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.