1140 Management jobs in Prattville

At Diversicare, we're more than just a company we're a passionate community dedicated to caregiving excellence. If you're driven by a desire to make a difference in the lives of patients and residents, then we invite you to be part of our extraordinary team.

Why Choose Diversicare:

• We're Proudly Agency-Free: Unlike other companies, we believe in building a direct connection with our team members, fostering trust, respect, and collaboration.
• Compassion-Driven Culture: At Diversicare, we value trust, respect, customer focus, compassion, diplomacy, appreciation, and strong communication skills. We're committed to creating a warm, caring, safe, and professional environment for both our customers and our team.
• Competitive Benefits: We offer a comprehensive benefits package that includes medical/dental/vision coverage, an excellent 401k plan, tuition reimbursement, vacation, holiday, and sick time, long and short-term disability, and much more.
• Room for Growth: Join a dynamic environment where you can grow in your career and make a lasting impact on the healthcare industry.
• Meaningful Mission: Our mission is to "Improve every life we touch by providing exceptional healthcare and exceeding expectations." A mission we truly live and breathe.
• Core Values: We are guided by five core values - Integrity, Excellence, Compassion, Teamwork, and Stewardship, as well as 12 Service Standards.

Responsibilities:

Join Diversicare Healthcare Services as our Health Information Management Coordinator and take charge of our medical records with precision and purpose. Your role involves maintaining accurate and comprehensive active medical records, conducting clinical record audits, and educating our team on Electronic Health Records. As an essential part of our compliance efforts, you'll ensure that we meet all privacy regulations, fostering a culture of awareness and understanding in line with state and federal laws.

Key Responsibilities:

1. Closely oversees and audits medical records for new admissions/readmissions and maintains the clinical record throughout the resident's entire stay within the center.
2. Oversees the transcription of physician's orders for completeness and accuracy.
3. Communicates with the company IT Department and is the center representative regarding electronic equipment and/or repair need(s).
4. Provides education of team members on the Electronic Health Record upon hire and as needed.
5. Active participant in center's Quality Improvement Program Committee, Clinical Start Up, Daily Business Meetings, Care Management Meeting, and any other area which benefits from the findings of record review activities.
6. Audits records for omissions/discrepancies and initiates and participates in follow-up involving the relevant Department Head/Managers, Licensed Nurses and provides review results to center Administrator and Quality Improvement Process Committee for improvement opportunities as necessary.
7. Maintains electronic and hybrid clinical records for all patients/residents in an organized manner.
8. Upholds the confidentiality of the patient/resident records to protect the sensitive information contained within.
9. Managing and retrieving patient/resident records and release to authorized company personnel only.
10. Reviews resident clinical records to verify established core data record set contains, at minimum, resident identifiable information, demographic information, diagnosis, treatment, and results of treatment.
11. Maintains separate files for active, thinned and discharged resident hybrid records in an organized fashion, for security and ease of retrieval.
12. Within 24 hours (or upon return from weekend, holidays or afterhours) of resident discharge or death, retrieves all records; initiates the process of placing hybrid record files in order and reviews electronic and hybrid records for completeness; routes deficient findings to appropriate staff member with follow-up to ensure completeness of records; reports deficient findings to the center Administrator.
13. Addresses requests for clinical records and submits to the Corporate Compliance department within a timely manner while maintaining records confidentiality.
14. Oversight of storage and destruction of records, according to the Record Retention/Destruction processes, and maintains log of destroyed records.
15. Participates in the center's Denials Management processes and is actively involved in records review with retrieval of supporting documentation as necessary.

Qualifications:

• Proficient in electronic health records and health information systems/applications.
• Ability to compile, interpret and utilize statistical and clinical data.
• Knowledgeable of legal aspects of documentation and medical terminology.
• Knowledgeable of regulatory and compliance practices, specific to state and federal requirements, related to health information.
• Knowledgeable of privacy and security regulations related to confidentiality, access, and release of information practices.
• Basic working knowledge of International Classification of Diseases (ICD-10) coding processes and maintains skills related to future updated classification systems versions.

Diversicare is committed to being an equal opportunity employer. Diversicare does not discriminate in employment opportunities or practices on the basis of race, color, religion, sex (including gender identity), national origin, age, or disability, sexual orientation, citizenship, marital status, veteran status, genetic information, or any other characteristic protected by law. (EOE)

Job ID Type Regular Full-Time Location Montgomery Nursing & Rehab Center Address 2020 North Country Club Dr Location US-AL-Montgomery

• Provide enrollment assistance and guidance to Medicaid-eligible recipients and their families regarding the HIPP / Premium Assistance program via phone or correspondence.
• Verify, document, and investigate existing health coverage for Medicaid recipients and their dependents (employer plans, COBRA, etc.).
• Assist in identifying members who may qualify for HIPP / Premium Assistance.
• Obtain and verify documents required for eligibility: insurance policies, employment verification, premium invoices, etc.
• Maintain active case files during open enrollment cycles, premium review, and payment processing.
• Process, review, and follow up on premium payments / reimbursements, ensuring timely and accurate payments, and tracking any discrepancies.
• Perform ongoing case maintenance and audits, updating records for status changes, renewals, terminations, or escalations.
• Complete periodic reporting (e.g. case metrics, enrollment trends, audit reports) as required by state or internal stakeholders.
• Respond to high volumes of inbound and outbound calls and inquiries about eligibility, coverage, program rules, and status.
• Conduct advanced document review, legal research or case escalation as needed, particularly on more complex cases.
• Prioritize case events, manage deadlines, escalate issues to supervisors or subject matter experts when appropriate.
• Ensure strict adherence to HIPAA privacy and security standards when handling protected health information (PHI).
• Follow Medicaid, federal, and Alabama-specific HIPP / premium assistance rules, policies, and procedures.
• Support internal or external audits, submitting documentation and explanations for case decisions.
• Participate in training, quality assurance, and performance improvement programs related to case management operations.
• Coordinate with state Medicaid agency staff, other internal teams, employers, insurers, and service providers as needed.
• Liaise with internal audit, legal, compliance, and escalation teams to resolve disputes or complicated cases.
• Provide feedback or suggestions to improve processes, workflows, policies, or system tools.

• At least 2 years of experience in health insurance, Medicaid, public health programs, or government-sponsored programs (or equivalent experience).
• At least 2 years call center / phone-based experience (inbound and outbound) making inquiries, responding to recipients.
• Strong customer service, written and verbal communication skills
• Excellent organizational, detail orientation, and ability to work under deadlines
• Ability to analyze data, apply logical reasoning, and make informed decisions
• Proficiency in Microsoft Word, Excel, and familiarity navigating web-based systems or internal tools
• Working knowledge of HIPAA privacy/security and handling of sensitive data
• Ability to handle stress, prioritize competing tasks, and escalate appropriately
• Professional demeanor, interpersonal skills, adaptability
• Experience specifically with HIPP, premium assistance, Medicaid or health insurance programs preferred
• Call center / high-volume case operations experience preferred
• Bilingual (especially in languages common in the region) preferred
• Familiarity with health care / insurance terminology preferred
• Previous experience with auditing, compliance, or fraud waste abuse program work preferred