Case Manager at TEKsystems
Jeffersonville, IN 47129
About the Job
Description:
A typical day in the life of a Case Manager will include the following:
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
Qualifications:
- Healthcare experience required
- Bilingual is a plus (in Spanish or Chinese/Mandarin)
- Must have availability to train for the first 8 weeks on an 8:30am - 5:00pm schedule
- Ability to work on-site in Jeffersonville, IN
- Medical terminology
- 6 months of payer benefits experience (reimbursement, prior auth, etc), healthcare industry experience or healthcare related experience is required
- 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
For Contract to Hire and Contract Roles:
- Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
- Medical, dental & vision
- Critical Illness, Accident, and Hospital
- 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
- Life Insurance (Voluntary Life & AD&D for the employee and dependents)
- Short and long-term disability
- Health Spending Account (HSA)
- Transportation benefits
- Employee Assistance Program
- Time Off/Leave (PTO, Vacation or Sick Leave)
Experience Level:
Entry Level
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.