Case Manager

Cary, North Carolina

Type: Temporary

Job ID: 7573

Management

Salary: $21.5$0 Per Hour

Posted Date: 07/09/2024

Job Description

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Case Manager  

 

Responsible for providing telephonic patient counseling, nursing intervention with some support to physicians and coordination and delivery of reimbursement and other services related to the patient support programs.

May be responsible for the coordination and delivery of services related to the patient support programs.

Involves interactions with patients, physicians and other health care professionals and members of multidisciplinary team using web based, telephony and face to face means of communication.

 

CAREER LEVEL DESCRIPTION: Demonstrates competence in own area, and is proficient in specific area of discipline. Typically works with moderate guidance in area of knowledge.

 

KNOWLEDGE: Full application of standard policies and procedures. May still be acquiring higher skill level, and gaining exposure to more complex tasks within job function.

 

PROBLEM COMPLEXITY: Provides resolutions to an assortment of problems of moderately complex scope.

Job requires judgment within defined practices and procedures.

MINIMUM EDUCATION & TYPICAL EXPERIENCE OR EQUIV. COMBINATION: Works under normal supervision.

Follows established procedures. Detailed instructions given for new assignments. Work is reviewed for accuracy and overall adequacy. CAREER LEVEL: B2

Insurance background

Key Responsibilities:

  • Process and perform adjudication of specialty pharmacy claims through point of sale functions.
  • Manage assigned queues keeping up-to-date and current on all claims.
  • Serve as a technical resource pertaining to adjudication while identifying areas for improvement.
  • Interact with other teams and function in strict accordance with standard, written procedures, and guidelines.
  • Enter detailed, accurate, and grammatically correct progress notes.

Minimum Requirements

  • 2+ years customer service experience
  • 2+ years medical or insurance industry experience

Critical Skills

  • 5 years experience in the healthcare industry including, but not limited to, Medicare and/or Medicaid program administration, insurance verification and/or claim adjudication, physician’s office or outpatient billing, pharmacy and/or pharmaceutical manufacturers
  • Must be able to analyze reimbursement specific data and prepare written reports for management and client communications.

Additional Knowledge & Skills

  • Excellent communication and organizational skills
  • Strong problem solving and decision making skills
  • Ability to effectively handle multiple priorities within a changing environment
  • Strong Interpersonal skills
  • Strong oral and written communication skills
  • Computer literacy
  • ICD-9, HCPCS, CPT experience •

 

Education:

  • HS Diploma or Equivalent

 

Monday-Friday (anywhere between 8am -8pm ) 8 hour shift, 1 hour lunch
21.50/hr

Hybrid role

Cary, NC

Please send resumes to dmguerra@elitestaffinginc.com

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