case manager.lewisville, texas (remote)posted 5 days ago job detailssummary$19.99 - $20 per hourtemporaryhigh schoolcategoryoffice and administrative support occupations reference AB_5039614 job details Role Overview We are seeking a highly organized Remote Case Manager to support patient access to therapy through Reimbursement Support Services. In this role, you will guide healthcare providers through the patient journey, handling referral intake, health insurance benefit investigations, and prior authorizations while ensuring strict HIPAA compliance. Key Responsibilities Conduct high-volume patient health insurance benefit investigations, prior authorizations, and step therapy reviews. Proactively follow up with insurance payers, specialty pharmacies, and support organizations to facilitate timely therapy coverage and product delivery. Mediate and de-escalate complex payer and pharmacy issues to ensure positive outcomes for patient access. Handle inbound and outbound calls while meeting daily task goals and maintaining strict quality support standards. Apply policies and past practices to resolve routine issues, consulting with senior peers on complex or unusual problems. Qualifications High School Diploma, GED, or equivalent required; additional education preferred. 3-6 years of experience in a related healthcare, insurance, or pharmaceutical field. 1-2 years of hands-on experience conducting patient health insurance benefit investigations, prior authorizations, and appeals highly desired. knowledge of Medicare, Medicaid, commercial payer practices, and the Affordable Care Act. Familiarity with medical/pharmacy billing, coding, and pharmacy benefits management. Excellent written and verbal communication skills with a attention to detail and creative problem-solving abilities.

salary:

$19.99 - $20 per hourshift: Firstwork hours: 8 AM - 5

PMeducation:

High SchoolResponsibilitiesConduct high-volume patient health insurance benefit investigations, prior authorizations, and step therapy reviews. Proactively follow up with insurance payers, specialty pharmacies, and support organizations to facilitate timely therapy coverage and product delivery. Mediate and de-escalate complex payer and pharmacy issues to ensure positive outcomes for patient access. Handle inbound and outbound calls while meeting daily task goals and maintaining strict quality support standards. Apply policies and past practices to resolve routine issues, consulting with senior peers on complex or unusual problems.

Skillsinbound, outboundcustomer supportcall qualityQualificationsYears of experience: 3 yearsExperience level: ExperiencedRandstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

Equal Opportunity Employer:

Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).This posting is open for thirty (30) days. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.