Case Management Specialist ( Healthcare )

Tenderness Health Care; Milwaukee (WI); On-site; USD 29,000 - 32,000; Full time

Benefits offered by this job

401(k)

Health insurance

Dental insurance

Vision insurance

Life insurance

Paid time off

Paid holidays

Growth opportunities

Training & development

Team environment

Career growth

A+ work culture

Job summary

Tenderness Health Care in Milwaukee is seeking a Bilingual Case Management Specialist to coordinate documentation, plans of care, and service authorizations. You will interact with clients, physicians, nurses, and internal teams to ensure timely processing and accurate records.

The role demands strong organization, attention to detail, confidentiality, and bilingual English/Spanish communication in a fast-paced healthcare setting.

Qualifications

• High school diploma or equivalent required.
• Bilingual English/Spanish required.
• Strong written and verbal communication in English and Spanish.
• Ability to maintain confidentiality per HIPAA.

Responsibilities

• Coordinate patient documentation, service authorizations and Plans of Care.
• Manage electronic health records and ensure accuracy and timeliness.
• Coordinate nursing assessments and documentation with care teams.
• Prepare and track authorizations, recertifications and renewals.
• Maintain professional communication with clients, physicians and internal staff.
• Protect patient confidentiality and adhere to HIPAA policies.

Skills

Bilingual English/Spanish

Documentation coordination

Healthcare professionalism

HIPAA compliance

Multitasking

Attention to detail

Education

High school diploma or equivalent

Job description

Bilingual Case Management Specialist

Tenderness Health Care | Milwaukee

Full-Time

Office locations:

• Milwaukee — 823 S Layton Blvd, Milwaukee, WI 53215
• Shorewood — 3569 N Oakland Ave, Suite B, Shorewood, WI 53211

For more than 15 years, Tenderness Health Care has been committed to providing quality care while building a workplace where employees feel valued, respected, and supported.

As we continue to experience rapid growth and expand our healthcare services, we are creating new opportunities for talented professionals who want to grow with us.

We are looking for an A+ team player who takes pride in their work, values teamwork and accountability, and is excited to build a long-term career with an established and growing healthcare organization.

At Tenderness, your work matters, your contributions are appreciated, and there is opportunity to grow as we grow.

Position Summary:

The Bilingual Case Management Specialist is responsible for coordinating medical documentation, client records, service authorizations, Plans of Care, recertifications, and communication among clients, physicians, nurses, insurance entities, and internal departments.

This position helps ensure required documentation is complete, accurate, properly maintained, and processed within required timeframes to reduce delays or interruptions in services.

The ideal candidate is highly organized, detail-oriented, comfortable working in a healthcare environment, and able to manage multiple time-sensitive responsibilities while maintaining professionalism and confidentiality.

Client & Medical Documentation Coordination:

• Communicate professionally with clients, physicians, medical offices, nurses, and internal departments regarding documentation and processing updates
• Coordinate with nursing staff regarding assessments, medical documentation, and administrative service requirements
• Request medical records from physician offices, clinics, schools, and other appropriate entities
• Maintain consistent follow-up until required documentation is received
• Review received records for completeness and required administrative information
• Identify documentation relevant to authorization and service-processing requirements
• Escalate clinical questions or determinations to the appropriate licensed clinical staff
• Verify physician information, insurance information, and other required client information through approved systems
• Scan, upload, organize, and maintain medical documentation within the electronic health record
• Ensure documentation is associated with the correct client record

Electronic Health Records:

• Complete accurate data entry into applicable healthcare systems
• Maintain current client demographic, insurance, physician, and service information
• Upload medical records, assessments, authorizations, Plans of Care, and supporting documentation
• Review electronic records for missing, outdated, or incomplete documentation
• Follow up with appropriate team members regarding outstanding items
• Maintain organized records to support authorizations, recertifications, audits, and ongoing service delivery
• Help ensure documentation is processed according to internal timelines and applicable program requirements

Nursing & Assessment Coordination:

