Referral & Case Coordination Specialist

Aperion Care; Lincolnwood (IL); On-site; USD 60,000 - 80,000; Full time

Job summary

Aperion Care in Lincolnwood, IL is seeking an organized Managed Care Case Manager to triage daily referral requests for Commercial, MMAI, and Medicare Advantage plans for skilled care stays. You will verify insurance details and plan benefits, acting as the key liaison among marketing, admissions, and case management teams.

The role requires understanding of Medicare rules in skilled care settings and strong multi-tasking ability. Effective communication with insurers and facilities is essential.

Qualifications

• Experience with Commercial and Medicare Advantage plans and claim processes.
• Skilled nursing facility environment and referral workflows.
• Two years of MCO insurance experience preferred.

Responsibilities

• Triager daily referral requests for Commercial, MMAI, and Medicare Advantage plans for skilled care stays.
• Ensure required information is present before handing off to Case Managers.
• Perform insurance verifications for commercial plans and plan benefits verifications for referrals.
• Serve as liaison between marketing, facilities admissions, and MCO Case Management.
• Review referrals for completeness and readiness for preauthorization.
• Able to maintain and close the Manage Care Referral Log.
• Assist Case Management Consultant with Auth and communications with communities and insurers.

Skills

MCO insurance experience

Organizational skills

Problem solving

Multi-tasking

Self-starter

Communication

Education

College degree

Job description

Aperion Care in Lincolnwood, IL is seeking an organized Managed Care Case Manager to triage daily referral requests for Commercial, MMAI, and Medicare Advantage plans for skilled care stays. You will verify insurance details and plan benefits, acting as the key liaison among marketing, admissions, and case management teams.

The role requires understanding of Medicare rules in skilled care settings and strong multi-tasking ability. Effective communication with insurers and facilities is essential.