Remote Managed Care Referral Coordinator

Aperion Care Corporate; Lincolnwood (IL); Remote; USD 60,000 - 75,000; Full time

Job summary

Aperion Care Corporate is seeking a Remote Managed Care Case Management support professional to triage daily referral requests for Commercial, MMAI, and Medicare Advantage plans. The role includes insurance verifications, plan benefits checks, and coordinating with facilities and case management teams.

Ideal candidates have SNF experience, familiarity with Medicare/Commercial plans, and strong organizational skills.

Qualifications

• Experience working in a skilled nursing facility.
• Understanding of how claims are paid under Commercial and Medicare Advantage plans for skilled services.
• 2 years working with MCO insurance experience is preferred.
• Self-starter with results-oriented mindset.
• Strong organizational, planning and problem-solving skills.
• Able to work multiple tasks before a task is completed.
• Understanding of differences in insurance types at a skilled nursing facility.
• Working understanding of Medicare rules as applied to SNF.

Responsibilities

• Liaise between marketing liaisons, facilities admissions and MCO Case Management for new referrals and readmissions.
• Maintain effective relationships with marketing teams, facility contacts and case management for referrals.
• Review referral requests for completeness and readiness for preauthorization by a case manager.
• Perform benefit verifications on all referrals per process.
• Hold facilities accountable to the referral process for MCO referrals.
• Maintain/Close out Manage Care Referral Log.
• Assist Case Management Consultant with obtaining auth and communicating with communities and insurers.

Skills

Organizational skills

Problem-solving

Multitasking

Communication

Education

College degree preferred

Job description

Aperion Care Corporate is seeking a Remote Managed Care Case Management support professional to triage daily referral requests for Commercial, MMAI, and Medicare Advantage plans. The role includes insurance verifications, plan benefits checks, and coordinating with facilities and case management teams.

Ideal candidates have SNF experience, familiarity with Medicare/Commercial plans, and strong organizational skills.