Job description
Title Case Manager
Type Contract to hire
Pay $22 per hour
Location Robinson Township PA
Responsibilities
Responsible for case management of a territory for the purpose of maintaining relationships with internal and external customers.
Responsible for case pull through, adherence to program service levels, and timely resolution of inquiries and escalations.
What you will do:
Participate in special projects and perform additional duties as required
There may be up to 5% travel
Skills:
INDSEA1
Type Contract to hire
Pay $22 per hour
Location Robinson Township PA
Responsibilities
Responsible for case management of a territory for the purpose of maintaining relationships with internal and external customers.
Responsible for case pull through, adherence to program service levels, and timely resolution of inquiries and escalations.
What you will do:
- Exhibit a leadership role within the assigned territory by managing the Care Coordination process through consistently identifying complex and specific issues and developing action plans accordingly. Demonstrate accountability for action plan execution, and energetically drive for success and results. Balance the needs of individual customers (clients, clinics, field representatives, patients, etc.) with the program's contractual obligations.
- Facilitate program services related to authorization and appeal support through tactical communication with healthcare providers, payers, and patients in order to promote product access.
- Maximize speed to therapy by expediting product access channel fulfillment through use of technology, understanding of the payer landscape, access requirements, and customer preferences.
- Provide claim support by answering medical billing inquires and coordinating payer review of denied or underpaid claims.
- Deliver education and access to financial assistance offerings, including client sponsored copay programs, patient assistance programs, charitable organizations and voucher offers by assessing customer eligibility based on the program guidelines.
- Maintains comprehensive understanding of the reimbursement process, billing/coding requirements, insurance plans, payer trends, and related resources.
- Verify insurance coverage for new patients and re-verify insurance coverage for existing patients.
- Strategically identify training opportunities, contribute to training activities, and create/update program SOPs and other tools as needed.
Participate in special projects and perform additional duties as required
There may be up to 5% travel
Skills:
- Minimum of 1 year, experience in a combination of home care management, case management review, utilization review, social service support, insurance reimbursement and patient advocacy, preferred. Related industry experience, preferred.
- Working knowledge of healthcare, case management, and insurance reimbursement. Knowledge of call center operations with insurance verification and claims expertise. Familiarity with regulatory and organizational requirements, policies and procedures and ensure compliance.
- Ability to become a subject matter expert within the assigned geographic territory. Provide timely and accurate responses to internal and external customers. Skillfully investigate conflicts and utilize problem solving techniques to ensure resolution of complex issues. Independently manage time and priorities. Highly proficient computer skills
INDSEA1
arclintfl.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, arclintfl.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, arclintfl.com is the ideal place to find your next job.