Want to know if this job is worth applying to?
Roanoke, Virginia, United States
Onsite
The Throughput and Discharge Assistant
Prioritizes daily workflow to support efficient patient throughput and discharge operations, including managing faxes, voicemails, correspondence, and distribution of incoming communications.
Coordinates P2P reviews by scheduling discussions between providers and payors, documenting determinations, communicating authorization decisions, and obtaining required demographic and clinical information.
Supports utilization management and appeals processes by coordinating denial and appeal documentation, communicating with payors, Carilion billing, and care management teams, and assisting with insurance, benefits, and coverage inquiries.
Processes health plan referral requirements, including prior authorizations, denial and appeal activities, and P2P requests related to admissions and patient progression.
Performs federally mandated regulatory activities, including supporting Medicare Important Message (IM), Lifetime Reserve (LTR), Status Change, Code 44, and Notice of Medicare Non-Coverage (NOMNC) workflows. Coordinates required documentation, distributes notifications, and records delivery in the electronic medical record.
Maintains Epic work queues, databases, spreadsheets, and departmental records to ensure accurate tracking, reporting, production, and distribution of utilization management and throughput activities.
Researches and resolves administrative issues affecting patient progression and discharge to facilitate timely care transitions.
Serves as a liaison among payors, providers, billing, patients, and care management staff by responding to inquiries regarding authorizations, approvals, denials, benefits, coverage, and insurance-related matters.
Coordinates the timely collection of required documentation, signatures, and correspondence from internal and external stakeholders to support efficient discharge planning.
Provides administrative support to utilization management physicians, nurses, and care management staff while assisting with departmental workflows and special projects.
Travels between regional facilities and provides virtual and telephonic support across enterprise Care Management locations to meet operational and patient throughput needs.
Maintains confidential records, prepares correspondence, manages office systems and equipment, and utilizes Microsoft Office applications and other software to support departmental operations.
Communicates effectively with leadership, clinical staff, patients, visitors, vendors, and external agencies while maintaining excellent customer service in a fast-paced environment with frequently changing priorities.
Maintains required competencies through continuing education, staff meetings, in-service training, and completion of required certifications.
Education: Associate’s degree or 2 years of experience may be considered in lieu of a degree.
Experience: 2 years of experience in data collection and analysis and/or advanced administrative support required.
Licensure, Certification, and/or Registration: Virginia Managed Long-Term Services and Supports (MLTSS/UAI) Certification required upon completion of orientation and must be maintained throughout employment.
Other Minimum Qualifications: Advanced proficiency with Microsoft Office applications and database or spreadsheet software. Excellent communication, customer service, organizational, and problem-solving skills. Ability to manage multiple priorities, maintain confidentiality, and work effectively in a dynamic healthcare environment.
This job description is intended to be a representative summary of the major responsibilities and accountabilities performed by incumbents in this role. Incumbents may be required to perform job-related tasks other than those specifically presented in this description.
Compensation Range:
$17.39 - $24.35Employee pay is based on a variety of factors, including qualifications, credentials, education, and prior work experience. The compensation range does not include benefits or pension plan.


Recruiter:
DANA JOHNSONRecruiter Email:
dejohnson@carilionclinic.orgFor more information, contact the HR Service Center at 1-800-599-2537.
Carilion Clinic is an Equal Opportunity Employer: We provide equal employment opportunities to all employees and applicants without regard to race, color, religion, sex, national origin, age (40 or older), disability, genetic information, or veterans status. Carilion is a Drug-Free Workplace. For more information or for individuals with disabilities needing special assistance with our online application process contact Carilion HR Service Center at 800-599-2537, 8:00 a.m. to 4:30 p.m., Monday through Friday.
For more information on E-Verify: https://www.carilionclinic.org/eoe-e-verify-and-right-work-policies


Carilion understands the importance of prioritizing your well-being to help you develop and thrive. That’s why we offer a well-rounded benefits package, and many perks and well-being resources to help you live a happy, healthy life – at work and when you’re away.
When you make your tomorrow with us, we’ll enhance your potential to realize the best in yourself. Below are benefits available to you when you join Carilion:
