Description:
Position Summary:
Care Manager responsibilities will vary by program and its lifecycle. Care Manager’s may be responsible for contacting insurance companies to obtain correct eligibility information, perform benefit investigations, copay assistance and check prior authorization and/or appeal status. Care managers may also be responsible for directly contacting patients and/or providers to evaluate eligibility for assistance programs and/or varied adherence support. This is a remote position.
Primary Responsibilities:
Responsible for all inbound and outbound phone calls to patients and providers.Responsible for single point of contact communication with providers and patients in a designated geographical area
Contact insurance companies to perform appropriate benefit investigation(s) and coverage eligibility for client product only
If applicable, assist with the prior authorizations with specific attention to detail and accuracy with provided information.
Assist patients with the enrollment process for manufacturer and non-profit organization copay assistance programs
Provide courteous, friendly, professional and efficient service to internal and external customers including physicians and patients.
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 and recommending improved procedures
Eligibility authorization and enrollment into Patient Assistance Program(s)
Ability to verify insurance requirements to support current billing processes
Demonstrate a firm grasp of medical billing processes communicating knowledge to internal and external customers
Identifying and providing corrective action for medical billing reimbursement support specifically to provider offices
Required Qualifications:
High School Diploma or equivalent, some college preferred
Minimum two years experience in pharmacy, medical billing, insurance verification, and/or similar related healthcare experience; must include work with J-code and/or HCPCS
Customer Service experience
Healthcare experience
Preferred Qualifications:
Previous experience in Patient Support Services (Hub)
Previous Customer Service experience in the healthcare field
Bilingual
Professional Competencies:
Business Skills and Knowledge• General Management
Demonstrate analytic and problem solving skills, and understand the impact of individual
decisions on other parts of the organization and the environment.
• Quality improvement
Application of techniques that continually improve the quality of care provided, patient
safety, organizational performance, and the financial health of the organization.
Knowledge of the Health Care Environment• Health Care Systems and Organizations
Demonstrate an understanding of how the various components of the health care
system is organized and financed, and how they interact to deliver medical and health
care.
• The Patient’s Perspective
Understand the patient experience, demonstrate a commitment to patients’ rights and
responsibilities, and ensure that the organization provides a safe environment for
patients and their families.
Communication and Relationship Management• Relationship Management
The ability to build and maintain relationships with internal as well as external
stakeholders that are anchored in trust and where decision-making is shared.
• Communication Skills
Be able to utilize verbal, written and presentation skills to communicate an
organization’s mission, vision, values and priorities to diverse audiences.
Professionalism• The ability to align personal and organizational conduct with ethical and professional standards
that include a responsibility to the patient and community, a service orientation, and a
commitment to lifelong learning and improvement.
Skills:
insurance verification, prior authorization, medical insurance, Call center
Top Skills Details:
insurance verification,prior authorization,medical insurance
Additional Skills & Qualifications:
High School Diploma or equivalent, some college preferred
Minimum one year experience in medical billing, 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
This is a remote position. 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.
Experience Level:
Expert Level
About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
We are an equal opportunity employers and will consider all applications without regard to race, genetic information, sex, age, color, religion, national origin, veteran status, disability or any other characteristic protected by law. To view the EEO is the law poster click here. Applicants with disabilities that require an accommodation or assistance a position, please call 888-472-3411 or email [email protected]. This is a dedicated line designed exclusively to assist job seekers whose disability prevents them from being able to apply online. Messages left for other purposes will not receive a response.