Case Manager

Job Description:

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

Managed through a contact center structure, this role supports outbound and inbound calls to patients, caregivers, specialty pharmacies and healthcare professionals.

Performs post benefits investigation calls to patients and/or physicians explaining coverage options and next steps in the access journey

Manages inbound calls as directed by the program-approved FAQs

Triage patients to internal or external resources as appropriate

Provides personalized case management to patients and HCPs including outbound communication to HCPs 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

Preferred Skills & Qualifications:

High School Diploma

2 years of experience in insurance reimbursement, patient access, direct patient care and/or patient education required

Medical terminology – strongly preferred

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

Hours

1st and 2nd Shift

This is a full-time opportunity with a reputable company! If you or someone you know is interested in this position, please send a resume !

About TEKsystems:

Were 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. Thats 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.