Kings County Hospital Center has a rich legacy for its pioneering role in medicine. Today, with over 625 beds, our hospital remains on the cutting edge of technology and provides the most modern procedures with state-of-the-art equipment. Built in 1831 as a one room infirmary for publicly supported care of the sick, Kings County Hospital Center continues to be a leading healthcare facility whose mission is to provide care to everyone regardless of their ability to pay. The hospital provides a wide range of health services, and specialties are offered in all fields of modern medicine. More than 200 clinics provide a wide array of ambulatory care services.

At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons.

Tour II: 9:00AM - 5:00PM

PURPOSE OF POSITION

Consistent with corporate job description: Provides the Care Management Division (CM)- that includes: (Utilization Review (UR), Utilization Management (UM), Care & Case Management Department (CM)), Social Work, and related areas across the care continuum with Clerical supportive services.

AREAS OF RESPONSIBILITIES

Care Management (CM).

SUMMARY OF DUTIES AND RESPONSIBILITIES

Consistent with corporate job description for Assignment Level IV functions: The following are examples of typical tasks:

• Process all correspondence e.g. mail, e-mail, explanation of benefits, end of day reports, in basket messages, faxes and phone calls etc. using Electronic Medical Records (EMR) and other systems including EPIC, AllScripts/CarePort, EDM, OnBase, Scanners, and databases etc.
• Provide information to insurance companies including birth stats, discharge dates, clinical reviews etc.
• Timely directs correspondences to appropriate staff, departments, or agency
• Daily communication with payor representatives to accomplish utilization activities including ascertaining status (Approvals, Denials etc.) determinations of admission and appeals. Document outcomes in designated systems
• Provide immediate communication of urgent correspondence requests to Care Management, Social Work, UR Nurses, Patient Accounts, HIM, UR, etc. for intervention
• Coordinate Peer to Peer process with UR Nurses, Care Managers and Physicians
• Supports UR and denial & appeal activities to ensure payor timeframes are met
• Timely and accurate data entry into OnBase/EDM, and Care Management/UR systems
• Facilitate activities for discharge planning to next level of care (NH, HC, DME, Transportation, Clothing etc.) via EMR and, care management systems (AllScripts etc.)
• Assist in coordinating regulatory activities performed by peer review organizations and external review agencies including discharge notice, patient appeals, and expedited appeals
• Facilitate coordination with Insurance, Patients, Finance, HIM, IT, UR, etc. regarding data transfers, consents, and medical records
• Makes recommendations regarding improvements for quality, increased efficiencies, productivity and cost reduction
• Furnishes information & prepares reports, collects utilization information, data and other related documents, analyses data, and prepares reports as directed
• Checks records for accuracy and conformity to Policy & Procedures
• Performs clerical work in personnel administration, payroll, accounts, budgeting, methods and organization, employee benefits administration, and other administrative and operational areas by processing, recording, checking, and maintaining records, furnishing information and preparing reports
• Assists with time and leave scheduling, daily assignments, and system entry
• Attends meetings and actively participates in PI projects and report preparation
• Trains and orients new staff
• Supervise and instruct staff engaged in clerical activities
• Serves as principal assistant to supervisor; in temporary absence of the supervisor, perform his/her supervisory duties
• Performs clerical work in maintaining and checking various kinds of records
• Assists with preparing and arranging services and activities in connection with receptions and other public functions
• Plans, assigns, and reviews the work of subordinates, and generally responsible for the satisfactory completion of the work performed by staff engaged in clerical activities
• Order supplies including procurement of POs and checks for external appeals
• Employs a high degree of skill in all oral and written communications and personal interactions.
• Uses appropriate resources and methods to resolve conflict with others
• Takes the initiative when interacting with hospital personnel to resolve problem/issues that may not necessarily require the Case Manager/Reviewer intervention
• Formulate and type letters and/or memoranda as necessary to accomplish the aforementioned tasks
• General filing faxing, mailing, communication processing
• Special projects as required, and other general related activities
• System implementation and training
• Participates in special projects and performs other related duties

1. A four-year High School Diploma or its educational equivalent and one year of satisfactory clerical experience.

Skills Requirement:
Keyboard familiarity with the ability to type at a minimum of 100 key strokes (20 words) per minute.

Please be advised that proof of Covid-19 vaccination is required prior to hire.

If you wish to apply for this position, please apply online by clicking the "Apply Now" button

NYC Health and Hospitals offers a competitive benefits package that includes:

• Comprehensive Health Benefits for employees hired to work 20+ hrs. per week
• Retirement Savings and Pension Plans
• Loan Forgiveness Programs for eligible employees
• Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts
• College tuition discounts and professional development opportunities
• Multiple employee discounts programs