Job Title: Case Management Processor
Pay Range: $24.00 per hour
Temp-to-Permanent - permanent eligible after 13 weeks
Schedule: Full-time, Monday to Friday, 8:30 am - 5:00 pm PST
Location: 100% Remote
Position Overview:
Eligible candidates must live in PST Time Zone. We are seeking a Case Management Processor to join a national Managed Care Organization on a temporary-to-permanent basis. The Case Management Processor will provide non-clinical support to the Case Management team, ensuring that tasks are managed efficiently and that members receive timely and effective care.
Duties and Responsibilities:
- Provide administrative support to the Case Management staff, performing non-clinical activities and assisting in managing department tasks.
- Conduct initial review and triage of Case Management tasks, helping to prioritize case needs.
- Review data to identify key member needs and work under the direction of the Case Manager to implement care plans.
- Screen members using organizational policies and procedures, assisting the clinical team in identifying appropriate medical services.
- Coordinate necessary services based on the member’s benefit plan.
- Foster communication internally and externally to improve the effectiveness of case management services (including communication with healthcare providers and team members).
- Generate and review reports to assist in the coordination of case management activities.
- Provide telephone support, take messages, and research information to support the Case Management team.
- Maintain accurate and complete documentation that complies with risk management, regulatory, and accreditation requirements.
- Ensure the confidentiality of member information in line with company and regulatory standards.
Knowledge, Skills, and Abilities:
- Excellent customer service skills with the ability to coordinate service delivery, paying close attention to member needs and proactively resolving issues.
- Demonstrated ability to effectively communicate and problem-solve while working with diverse individuals.
- Working knowledge of medical terminology and abbreviations.
- Strong analytical and problem-solving skills.
- Strong interpersonal and team collaboration skills.
- High regard for confidential information and adherence to HIPAA compliance.
- Ability to work independently in a fast-paced environment as well as part of a team.
- Proficient in PC usage with experience in a Windows environment and accurate data entry (minimum 40 WPM).
- Ability to establish and maintain positive work relationships with coworkers, clients, members, and providers.
Education and Experience:
- Required Education: High School Diploma or G.E.D.
- Required Experience: 1-3 years of experience in an administrative support role in healthcare.
- MUST LIVE IN CST Time Zone