Remote Healthcare Appeals & Access Case Manager

PRO-spectus; United States; Remote; USD 55,000 - 74,000; Full time

Benefits offered by this job

Employee Ownership Program

401(k) with employer matching

Paid time off

Job summary

PRO-spectus is seeking a Case Manager for Healthcare Appeals & Patient Access Advocacy. This remote role coordinates case workflows across payors, providers, and patients to expedite access to care while securing payment channels.

You will interpret medical documentation, prepare authorization submissions, and collaborate with interdisciplinary teams to resolve complex cases. Ideal candidates will have a healthcare or medical insurance background, strong communication, and the ability to manage

Qualifications

• Clear and thorough written and verbal communication with stakeholders.
• Ability to coordinate multiple priorities and deliverables.
• Experience managing caseloads independently in healthcare or insurance contexts.

Responsibilities

• Serve as single point of contact among internal team, client, providers, payor, facility and patient as needed.
• Support cases through approval/denial with urgency while maintaining accuracy.
• Coordinate efforts with Payor, Reimbursement, Clinical teams and client sales/MSL to ensure complete cases.
• Identify trends impacting business processes and share with management.
• Provide resources to patients for financial assistance and transportation.

Skills

Communication

Time management

Critical thinking

Problem solving

Empathy

Adaptability

Education

Bachelor's or Associate Degree

Job description

PRO-spectus is seeking a Case Manager for Healthcare Appeals & Patient Access Advocacy. This remote role coordinates case workflows across payors, providers, and patients to expedite access to care while securing payment channels.

You will interpret medical documentation, prepare authorization submissions, and collaborate with interdisciplinary teams to resolve complex cases. Ideal candidates will have a healthcare or medical insurance background, strong communication, and the ability to manage