Description
We are seeking a Care Manager to join our team. As a Care Manager, you will be responsible for contacting insurance companies to obtain correct eligibility information, perform benefit investigations, copay assistance and check prior authorization and/or appeal status.
Responsibilities:
- Perform outbound calls to obtain appropriate information and document accurately
- Answer in-bound calls and assist customers with pharmacy related services
- Maintain strict professionalism in all communication methods while providing efficient, courteous, and friendly service
- Contact insurance companies for benefit investigation and coverage eligibility
- Provide prior authorizations and appeals support
- Assist patients with the enrollment process for manufacturer and non-profit organization copay assistance programs
- Update job knowledge by participating in educational opportunities and training activities
- Work efficiently both individually and within a team to accomplish required tasks
- Maintain and improve quality results by adhering to standards and guidelines by meeting quality standards set forth by program KPI's
- Report ADE's according to program policy and guidelines
- Adhere to all HIPAA guidelines
Requirements:
- High School Diploma or equivalent
- Minimum one year experience in medical billing, reimbursement, insurance verification, or similar related medical office experience
- Previous data entry experience (minimum three months) and ability to type 30wpm+
- Able to demonstrate high attention to detail in work
- Must be computer savvy, to include navigating multiple computer tabs, monitors, and applications
- Advanced ability/knowledge of all Microsoft Suite programs (Teams, Word, Excel, Outlook, etc.) and soft phone systems (WebEx, Mitel, Shoretel, etc.)
- Exceptional communication skills, both written and verbal
- Able to work in a virtual team environment by being available and responsive during working hours
- Excellent follow through
- Employees must have a private workspace free of distraction to adhere to HIPAA compliance/guidelines
- Workspace must include internet plug-in accessibility. Wi-fi connectivity is not permitted
- Must reside in country where the job is posted
Preferred Qualifications:
- Some College
- Bilingual Spanish - English
- Previous experience in Patient Support Services (Hub)
- Previous Customer Service experience in the healthcare field
This is a remote position. The potential base pay range for this role is $22.00 - $23.00 per hour.