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Case Management Representative

Our Lady of the Lake RMC

This is a Full-time position in Baton Rouge, LA posted July 14, 2021.

The Case Management Rep coordinates the day-to-day operations of Utilization Management by handling all denials and appeals.

Ensures the Clinical Resource Coordinators submit reviews in a timely manner for payers and prepares daily assignments for them..

Serves as the liaison between various departments in the hospital, including HIM, Business Office, physicians’ offices, and Access Services.

Coordinates Medical Management Tracker, denial log, and TQ reports.

Description Minimum Required  
Experience
   
Experience

Education

High School or equivalent
 
Education

Training
   
Training

Special Skills
Prior health insurance experience dealing with denials and appeals strongly preferred  
Special Skills

Licensure
 
 #CB

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