Patient Case Manager

Description

Patient Case Manager

AICA Winder & Gainesville

Drive Case Success Through Systematic Execution

AICA Orthopedics seeks a Patient Case Manager to ensure optimal patient outcomes and case value through systematic execution of comprehensive case management protocols across our 21-location network.

Core Responsibilities

Case Documentation & Management

• Secure police reports within 72 hours and coverage limits within 60 days to maximize case value
• Execute company-approved checklists to collect comprehensive case information and prevent coverage gaps
• Track care plan compliance against AICA clinical pathways using dashboards to ensure maximum medical improvement
• Maintain accurate documentation meeting Georgia medical record requirements for audit protection

Internal Stakeholder Coordination

• Conduct care reviews with Clinic Directors, Practice Managers, and Corporate Case Management teams
• Coordinate with Verification Department to determine patient financial responsibility and prevent billing issues
• Collaborate with Front Desk teams to collect payments prior to service delivery
• Provide case status reports and financial summaries to clinic leadership for decision-making

Patient Care & External Relations

• Coordinate patient flow across your assigned clinic locations to minimize treatment delays and ensure completion
• Maintain professional relationships with attorney representatives and third-party stakeholders
• Facilitate patient financial discussions and payment arrangements to remove care barriers
• Ensure compliant communication with legal counsel while protecting patient privacy

Success Metrics

• 95%+ completion of required case documentation checklist items
• 72-hour/60-day targets for police reports and coverage limits
• 85%+ treatment completion rates through systematic care coordination
• 100% compliance with training and regulatory certifications

Required Qualifications

• 1-3 years Personal Injury case management experience with systematic case tracking
• Medical office experience preferred with insurance verification and patient coordination
• Microsoft Office/Excel proficiency for reporting and case tracking
• Strong organizational skills for managing multiple cases and deadlines
• Professional communication with internal teams, patients, and legal stakeholders

Georgia Compliance Requirements

• Georgia healthcare compliance certification within 90 days
• HIPAA privacy training with annual recertification
• Professional ethics training for attorney communication boundaries
• Quarterly compliance assessments with corrective action as needed

Technology & Systems

• NextGen EHR for patient records and case tracking
• Excel for dashboard analysis and reporting
• Case management platforms for systematic information organization

Career Development & Benefits

• Growth opportunities: Senior Case Manager, Team Lead, Clinical Operations roles
• Professional development: Advanced certification support and healthcare training
• Comprehensive benefits: Medical, dental, vision, 401(k) match, professional development fund
• Mentorship program with experienced case management professionals

Ready to drive case success through systematic execution? Join AICA and make a measurable impact on patient outcomes across Atlanta's premier orthopedic network!

Requirements

Required Qualifications 

1-3 years of Personal Injury case management experience with systematic case tracking 

Medical office experience preferred with insurance verification and patient coordination 

Microsoft Office/Excel proficiency for reporting and case tracking 

Strong organizational skills for managing multiple cases and deadlines 

Professional communication with internal teams, patients, and legal stakeholders 

Georgia Compliance Requirements 

Georgia healthcare compliance certification within 90 days 

HIPAA privacy training with annual recertification 

Professional ethics training for attorney communication boundaries 

Quarterly compliance assessments with corrective action as needed