Duties and Responsibilities
Case Management
- Facilitates timely access to care by ensuring patient eligibility and benefits are verified prior to service
- Assess and determine if a patient qualifies for Medicaid or the Federal Marketplace insurance coverage and assists in the application process.
- Works with health plans to obtain coverage for uninsured patients seeking services
- Responsible for correcting denied or rejected eligibility of benefits.
- Assist patients with completing applications for enrollment with Medicaid plans.
- Track Medicaid applications, to ensure completeness and acceptance.
- Update Electronic Health Record (EHR) as required for timely and accurate billing.
- Assist patients with identifying the appropriate Financial Assistance Program that meets their needs.
- Perform client check out review to ensure that no additional information has been provided before claim submission.
- Coordinates care for patients to ensure services are coordinated with facility staff.
- Identifies gaps in service needs in service delivery to the patient, and make recommendations to meet patients’ needs before discharge.
- Collaborates with interdisciplinary treatment team to engage, monitor and communicate with Patient.
- Maintains the clinic record of patient and obtain signatures from patient regarding treatment.
- Documents all services and patient activities in the medical record regarding brief interventions, coordination of care, discharge planning, treatment planning, etc.
- Monitor petition process to ensure timeliness are adhered to, and forms are complete and thorough.
- Attend Court Ordered hearings as required
- Perform other duties as directed by Supervisor
Care Coordination
- Answer incoming calls and assists or transfers calls as necessary to meet requests and document calls
- Maintains standards of conduct that are empowerment-based and nonjudgmental
- Respond to all calls in a professional manner with a tone of calmness, sensitivity, and empathy
- Provide support to Patients in crisis situations with sensitivity and awareness to diversity
- Provides administrative support to clinical team to help with scheduling and referrals
- Coordinates the administrative process for handling petitions.
- Checks petitions for completeness, notarizes petitions, logs the petition and hands off the petition to prescribing Provider for review.
- Monitors medical and clinical timelines of involuntary process and arranges pick up orders with police.
- Documents all efforts made to law enforcement regarding pick up orders.
- Oversees all Court Ordered Evaluations (COE)/Persistently and Acutely Disabled (PAD) detention orders are served and proof is sent to the County Psychiatric Hospital’s legal department within prescribed deadlines.
- Coordinates and oversees bed placement of patient with other facilities
- Maintains the patient board: entering new arrivals, assigns Providers, Nurses, Crisis Workers, and prioritizes arrivals.
- Monitors electronic patient tracking system to ensure that all patient records reflect real time admission status
Knowledge, Skills and Abilities
- Must have patience and good communication skills.
- Adhere to a professional code of ethic and confidentiality.
- Knowledge about A.R.S Title 36 Involuntary Commitment process.
- Recognize the rights of Clients and their families.
- Knowledge of community resources to help meet patient’s recovery needs.
- Knowledge of Medicaid, Medicare, and Commercial insurance.
- Participate in ongoing education and including in-services training
Education, Experience and Qualifications
- A high school diploma or GED
- 1 year experience in a healthcare or behavioral health crisis call center
- 1 year clinical administrative experience
- Public Notary required or the ability to become a notary within the first 90 days
- Must have a current Level 1 Fingerprint Clearance Card,
- Current CPR and First Aid,
- Current negative TB skin or chest X-ray within the last six months