Case Manager

Case Manager#26-12567 Dublin, OH Onsite Job Description

• Monitor system accounts for new Patient cases
• Conduct outbound calls to patients to confirm approval/denials of coverage, co-pays and verification of specialty pharmacies dispensing medication(s)
• Contact insurance companies as required to obtain / enter accurate benefit information related to patient coverage
• Mediate effective resolution for complex payer/pharmacy issues toward a positive outcome
• Maintain quality while providing an empathetic and supportive experience to the patients, providers, and physician offices
• Resolve patient's questions and concerns regarding status of their request for assistance
• Enter detailed information into company proprietary software while conversing via telephone
• Steward patient accounts from initial contact through final approval/denial
• Process all patient applications in accordance to set policy, procedures, and PHI compliance
• Works with / provides updates to team members and leadership on patients' cases
• Ability to identify, document and compliantly submit Adverse Events during customer contact or via received documentation
• Conduct research associated with alternative funding / foundations to determine patient eligibility to receive product
• Effectively applies knowledge of job and company policies and procedures to complete a variety of assignments
• Applies advanced skills to resolve complex problems independently
• Works independently within established procedures

Skills:

• Ability to multitask, utilizing specific software programs while speaking with patients and/or healthcare staff.
• Ability to type a minimum of 40 WPM.
• Ability to transcribe (type) accurate notes while speaking to customer.
• Strong Microsoft Products experience required.
• Ability to navigate video conferencing tools such as Microsoft Teams and Zoom.
• Strong video conferencing experience.
• Must have the ability to work via video conferencing as required by leadership.
• Organized with the ability to prioritize multiple, concurrent assignments and work with a sense of urgency
• Exceptional communication skills both verbally and written
• Strong attention-to-detail and quality documentation
• Exceptional, professional verbal communication skills with friendly, empathetic, and patient centric focus
• Independent worker and self-starter with solid time management skills and ability to work with high volume production teams
• Continuous learner with a desire to move into a senior level role
• Solid work-ethic and driven to achieve daily/weekly metrics
• Strict adherence to company attendance policies
• Self-starter with demonstrated initiative, creativity and a willingness to be a team player

REMOTE DETAILS

All U.S. residents are eligible to apply to this position. You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with access to high-speed internet. We will provide you with the computer, technology and equipment needed to successfully perform your job. You will be responsible for providing high-speed internet.

Internet requirements include the following:

Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. Dial-up, satellite, WIFI, Cellular connections are NOT acceptable. Download speed of 15Mbps (megabyte per second)

• Upload speed of 5Mbps (megabyte per second)
• Ping Rate Maximum of 30ms (milliseconds)
• Hardwired to the router
• Surge protector with Network Line Protection for CAH issued equipment Inability to meet these requirements at any time may result in termination of the contract / employment.

Keywords:

Education:

• Minimum of HS diploma; additional education preferred
• Previous healthcare experience with insurance or in pharmaceutical industry, preferred
• Pharmacy benefits management experience preferred with specific knowledge of Medicare, Medicaid and commercially insured payer common practices and policies, preferred
• Previous prior authorization and appeals experience highly desired # of

Positions:

2

Location:

Lewisville, TX 2730

S Edmonds Ln, TX-Lewisville:

Suite 300:

USCentral EEO:

- Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of - Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans