Medical Case Manager | 8098  

The Intake Case Manager serves as a liaison between patients, their families, and healthcare providers with the goal of qualifying each patient (our customer) for insurance coverage for DME ordered by their physician (our referral source). This position is responsible for data entry, verifying insurance benefits and eligibility, providing customer support, and obtaining the necessary documentation from physician offices to support insurance medical necessity requirements.

Job Functions:

• Answer inbound calls, talk with patients, their doctors, and their Health Insurance companies by phone, fax, and email
• Receive, process, track, and prioritize prescription orders for home medical equipment with speed and accuracy
• Contact physician’s office and other facility offices to request prescriptions, progress notes, and other medical information necessary to process orders
• Data entry of patient demographics
• Verification of insurance benefits and eligibility
• Communicate effectively with patients and healthcare professionals
• Provide on-going customer support

• Bachelor's degree in health-related field and/or Nursing Degree preferred, but experience accepted commensurate with job requirements.
• Prefer 3-5 years in healthcare related setting(s).
• Knowledge of medical terminology, anatomy and physiology.
• Experience reviewing patient medical records.
• Outstanding organizational and communication skills both verbal and written.
• Microsoft Office365 (Outlook, Excel, Word, OneNote)
• Microsoft Sharepoint (a plus)
• Adobe Acrobat PDF (or equivalent pdf software)

Nice-to-haves:

• Process Street (a plus)
• Brightree Web Software (preferred but not required)
• Knowledge of Medicare/Medi-Cal/Commercial Health Insurance.
• Experience with Health Insurance eligibility verification.
• Experience with Durable Medical Equipment (DME) is a plus.
• Experience in Case management is a plus.
• Experience with ICD-10 coding is a plus.
• Experience with HCPCS Medical Coding is a plus.
• Experience with Medicare/Medi-Cal guidelines as they pertain to Power & Manual Wheelchairs, Hospital Beds, and other durable/home medical equipment (DME/HME) is a huge plus.

What’s in it for you?

• Above par industry compensation and benefits package
• Training Opportunities
• Opportunities for Career and Professional Advancement
• Social responsibility events
• Employee engagement program