Remote Benefit Verification/Case Manager

TEKsystems • Houston, TX

65d • $21 - $21

About The Position

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. The information contained herein is intended to be an accurate reflection of the duties and responsibilities of the individuals assigned to this position. They are not intended to be an exhaustive list of the skills and abilities required to do the job. AllCare Plus Pharmacy reserves the right to revise the job or to require that other or different tasks be performed as assigned.

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.

Benefits

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

What This Job Offers

• Number of Employees: 5,001-10,000 employees