Care Manager – Patient Support Call Center - Remote

Position Summary

Care Managers are responsible for contacting insurance companies to obtain correct eligibility information, perform benefit investigations, copay assistance and check prior authorization and/or appeal status. Responsibilities will vary by program and its lifecycle. Care Managers may also be responsible for directly contacting patients and/or providers to evaluate eligibility for assistance programs and/or varied adherence support. This is a remote position.

Job Responsibilities

• Perform outbound calls to obtain appropriate information and document accurately
• Responsible for answering in-bound calls and assisting customers with pharmacy related services
• Maintain strict professionalism in all communication methods while providing efficient, courteous, and friendly service
• Contact insurance companies for benefit investigation and coverage eligibility
• Provide prior authorizations and appeals support
• Assist patients with the enrollment process for manufacturer and non-profit organization copay assistance programs
• Update job knowledge by participating in educational opportunities and training activities
• Work efficiently both individually and within a team to accomplish required tasks
• Maintain and improve quality results by adhering to standards and guidelines by meeting quality standards set forth by program KPI’s
• Report ADE’s according to program policy and guidelines
• Adhere to all HIPAA guidelines
• May assist with onboarding new employees

Schedule

Must be available for an 8 hour shift between 8am-8pm EST.

Required Qualifications

• High School Diploma or equivalent
• Minimum one year experience in medical billing, reimbursement, insurance verification, or similar related medical office experience
• Previous data entry experience (minimum three months) and ability to type 30wpm+
• Able to demonstrate high attention to detail in work
• Must be computer savvy, to include navigating multiple computer tabs, monitors, and applications
• Advanced ability/knowledge of all Microsoft Suite programs (Teams, Word, Excel, Outlook, etc.) and soft phone systems (WebEx, Mitel, Shoretel, etc.)
• Exceptional communication skills, both written and verbal
• Able to work in a virtual team environment by being available and responsive during working hours
• Excellent follow through
• Employees must have a private workspace free of distraction to adhere to HIPAA compliance/guidelines
• Workspace must include internet plug-in accessibility; Wi-fi connectivity is not permitted
• Must reside in country where the job is posted

Preferred Qualifications

• Some College
• Bilingual Spanish - English
• Previous experience in Patient Support Services (Hub)
• Previous Customer Service experience in the healthcare field