EVERSANA

  • Case Manager

    Job Locations US-MO-Chesterfield
    Job ID
    2019-4476
    # of Openings
    6
    Category
    Patient Support Services
  • Overview

    OUR CULTURAL BELIEFS

    Patient Minded I act with the patient’s best interest in mind.

    Client Delight I own every client experience and its impact on results.

    Take Action I am empowered and empower others to act now.

    Grow Talent I own my development and invest in the development of others.

    Win Together I passionately connect with anyone, anywhere, anytime to achieve results.

    Communication Matters I speak up to create transparent, thoughtful and timely dialogue.

    Own It I hold myself and others accountable for results.

    THE POSITION:

    The Case Manager is responsible for providing reimbursement support to healthcare providers/facilities. They are the liaison between healthcare providers, HUB care teams, and client reimbursement teams. Additionally they are the subject matter expert for the healthcare providers/facilities in regards to patient eligibility, reimbursement, and billing support.

    Responsibilities

    ESSENTIAL DUTIES AND RESPONSIBILITIES:
    Our employees are tasked with delivering excellent business results through the efforts of their teams. These results are achieved by:

      • Provide dedicated, personalized support delivered over the phone and via online portal.
      • Collaborate with health care providers to assist with issues related to enrollments, payments, reimbursements, denials, and appeals
      • Complete benefit verification and assist with prior authorizations
      • Respond to inquiries from healthcare providers and business partners, and follow up on requests in a timely, courteous and professional manner. 
      • Assist healthcare providers with claim submissions and denials.
      • All other duties as assigned

    Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position.

     

    EXPECTIONS OF THE JOB:

    • Complete benefit verifications and report results to healthcare providers and client reimbursement teams
    • Act as the subject matter expert for healthcare providers in regards to medical claim denials
    • Act as the primary point of contact for healthcare providers to obtain complete patient eligibility
    • Assist Program Manager with client reporting requirements
    • Learn, understand and follow all company and client policies and procedures

    The above list reflects the general details necessary to describe the expectations of the position and shall not be construed as the only expectations that may be assigned for the position.

    An individual in this position must be able to successfully perform the expectations listed above.

     

    MINIMUM KNOWLEDGE, SKILLS AND ABILITIES:

    The requirements listed below are representative of the experience, education, knowledge, skill and/or abilities required.

    • High School Diploma and 5 years’ experience or Associate’s Degree and 3 years’ experience in healthcare claim billing and coding.
    • 2 years’ experience in Medicare billing
    • Strong medical reimbursement skills
    • Strong customer service skills
    • Strong oral, written, and interpersonal communication skill
    • Ability to multi task and perform accurate and detail-oriented work
    • Ability to obtain state of Missouri pharmacy technician registration
    • Strong computer skills with a working knowledge of Microsoft Word and Excel 

    Qualifications

    PREFERRED QUALIFICATIONS:

    • Medical coding and billing certificate and or degree
    • Experience in pharmaceutical industry
    • Work experience in an Ambulatory Surgery Center
    • Work experience in a Healthcare Provider office

     

    PHYSICAL/MENTAL DEMANDS AND WORKING ENVIRONMENT:

    The physical and mental requirements along with the work environment characteristics described here are representative of those an individual encounters while performing the essential functions of this position.

    This is a largely sedentary role. While performing the essential functions of this job the employee is regularly required to stand and/or sit for long period of time (up to 90%). Additionally they are regularly required to talk or hear, type and engage in repetitive motion, reach and grasp; occasionally required to lift and/or move up to 25 pounds. The employee is intermittently required to stoop or crouch; push or pull; or kneel. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

    This role requires mental alertness. The employee must regularly communicate both verbally and written; concentrate on tasks; and remember and observe details. The employee must frequently adjust to changes; handle stress and emotions; and think analytically.

    This job operates in a professional office environment. This role routinely uses standard office equipment.

    The noise level in the work environment is usually moderate, with frequent interruptions and multiple demands.

     

    Options

    Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
    Share on your newsfeed

    Need help finding the right job?

    We can recommend jobs specifically for you! Click here to get started.