required
Experience:
- Customer Service- 1 year REQUIRED
- Strong written and verbal communication skills REQUIRED
- Prior authorization experience highly preferred
- Medical terminology knowledge and insurance/payor experience preferred.
- Excel and work proficiency preferred.
Sentara Health, an integrated, not-for-profit health care delivery system, celebrates more than 130 years in pursuit of its mission – "we improve health every day." Sentara is one of the largest health systems in the U.S. Mid-Atlantic and Southeast, and among the top 20 largest not-for-profit integrated health systems in the country, with 30,000 employees, 12 hospitals in Virginia and Northeastern North Carolina, and the Sentara Health Plans division which serves more than 1 million members in Virginia and Florida. Sentara is recognized nationally for clinical quality and safety, and is strategically focused on innovation and creating an extraordinary health care experience for our patients and members. Sentara was named to IBM Watson Health's "Top 15 Health Systems" (2021, 2018), and was recognized by Forbes as a "Best Employer for New Grads" (2022), "Best Employer for Veterans" (2022, 2023), and "Best Employer for Women" (2020).
Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.
Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!