Case Manager (Benefit Investigation) Position Available In Fulton, Georgia

Job Description:

Job Title:

Case Manager (Benefit Investigation)

Location:

RemoteBUT schedule is based in CST time zone.

TRAINING

M-F 8:00am-5:00pmCST , mandatory virtual attendance is required. Must attend 100% oftraining and pre-planned appointments/time off will not beaccepted.

Schedule:

Must be able to work any 8hr. shift between7am-7pm CST (as assigned)

Pay:

$20.00/hr.

Benefits:

Health, Dental,Vision, Life Insurance, and short-term disability after 90 days Formore information, please contact Breanna D. directly atbdrollinger@alinestaffing.com Case Manager (Benefit Investigation)Description/Duties

• Manage the entire care process with a sense ofurgency from benefit investigation and verification to medicationdelivery, ensuring an exceptional patient experience
• Conductbenefit verifications and collaborate with various healthcareproviders, including physicians, specialty pharmacies, andinsurance companies, to ensure seamless coordination of patientcare and timely access to necessary services
• Assist in obtaininginsurance, prior authorization, and appeal requirements andoutcomes
• Help patients understand their insurance plan coverage,including out-of-pocket costs, and provide guidance on the appealsprocess if needed
• Resolve patient’s questions and anyrepresentative for the patient’s concerns regarding status of theirrequest for assistance
• Demonstrate expertise in payer landscapesand insurance processes. Remain knowledgeable about long andshort-range changes in the reimbursement environment includingMedicare, Medicaid, Managed Care, and Commercial medical andpharmacy plans while planning for various scenarios that may impactprescribed products
• Process enrollments via fax, phone, andelectronically as needed
• Scrutinize forms and supportingdocumentation thoroughly for any missing information or newinformation to be added to the database
• Support inbound phone quefrom patients, healthcare provider offices, SPs, and customers,striving for one-call resolution