Excellent employment opportunity!
About Us:
CareMore is looking for dynamic individuals to join our team! CareMore is a leading healthcare system specializing in providing a complete, pro-active health care experience to Senior Americans. CareMore strongly believes in our innovative and caring vision to lead the next generation of health care and we look for candidates that share in our passion.
As a leader in senior healthcare for over 20 years, our vision is to significantly improve the lives of Medicare recipients by employing a dedicated staff of professionals who are passionate about changing lives. When you join CareMore, we’ll give you every opportunity to make a real difference.
Live More, Laugh More, CareMore.
NURSE EXTENDER
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Job Description:
The Nurse Extender provides the non-clinical component of all activities within the patient referral process and inpatient case management.
Essential Duties and Responsibilities Include:
- Enter and process patient referrals from Primary Care Physicians (PCP) and/or Specialists’ offices into the computer.
- Check eligibility and/or benefit coverage, correct referral information (i.e., coding and requested services) prior to clinical review.
- Ensure that all required information has been submitted. Contact Physician offices/hospitals to gather this information.
- Automatically authorizes referral requests as outlined in “Automatic Authorizations.”
- Each point of activity in the process requires accurate documentation in EZ Cap.
- Generate Denial, Modification, and Approval letters.
- Initiate telephone calls to patients, physicians, and vendors as directed by Lead Nurse Extender and/or Case Manager.
- Demonstrates ability to locate information accurately and promptly. Recognizes work related problems and contributes to solutions.
- Meet specific deadlines. Responds to variations in daily workload by assigning task priorities according to Department policies and standards.
- Promote positive public relations; displays pleasant, prompt, and courteous telephone manners. Initiate good working relationships with customers (i.e., physicians, offices, and/or staff).
- Perform other duties as assigned.
- Generate Health Provider Reports submit to Quality Management (QM) before distribution for review.
Education and Experience:
- High school diploma or general education degree (GED); or one to three months related experience and/or training; or equivalent combination of education and experience.
- Must have at least two years experience in a managed care delivery system and/or utilization management.
- Knowledge of Utilization Management (UM) patient referral process (i.e., Turn-around-times, eligibility, benefits, and Health Plan regulations and/or guidelines).
Compensation/Benefits:
CareMore offers a comprehensive benefits package to include medical, dental, vision, life, long term disability, flexible spending accounts, 401(k), PTO, and much more.
AA/EOE M/F/D/V
Watch how our CareMore Employees care more, in the video below.
