Case Manager at TEKsystems

Case Manager

Location: Jeffersonville, IN 47130

Pay Rate: $19.50-$21/hr

Description:

RELATIONSHIP MANAGEMENT:

- Builds trusted relationships with patients, prescribers, client stakeholders through proactive communication, timely and accurate execution of deliverables and demonstrated relentless passion for helping patients

- Manages all relationships in a manner that adheres to healthcare laws and regulations

COMMUNICATIONS:

- Perform program welcome calls to patients

- Performs post benefits investigations calls to patients and physicians explaining coverage options

- Manages all client inquiries unable to be determined by client through reporting

- Manages HCP inquiries, as applicable, pursuant to business rules

INBOUND CALL MANAGEMENT:

- Manages inbound calls as directed by the program-approved FAQ's

- Triage patients to internal or external resources as appropriate

PERSONALIZED CASE MANAGEMENT

- Provides personalized case management to patients and HCP's including outbound communication to HCP's and patients to communicate benefits coverage and next steps in obtaining coverage

- Leverages electronic tool to identify benefits and payer coverage; completes manual benefit investigations as needed

- Identifies and communicates patients' plan benefit coverage including the need for prior auth, appeal, tier exception, and/or formulary exclusions

- Uses electronic resources to obtain benefit coverage outcome and if needed ,outbound call to payers and healthcare providers to follow up on proper submission/or outcome

Requirements for Case Manager:

- No degree requirement

- Healthcare experience required - unless candidate has bachelors degree & Strong customer service experience/tenure

- Medical terminology - strongly preferred

- 6 months of payer benefits experience (reimbursement, prior auth, etc), healthcare industry experience or healthcare related experience is required

Top Skills' Details:

Healthcare experience

Insurance Verification

Prior Authorization

Customer Service

Additional Qualifications:

- Service minded individuals - focus on recognizing and meeting the needs of others (especially patients and care partners)

- Trouble-shooting and problem solving individuals

- Tough conversations - able to be a patient advocate for patients with high prescription costs

- Ability to handle personal health information with confidentiality

- Commitment to honesty and integrity

- Professionalism and a strong sense of proper business and customer service etiquette

- Clear verbal and written communication skills

- Accountability for results

- Ability to plan and prioritize tasks with close attention to detail

- Positive Attitude

#priorityeast

About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.