Managed Care Case Manager

Touch Support

1d•Remote

About The Position

Touch Support, a multinational Business Process Optimization company, is rapidly expanding its finance and support teams. We are seeking a motivated, detail-oriented individual in Mexico to join our team as a Managed Care Case Manager. With over 350 employees across the US and Europe and a proven track record of successful remote onboarding, we are excited to offer this long-term opportunity to talented professionals like you.

Requirements

2–4 years of experience as an RN, LPN, USRN, or Healthcare Virtual Assistant with clinical nursing education.
Knowledge of US healthcare insurance, Medicare Advantage, Medicaid MCOs, commercial payors, and criteria such as InterQual/MCG is a plus.
Experience with PointClickCare, MatrixCare, Availity, NaviHealth, or similar systems.
Strong English communication, organization, attention to detail, and time-management skills.
Ability to manage high-volume authorization workflows independently.

Responsibilities

Manage pre-admission and prior authorizations with MCOs, Medicare Advantage, and commercial insurers.
Conduct concurrent reviews and clinical chart audits to support continued stays.
Track authorizations, length of stay, and expiration dates to prevent coverage gaps and lost revenue.
Communicate with insurance case managers, medical directors, and facility clinical teams.
Support Peer-to-Peer reviews and appeals when coverage is denied.
Coordinate with intake, nursing, social work, and billing teams.
Maintain accurate authorization records in the EHR.
Provide weekend/high-volume coverage and ensure smooth team handoffs.