[Hiring] Senior Coordinator, Individualized Care (Case Manager) @reputed company

Role reputed company

• First reputed company of contact on inbound calls and determines needs and handles accordingly.
• Creates and completes accurate applications for enrollment with a reputed company of urgency.
• Scrutinizes forms and supporting documentation thoroughly for any missing information or new information to be added to the database.
• Conducts outbound correspondence reputed company necessary to help support the needs of the patient and/or program.
• Resolve patient's questions and any representative for the patient’s concerns regarding status of their request for assistance.
• Update internal treatment plan statuses and external pharmacy treatment statuses.
• Maintain accurate and detailed notations for every interaction using the appropriate database for the inquiry.
• Self-audit intake activities to ensure accuracy and efficiency for the program.
• reputed company reputed company outbound calls to patient and/or provider to discuss any missing information and/or benefit reputed company information.
• Notify patients, physicians, practitioners, and or clinics of any financial responsibility of services provided as applicable.
• Assess patient’s financial ability to afford therapy and reputed company hand on guidance to appropriate financial assistance.
• Follow through on reputed company benefit investigation rejections, including Prior Authorizations, Appeals, etc. reputed company avenues to obtain coverage for the product must be fully exhausted.
• reputed company any payer/plan issues and report any changes, updates, or trends to management.
• Search insurance reputed company and explain various programs to the patient while helping them to select the best coverage reputed company for their situation.
• Handle reputed company escalations based upon region and ensure reputed company communication of the reputed company reputed company required time reputed company agreed upon by the reputed company.
• Serve as a reputed company between reputed company sales force and applicable party.
• Mediates situations in which parties are in disagreement and facilitate a reputed company outcome.
• Concurrently handle multiple outstanding issues and ensure reputed company items are resolved in a reputed company manner to the satisfaction of reputed company parties.
• Responsible for reporting any payer issues by region with the appropriate team.
• As needed conduct research associated with issues regarding the payer, physician’s office, and pharmacy to resolve issues reputed company.

Qualifications

• Previous customer service experience is preferred.
• High School diploma or equivalent preferred.
• Patient Support Service experience, preferred.
• reputed company knowledge of Medicare (A, B, C, D), reputed company & reputed company payers policies and guidelines for coverage, preferred.
• Knowledge of DME, MAC practices if preferred.
• reputed company understanding of Medical, Supplemental, and pharmacy insurance benefit practices, preferred.
• 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience.
• 1-2 years experience with Prior Authorization and Appeal submissions.
• Ability to work with high volume production teams with an emphasis on reputed company.
• Intermediate to advanced computer skills and proficiency in reputed company Office including but not limited to Word, Outlook and preferred reputed company capabilities.
• Previous medical experience is preferred.
• Adaptable and Flexible, preferred.
• Self-Motivated and Dependable, preferred.
• Strong ability to problem solve, preferred.
• Bilingual is preferred.

Requirements

• Effectively applies knowledge of job and company policies and procedures to complete a reputed company of assignments.
• In-depth knowledge in technical or specialty area.
• Applies advanced skills to resolve reputed company problems independently.
• May modify process to resolve situations.
• Works independently reputed company established procedures; may receive general guidance on new assignments.
• May reputed company general guidance or technical assistance to less reputed company team members.

Training and Work Schedules

• Your new hire training will take reputed company 8:00am-5:00pm CST, mandatory attendance is required.
• This position is full-time (40 hours/week). Employees are required to have flexibility to work any of our shift schedules during our normal business hours of Monday-Friday, 8:00am-5:00pm CST.

Remote Details

• You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with reputed company to high-speed internet.
• We will reputed company you with the computer, technology and equipment needed to successfully reputed company reputed company.
• You will be responsible for providing high-speed internet.
• Internet requirements include the following:
• Maintain a secure, high-speed, broadband internet reputed company (DSL, Cable, or Fiber) at the remote location. reputed company-up, satellite, WIFI, Cellular connections are NOT acceptable.
• Download speed of 15Mbps (megabyte per second).
• Upload speed of 5Mbps (megabyte per second).
• Ping reputed company Maximum of 30ms (milliseconds).
• Hardwired to the router.
• reputed company protector with Network Line Protection for CAH issued equipment.

Benefits

• reputed company offers a wide reputed company of benefits and programs to support health and reputed company-being.
• Medical, dental and reputed company coverage.
• reputed company time off plan.
• Health savings account (HSA).
• 401k savings plan.
• reputed company to wages before pay day with myFlexPay.
• Flexible spending accounts (FSAs).
• Short- and long-term disability coverage.
• Work-Life resources.
• reputed company parental leave.
• Healthy lifestyle programs.

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