Case Management Regulatory Clerk (Full-Time, Days)

ENL Case Management

Compensation Range

$21.10 - $27.01

Your rate of pay will be based on applicable experience

Shift: Days

Days off: Variable

Hours per pay period: 80

Shift length: 8 Hours

Enloe Health is a Level II Trauma Center located in beautiful Northern California. We offer a full array of medical services, and our mission is to elevate the health of the communities we serve. As a Planetree organization, we place high value on hiring the right team to care for our patients and their families—care that is steeped in compassion, human connection, and mutual support. If you feel called to make a meaningful impact through empathetic, person-centered care, and thrive in a culture that values collaboration and purpose, we welcome you to join our team.

Position Summary

The Case Management Regulatory Clerk (CMRC) functions as a member of the Case Management department. The primary role of the CMRC will be to support Case Management specific compliance with Centers for Medicare and Medicaid Service (CMS) (including Condition of Participation) and Joint Commission in completing the following clerical tasks: One, as per CMS, ensure timely, accurate delivery and documentation of the Admission and Discharge Important Message from Medicare (IMM) letter to all inpatient Medicare and Medicare Advantage Beneficiaries. Two, as per CMS, ensure timely, accurate delivery and documentation of the Medicare Outpatient Observation Notice (MOON) to all outpatient Medicare and Medicare Advantage Beneficiaries. Three, support the CMS hospital Conditions of Participation (CoP) and the Joint Commission requirements that hospitals address regarding patient decisions about care, treatment, and services received at the end of life or if incapacitated by patient screening. The CMRC will possess strong knowledge of regulatory compliance related to delivery of IMM letters, MOONs. and screening for Advanced Directives. In addition, the CMRC will support other Case Management (CM) compliance related matters such as audits for patient choice and timely CM patient assessments. Finally The CMRA will support the clerical needs of the department such as maintaining the department phone line, faxing, emailing, data collection, file management, photocopying, and support the Case Management Assistant (CMA) with any outstanding clerical/regulatory duties.

Minimum

EDUCATION / TRAINING / EXPERIENCE:

• Two-year computer experience including Microsoft Office.
• One-year experience in health care/medical setting OR 2-year degree in human service or healthcare related field
• One-year experience working in an office environment performing general clerical duties to include data collection, data entry, typing, customer relations and filing.
• One year experience in a customer service role

Desired

• Previous experience in healthcare regulatory compliance or another field.
• Experience in EPIC software system

Licenses and Certifications

• None

Skills / Knowledge / Abilities

Must have working knowledge of medical terminology. Demonstrates strong skills in confidentiality and maintain all protected patient information in strict confidence. The CMRA must demonstrate positive, professional, and effective interpersonal relations with patients, public, physicians, and staff and demonstrate the ability to work in a multidisciplinary team environment. The CMRA must demonstrate the ability to communicate with patients and families during time of emotional and physical stress. Must have excellent analytical, grammatical, punctuation, spelling, and formatting skills as are necessary to communicate effectively, both verbally and in writing. Must be self-motivated, flexible, and detail oriented. Demonstrates knowledge of regulatory requirements as outlined by the Centers for Medicare and Medicaid Service (CMS). The CMRC must demonstrate high ethical standards. Must be able to fulfill the essential functions of the position.

Benefits Information

Enloe offers a comprehensive and competitive benefits package to all eligible employees, including, but not limited to:

• $0 premium medical plan to include vision insurance
• Prescription and dental group insurance
• Retirement with employer match
• Generous paid time off (PTO) plan that starts accruing immediately and can be used as it's earned
• Extended Sick Leave
• Flexible Spending Accounts for unreimbursed medical expenses and dependent care
• Employee Assistance Program
• Educational Assistance

Please visit the employee benefits page at http://www.enloe.org/benefits to get more in-depth benefits and coverage information or email ***email_hidden*** to receive a full summary of benefits.