Case Manager - Nationwide

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Requirements:

• Previous customer service experience preferred.
• High School diploma or equivalent preferred.
• Patient Support Service experience preferred.
• Knowledge of Medicare, Medicaid, and Commercial payers preferred.
• 1-2 years of Pharmacy and/or Medical Claims billing and coding experience.
• 1-2 years experience with Prior Authorization and Appeal submissions.
• Intermediate to advanced computer skills, including Microsoft Office proficiency.
• Self-motivated and dependable.
• Strong problem-solving ability.

Responsibilities:

• First point of contact on inbound calls; determines needs and handles accordingly.
• Creates accurate applications for enrollment with urgency.
• Scrutinizes forms for missing information.
• Conducts necessary outbound correspondence.
• Resolves patient inquiries and issues.
• Updates treatment plan statuses.
• Maintains detailed interaction notations.
• Self-audits intake for accuracy.
• Handles multiple issues simultaneously and mediates disagreements.