Remote Case Manager

InnoSource Inc.; Greenville (SC); Remote; USD 42,000; Full time

Job summary

A leading healthcare solutions provider seeks a Case Manager in Greenville, SC. In this role, you will utilize your skills to assist patients and coordinate with healthcare providers while ensuring efficient operations. We offer a supportive environment to foster growth and career advancement, with a focus on delivering exceptional patient support.

Benefits

Medical Insurance

Life Insurance

Dental Reimbursement

Opportunity for Advancement

Qualifications

• Experience as a Case Manager in insurance or pharmaceutical industry preferred.
• Knowledge of Medicare, Medicaid, and common payer practices.
• Experience with prior authorization and appeals is highly desired.

Responsibilities

• Handle multiple assignments while ensuring clear documentation.
• Provide guidance to patients and support their program needs.
• Self-audit for accuracy and manage payer-related issues.

Skills

Communication

Customer Support

Problem Solving

Prioritization

Education

High School Diploma

Additional Education Preferred

Tools

Microsoft Excel

Job description

Are you looking to expand your skillsets in the healthcare industry working for a Fortune 100 company? Personalized service and creative solutions executed through a flexible technology platform means providers are more confident in prescribing drugs, patients can more quickly obtain and complete therapy, and manufacturers can directly access more actionable insight than ever before. With all services centralized in our custom-designed facility outside of Dallas, Texas, we help manufacturers rethink how far their products can go.

Key Responsibilities

• Effectively applies knowledge of job and company policies and procedures to complete a variety of assignments
• In-depth knowledge in technical or specialty area
• Applies advanced skills to resolve complex problems independently
• May modify process to resolve situations
• Works independently within established procedures; may receive general guidance on new assignments
• May provide general guidance or technical assistance to less experienced team members
• Demonstrate superior customer support talents
• Prioritize multiple, concurrent assignments and work with a sense of urgency
• Must communicate clearly and effectively in both a written and verbal format
• Conducts outbound calls when necessary to help support the needs of the patient and/or program
• Provides detailed activity notes as to what appropriate action is needed for the Benefit Investigation processing
• Working alongside teammates to best support the needs of the patient population
• Make outbound calls to the patient and/or provider to discuss benefit related information
• Documentation must be clear and accurate and stored in the appropriate sections of the database
• Must self-audit activities to ensure accuracy and efficiency for the program
• Must track any payer/plan issues and report any changes, updates, or trends to management
• Concurrently handle multiple outstanding issues and ensure all items are resolved in a timely manner to the satisfaction of all parties

Requirements

Education and Experience – Case Manager

• Minimum of HS diploma; additional education preferred
• Previous Case Manager experience within insurance or 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
• Intermediate Microsoft skills with specific experience with Excel

Benefits & Pay

• Starting pay rate of $20/hour.
• Monday through Friday schedule that varies between 7 a.m.-7 p.m. Central Standard Time Zone
• Opportunity for advancement and growth
• Generous benefits including medical insurance, life insurance, and dental reimbursement

InnoSource has been Putting Passion to Work for over 25 years. We care about our associates and our clients, and we aim to deliver for both. This means connecting each individual with the best long-term career fit based on unique skills and needs, and guiding you through the process along the way.

Application Assistance

If you are an individual with a disability and need assistance in the application process please contact 614-775-1400 or email [e-mail] .

We are an equal Opportunity Employer – Age / Race / Color / Sex / Sexual Orientation / Gender Identity / Disability / Veteran.