• Request RN assessments when required
• Coordinate with nursing staff regarding pending assessments and documentation
• Track completion of nursing assessments
• Enter information from completed nursing assessments into approved systems or forms as directed, without changing clinical findings
• Follow up regarding incomplete or outstanding documentation
• Assist with coordinating documentation for new clients, amendments, recertifications, and service changes
• Escalate clinical documentation questions to the appropriate licensed nurse or clinical supervisor

Plan of Care Processing:

• Prepare and process Plans of Care and related documentation based on approved clinical and authorization information
• Ensure Plans of Care accurately reflect information provided by appropriate clinical and authorization sources
• Route Plans of Care for required clinical review and signatures
• Track outstanding physician signatures and follow up as needed
• Upload completed Plans of Care into the appropriate electronic record
• Monitor Plan of Care effective dates and renewal requirements
• Maintain accurate documentation related to Plan of Care processing

Authorizations & Recertifications:

• Assist with preparing and submitting authorization-related documentation
• Track pending authorizations and follow up on outstanding requests
• Monitor authorization effective dates, expiration dates, and approved services
• Coordinate required documentation for recertifications
• Track recertification deadlines and initiate administrative follow-up in advance
• Communicate missing documentation to clients, physicians, nurses, or internal departments as appropriate
• Help prevent service interruptions caused by incomplete or expired administrative documentation
• Maintain detailed notes regarding authorization and recertification activity

Case Management Support:

• Maintain an assigned administrative caseload
• Track clients through applicable documentation, authorization, assessment, and recertification processes
• Provide appropriate status updates to clients and internal teams
• Identify outstanding items and follow through until resolved or appropriately escalated
• Coordinate across departments to help ensure timely processing
• Maintain professional and courteous communication with clients and families
• Protect confidential information and handle protected health information in accordance with HIPAA and company policies

QualificationsRequired

• High school diploma or equivalent
• Bilingual English/Spanish
• Strong written and verbal communication skills in both English and Spanish
• Strong attention to detail and accuracy
• Excellent organizational and time-management skills
• Ability to manage multiple time-sensitive assignments and deadlines
• Ability to communicate professionally with clients, physicians, nurses, insurance representatives, and internal staff
• Comfortable using computers, electronic records, email, web-based systems, and document management
• Ability to maintain confidentiality and appropriately handle protected health information
• Ability to work independently while collaborating effectively with multiple departments

Preferred

• Healthcare administration, medical records, patient services, insurance authorization, home care, or related experience
• Medical Assistant training, certification, or related healthcare education preferred
• Experience working with electronic health records
• Knowledge of medical terminology and healthcare documentation
• Experience with Medicaid, managed care, or insurance authorization processes
• Familiarity with personal care or home care services
• Experience with Plans of Care, recertifications, or medical-record coordination
• Experience managing an administrative healthcare caseload

We are looking for a Team Player:

• Wants to grow with an established and rapidly expanding healthcare organization
• Takes ownership of their responsibilities
• Pays close attention to detail
• Follows through until tasks are completed
• Does not allow important items to fall through the cracks
• Communicates proactively and professionally
• Is comfortable following up persistently when documentation is outstanding
• Supports coworkers and contributes to a positive team environment
• Is organized and able to manage multiple deadlines
• Looks for ways to improve processes
• Takes pride in accurate, high-quality work
• Values accountability, teamwork, respect, and continuous improvement

Benefits we and What we offer

• 401(k)
• Health insurance
• Dental insurance
• Vision insurance
• Life insurance
• Paid time off
• Paid holidays, where applicable
• Opportunities for professional growth and advancement
• Training and professional development opportunities
• Exposure to multiple areas of healthcare administration, case management, and patient services
• Supportive and collaborative team environment
• Leadership that values initiative, accountability, and continuous improvement
• Opportunity to contribute ideas and help improve company processes
• Opportunity to grow alongside an organization experiencing rapid growth and expansion
• An A+ work culture focused on respect, teamwork, accountability, excellence, and continuous improvement
• A workplace where your work matters and your contributions are valued and appreciated

Work Location

In person – Milwaukee, Wisconsin

Pay:

$21.00 - $23.00 per hour

Expected hours:

40.0 per week

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance
• Work Location: In person