Case Manager

  • Location
    Lewisville , Texas
  • Category
    Medical & Science - Administration
  • Job type

Role: Case Manager
Pay: $17.00/hour
Location of Assignment (address): Lewisville TX
Total Weekly Hours: 40
Shift: 8-5 M-F
Length: 3 months

Description of Work:
We are a trusted partner to pharmaceutical manufacturers, healthcare providers and patients—working together to ensure access to and successful completion of prescribed therapy.

The Case Manager supports patient access to therapy through Reimbursement Support Services in accordance with the program business rules. This position is responsible for guiding the patient through the various process steps of their patient journey to therapy. These steps include patient referral intake, investigating all patient health insurance benefits, and proactively following up with various partners including the insurance payers, specialty pharmacies, support organizations, and the patient/physician to facilitate coverage and dispense of product in a timely manner.

• Prioritize assignments and work with a sense of urgency
• Investigate and resolve patient/physician inquiries and concerns in a timely manner
• Mediate effective resolution for complex payer/pharmacy issues toward a positive outcome to de-escalate
• Must be able to manage multiple concurrent assignments.
• Must communicate clearly and effectively in both a written and verbal format
• Proactive follow-up with various contacts to ensure patient access to therapy

Key Characteristics
• Adaptable and Flexible
• Self-Motivated and Dependable
• Problem Solving
• Strong customer support skills
• Team Spirited
• Punctual and Efficient
• Great work attitude

• Experience conducting and documenting patient health insurance benefit investigations, prior authorizations, and appeals is a must
• Knowledge of Medicare, Medicaid and Commercially insured payer common practices and policies is a must
• Knowledge of the Health Insurance Market Place and the Affordable Care Act preferred
• Knowledge of ICD9/ICD10 coding is preferred
• Critical and creative thinking is a must
• Important to have a strong attention to detail

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Reference number US_EN_2_022862_397512