Case Manager

ICONMA; Brackettville (TX); Remote; USD 40,000 - 60,000; Full time

Job summary

A clinical services company is seeking a Remote Case Manager to oversee patient cases, conduct outbound calls regarding insurance coverage, and resolve payer/pharmacy issues. The role requires excellent communication skills, the ability to multitask, and strong attention to detail. Preferred candidates will have prior healthcare experience and a high school diploma. This position offers health benefits and growth opportunities.

Benefits

Health Benefits

Referral Program

Excellent growth and advancement opportunities

Qualifications

• Exceptional communication skills both verbally and written.
• Strong attention-to-detail and quality documentation.
• Independent worker with solid time management skills.

Responsibilities

• Monitor system accounts for new patient cases.
• Conduct outbound calls to patients regarding coverage.
• Mediate resolution for complex payer/pharmacy issues.

Skills

Multitasking

Typing 40 WPM

Microsoft Products

Video Conferencing Tools

Communication Skills

Attention to Detail

Time Management

Education

High School Diploma

Job description

Our Client, a Clinical company, is looking for a Case Manager for their Remote location.

Responsibilities

• Monitor system accounts for new Patient cases
• Conduct outbound calls to patients to confirm approval/denials of coverage, co-pays and verification of specialty pharmacies dispensing medication(s)
• Contact insurance companies as required to obtain / enter accurate benefit information related to patient coverage
• Mediate effective resolution for complex payer/pharmacy issues toward a positive outcome
• Maintain quality while providing an empathetic and supportive experience to the patients, providers, and physician offices
• Resolve patient's questions and concerns regarding status of their request for assistance
• Enter detailed information into company proprietary software while conversing via telephone
• Steward patient accounts from initial contact through final approval/denial
• Process all patient applications in accordance to set policy, procedures, and PHI compliance
• Works with / provides updates to team members and leadership on patients’ cases
• Ability to identify, document and compliantly submit Adverse Events during customer contact or via received documentation
• Conduct research associated with alternative funding / foundations to determine patient eligibility to receive product
• Effectively applies knowledge of job and company policies and procedures to complete a variety of assignments
• Applies advanced skills to resolve complex problems independently
• Works independently within established procedures

Requirements

• Ability to multitask, utilizing specific software programs while speaking with patients and/or healthcare staff.
• Ability to type a minimum of 40 WPM.
• Ability to transcribe (type) accurate notes while speaking to customer.
• Strong Microsoft Products experience required.
• Ability to navigate video conferencing tools such as Microsoft Teams and Zoom.
• Strong video conferencing experience.
• Must have the ability to work via video conferencing as required by leadership.
• Organized with the ability to prioritize multiple, concurrent assignments and work with a sense of urgency
• Exceptional communication skills both verbally and written
• Strong attention-to-detail and quality documentation
• Exceptional, professional verbal communication skills with friendly, empathetic, and patient centric focus
• Independent worker and self-starter with solid time management skills and ability to work with high volume production teams
• Continuous learner with a desire to move into a senior level role
• Solid work-ethic and driven to achieve daily/weekly metrics
• Strict adherence to company attendance policies
• Self-starter with demonstrated initiative, creativity and a willingness to be a team player
• Minimum of HS diploma; additional education preferred
• Previous healthcare experience with insurance or in pharmaceutical industry, preferred
• Pharmacy benefits management experience preferred with specific knowledge of Medicare, Medicaid and commercially insured payer common practices and policies, preferred
• Previous prior authorization and appeals experience highly desired

Benefits

• Health Benefits
• Referral Program
• Excellent growth and advancement opportunities

As an equal opportunity employer, ICONMA provides an employment environment that supports and encourages the abilities of all persons without regard to race, color, religion, gender, sexual orientation, gender identity or express, ethnicity, national origin, age, disability status, political affiliation, genetics, marital status, protected veteran status, or any other characteristic protected by federal, state, or local laws.