Administrative Assistant

Full-time

Under the direct supervision of the Enrollment Supervisor and in collaboration with the Care Management Team and Community Care Manager RN, the Administrative Assistant will be responsible for the timely processing, documenting, and follow up of Care Management documentation in accordance with the Community Based Care Management program.

To succeed in this role, the Administrative Assistant should have excellent

time management and communication skills, as he / she will collaborate with patients, family members / caregivers, internal teams, and external teams to deliver results.

Essential Functions of the Job :

  • Receives notification of interest for Community Based Care Management program enrollment from Toll-Free number, Transition of Care documentation, referral form, fax line, e-mail, mail, and / or external facilities.
  • Checks Community Based Care Management program eligibility requirements.
  • Tracks, monitors, and reviews program availability or waitlist status for potential participants.
  • Assigns a Care Management Team to the potential participant, schedules the initial assessment, and keeps track of upcoming appointments.
  • Requests / receives participant records from Primary Care Provider (PCP) or works with the potential participant or their circle of support to establish a PCP.
  • Requests / receives participant documentation from DHCS.
  • Obtains Community Based Care Management program documentation from DHCS via phone, writing, or electronic media. In addition, follows-up on missing documentation to obtain enrollment approval or scheduling when appropriate.
  • Responds to inquiries as to current status of authorization by assessing the request and evaluating the circumstances to provide the correct information.
  • Reviews, tracks, and monitor Medi-Cal and Community Based Care Management program continued eligibility for enrolled patients and service providers.
  • Files, uploads, and keeps up to date assigned patient files.
  • Uses various computer systems to obtain information, schedule appointments, query information, and obtain patient documentation.
  • Provides data entry and report generation as needed.

Additional Duties and Responsibilities :

  • Maintains established departmental policies and procedures, objectives quality assurance programs, safely, environmental and infection control standards.
  • Enhances professional growth and development through participation in educational programs, current literature, in-service meetings and workshops.
  • Attends meetings as required and participates in committees as directed.
  • Performs other related duties as assigned or requested.

Job Requirements :

Education Required (Minimum level of education) : High school diploma or GED equivalent.

Certifications / Licenses Required : CA drivers license with appropriate insurance coverage

Experience Preferred (Minimum level of experience) : A minimum of 1 year experience in healthcare setting to include front with back office or referral authorization knowledge of programs and health plans eligibility and guidelines.

Medical Assistant Certificate or Business Office Administration Certificate in lieu of experience.

Verbal and Written Skills Required to Perform the Job : Good verbal and written communication skills.

Technical Knowledge and Skills Required to Perform the Job : Medical terminology and basic computer. Typing of 35 wpm. Ability to handle multiple activities simultaneously.

Be attentive to patient needs and concerns. Willing to work with others as a team member.

Equipment Used : Personal computer, Nextgen, FAX, additional software, as required.

Working Conditions and Physical Requirements : Prolonged sitting position, walking, constant telephone communication.

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