Facility: 531 Roselane Street NW

Job Summary:

The Care Transition Assistant reports directly to the Manager of Community Care Transitions with primary responsibility to support the Post-Acute Navigation (PAN) team by initiating/obtaining insurance authorizations timely utilizing effective communication (written and oral) to the PAN team members. Key responsibilities of the role include but are not limited to: verifying patient-eligibility, review of patient medical chart to locate care details as well as reviewing insurance information and determine if any authorization or official confirmation is necessary before services can be provided. As a care transition coordinator, you also perform prior authorization responsibilities, which entail determining if the insurance company covers a given service. Your duties are to compile paperwork related to the patient, assess their eligibility for services, communicate with the insurance provider, and track the progress of a case.

Core Responsibilities and Essential Functions:

a. Obtaining authorizations for placement and treatment in insurance system, Review patient's medical history and insurance coverage for approval, Contact referring PAN/providers for additional information as needed, Complete authorizations and referrals for services, which could include appointments and procedures. a. Identify insurance documents in Trace system and route to appropriate department team member, b. Distribute daily community availability survey, c. Maintain accurate distribution list of community availability, d. Assist with developing specialty service database a. Develop/maintain database of facility/MD NPI numbers, b. Assist with other tasks to support Community Transitions Department as needed Performs other duties as assigned Complies with all Wellstar Health System policies, standards of work, and code of conduct.

Required Minimum Education:

GED Required or High school diploma Required or Associate's Degree Preferred

Required Minimum License(s) and Certification(s):

All certifications are required upon hire unless otherwise stated.

Additional License(s) and Certification(s):

Required Minimum Experience:

Minimum 2 years Some experience in medical billing or insurance authorization Required Minimum 2 years Knowledge of medical terminology Required Minimum 2 years Basic computer skills Required Minimum 1 year Experience with payor portals preferred (Availity, NaviHealth, Carelon/MyNexus, EviCore) Preferred Less than 1 year One year in a healthcare setting Preferred

Required Minimum Skills:

Computer/data entry experience. High Ability to communicate with various members of the health care team. Ability to use EXCEL, Word and have basic computer operational knowledge. Epic EMR experience preferred. Attention to detail. Excellent communication skills. Ability to adapt to a rapidly changing environment/priorities.