Remote Case Management Assistant - Day Shift (Entry)

Tristar Insurance; South Carolina; Hybrid; USD 24,796 - 30,307; Full time

Job summary

Tristar Insurance is seeking a Case Management Assistant to support case management staff by handling referral setup, answering calls, screening inquiries, and routing communications within the Utilization Review/Case Management system. The role requires independent work, a strong phone demeanor, and excellent customer service in a non‑clinical environment.

The position is full-time with a day shift, remote work, and hourly compensation in the $18.00–$22.00 range.

Qualifications

• High school diploma or GED required; medical or managed-care background preferred.
• One year of experience in a medical or managed-care environment preferred.
• Knowledge of medical terminology and referral criteria is preferred.
• Bilingual English/Spanish is preferred.
• Strong communication and customer-service mindset; team oriented.
• Proficient typing 35–40 wpm; good computer skills.

Responsibilities

• Respond to phone inquiries from providers, patients, case managers, and peer reviewers; route calls appropriately.
• Make initial contact for case management staff and obtain required clinical information from providers.
• Assist with case management workflow and documentation – prepare routine correspondence for case managers, physicians, and patients.
• Identify caller needs and determine next action, including clinic referral or escalation process activation.
• Communicate effectively with case managers, physicians, claims team, and ancillary vendors to ensure accurate, complete patient information.
• Print and mail correspondence according to state rules and regulations.
• Process determinations and correspondence within 24 hours of receipt.
• Monitor dedicated call queues and emails, complete assigned deliverables and billable hours.
• Identify referral trends and communicate findings with management.
• Perform other duties as assigned by the supervisor.

Skills

Communication

Customer service

Bilingual EN/ES

Typing 35–40 wpm

Medical terminology

Education

High School Diploma or GED

Tools

Windows

Outlook

Word

Excel

Job description

Tristar Insurance is seeking a Case Management Assistant to support case management staff by handling referral setup, answering calls, screening inquiries, and routing communications within the Utilization Review/Case Management system. The role requires independent work, a strong phone demeanor, and excellent customer service in a non‑clinical environment.

The position is full-time with a day shift, remote work, and hourly compensation in the $18.00–$22.00 range.