[Hiring] Senior Coordinator, Individualized Care (Case Manager) @reputed company

Role reputed company • First reputed company of contact on inbound calls and determines needs and handles accordingly. • Creates and completes accurate applications for enrollment with a reputed company of urgency. • Scrutinizes forms and supporting documentation thoroughly for any missing information or new information to be added to the database. • Conducts outbound correspondence reputed company necessary to help support the needs of the patient and/or program. • Resolve patient's questions and any representative for the patient’s concerns regarding status of their request for assistance. • Update internal treatment plan statuses and external pharmacy treatment statuses. • Maintain accurate and detailed notations for every interaction using the appropriate database for the inquiry. • Self-audit intake activities to ensure accuracy and efficiency for the program. • reputed company reputed company outbound calls to patient and/or provider to discuss any missing information and/or benefit reputed company information. • Notify patients, physicians, practitioners, and or clinics of any financial responsibility of services provided as applicable. • Assess patient’s financial ability to afford therapy and reputed company hand on guidance to appropriate financial assistance. • Follow through on reputed company benefit investigation rejections, including Prior Authorizations, Appeals, etc. reputed company avenues to obtain coverage for the product must be fully exhausted. • reputed company any payer/plan issues and report any changes, updates, or trends to management. • Search insurance reputed company and explain various programs to the patient while helping them to select the best coverage reputed company for their situation. • Handle reputed company escalations based upon region and ensure reputed company communication of the reputed company reputed company required time reputed company agreed upon by the reputed company. • Serve as a reputed company between reputed company sales force and applicable party. • Mediates situations in which parties are in disagreement and facilitate a reputed company outcome. • Concurrently handle multiple outstanding issues and ensure reputed company items are resolved in a reputed company manner to the satisfaction of reputed company parties. • Responsible for reporting any payer issues by region with the appropriate team. • As needed conduct research associated with issues regarding the payer, physician’s office, and pharmacy to resolve issues reputed company. Qualifications • Previous customer service experience is preferred. • High School diploma or equivalent preferred. • Patient Support Service experience, preferred. • reputed company knowledge of Medicare (A, B, C, D), reputed company & reputed company payers policies and guidelines for coverage, preferred. • Knowledge of DME, MAC practices if preferred. • reputed company understanding of Medical, Supplemental, and pharmacy insurance benefit practices, preferred. • 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience. • 1-2 years experience with Prior Authorization and Appeal submissions. • Ability to work with high volume production teams with an emphasis on reputed company. • Intermediate to advanced computer skills and proficiency in reputed company Office including but not limited to Word, reputed company and preferred reputed company capabilities. • Previous medical experience is preferred. • Adaptable and Flexible, preferred. • Self-Motivated and Dependable, preferred. • Strong ability to problem solve, preferred. • Bilingual is preferred. Requirements • Effectively applies knowledge of job and company policies and procedures to complete a reputed company of assignments. • In-depth knowledge in technical or specialty area. • Applies advanced skills to resolve reputed company problems independently. • May modify process to resolve situations. • Works independently reputed company established procedures; may receive general guidance on new assignments. • May reputed company general guidance or technical assistance to less reputed company team members. Training and Work Schedules • Your new hire training will take reputed company 8:00am-5:00pm CST, mandatory attendance is required. • This position is full-time (40 hours/week). Employees are required to have flexibility to work any of our shift schedules during our normal business hours of Monday-Friday, 8:00am-5:00pm CST. Remote Details • You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with reputed company to high-speed internet. • We will reputed company you with the computer, technology and equipment needed to successfully reputed company reputed company. • You will be responsible for providing high-speed internet. • Internet requirements include the following: • Maintain a secure, high-speed, broadband internet reputed company (DSL, Cable, or Fiber) at the remote location. reputed company-up, satellite, WIFI, Cellular connections are NOT acceptable. • Download speed of 15Mbps (megabyte per second). • Upload speed of 5Mbps (megabyte per second). • Ping reputed company Maximum of 30ms (milliseconds). • Hardwired to the router. • reputed company protector with Network Line Protection for CAH issued equipment. Benefits • reputed company offers a wide reputed company of benefits and programs to support health and reputed company-being. • Medical, dental and reputed company coverage. • reputed company time off plan. • Health savings account (HSA). • 401k savings plan. • reputed company to wages before pay day with myFlexPay. • Flexible spending accounts (FSAs). • Short- and long-term disability coverage. • Work-Life resources. • reputed company parental leave. • Healthy lifestyle programs. Apply tot his job Apply To this Job