SUMMARY: In support of Managed Care Case Management perform the duties of triaging daily referral requests for all Commercial, MMAI, and Medicare Advantage plans for skilled care stays for all facilities. Insures all required information is provided before handing off to Case Managers. Performs insurance verifications for commercial plans as well as plan benefits verifications for all referrals.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Primary liaison between marketing liaisons, facilities admissions and MCO Case Management for new referrals and readmissions.


• Communicates and maintains effective working relationships with marketing teams, facility contacts, and case management team as relates to referral process.


• Performs review of referral requests for completeness of information and determines when ready to move to a case manager for preauthorization.


• Perform benefit verifications...