Care Management Support Specialist - Remote Eligible

Humana, Inc.; Parma Heights (OH); Remote; USD 38,000 - 46,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) retirement savings plan

Paid time off & holidays

Parental & caregiver leave

Disability insurance

Life insurance

Job summary

Humana, Inc. invites applications for the Care Management Support Assistant, supporting care management administration and non-clinical assessment activities. The role reviews referrals, verifies eligibility, and coordinates services with providers to support members’ wellness goals.

It emphasizes confidentiality and patient communication. Remote work option may be available; requires strong customer service, good communication, and familiarity with Medicare/Medicaid requirements.

Qualifications

• 1-3 years Home Health, or Infusion Pharmacy experience is required.
• Wound care/Ostomy supplies experience is preferred.
• Microsoft Office technical experience with Word, Outlook, and Excel is preferred.
• Knowledge of Medicare/Medicaid & commercial insurance is required.
• Experienced with medical authorizations is required.
• Knowledge of medical billing is preferred.
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences
• Excellent customer service and communication skills.

Responsibilities

• Review inbound referrals and correspondence for processing, fulfilment or resolution.
• Screen physician’s orders and documentation to identify required information; request additional information if needed.
• Verify benefits coverage and eligibility for services per Health Plan contract.
• Coordinate delivery of care and services with providers; contact entities, providers and members regarding referral decisions.
• Maintain HIPAA compliance and confidentiality; document patient, physician, referral source and interactions.

Skills

Home Health/Infusion Pharmacy exp.

MS Office (Word/Outlook/Excel)

Medicare/Medicaid knowledge

Medical authorizations

Medical billing knowledge

Customer service & communication

Job description

Humana, Inc. invites applications for the Care Management Support Assistant, supporting care management administration and non-clinical assessment activities. The role reviews referrals, verifies eligibility, and coordinates services with providers to support members’ wellness goals.

It emphasizes confidentiality and patient communication. Remote work option may be available; requires strong customer service, good communication, and familiarity with Medicare/Medicaid requirements.