Unknown Company

Case Manager

lewisville, tx • Posted 1 weeks ago
Remote Full Time Community and Social Service Occupations

Case Manager (Remote / Work From Home) Position Title:Case Manager (Reimbursement Support Services) — Remote (WFH) Pay:$20.00/hr Schedule:Full-time,40 hrs/week. Must be flexible to work an assigned shiftMonday–Friday between 7:00 AM–7:00 PM CT. Training:Monday–Friday 8:00 AM–5:00 PM CT(mandatory attendance) Location:100% Remote (U.S. residents eligible) Role Overview We are hiring a Remote Case Manager to support patient access to therapy through Reimbursement Support Services. In this role, you will guide provider offices through the steps required to move patients from referral intake to coverage determination and therapy start. You’ll conduct benefit investigations, identify prior authorization and step therapy requirements, follow up with payers and specialty pharmacies, and document each case accurately while meeting daily productivity and quality expectations. Key Responsibilities Monitor and manage new patient referrals and case queues in accordance with program rules and HIPAA/PHI requirements Conductbenefit investigationsand verify coverage details for patient health plans Identify and initiateprior authorizationandstep therapyreview needs (and support appeals processes when applicable) Make and receive inbound/outbound calls with professional call quality and strong documentation Follow up withinsurance payers, specialty pharmacies, and support partnersto drive timely resolution Resolve payer/pharmacy issues through strong problem-solving, de-escalation, and persistence Maintain detailed, accurate case notes and status updates in proprietary systems Required Qualifications High School Diploma / GED (or equivalent work experience) Strong phone communication + professional written documentation skills High attention to detail, strong organization, and ability to manage multiple cases at once Comfort working in a productivity-driven environment with daily goals/metrics Ability to follow written procedures and navigate multiple systems accurately Preferred Qualifications 1–2+ years inbenefit investigations, prior authorizations, and/or appeals Knowledge ofMedicare, Medicaid, and Commercialpayer processes Experience in healthcare, insurance, patient access, specialty pharmacy, or pharma support services Familiarity with medical/pharmacy billing and coding (helpful, not required) Remote / Work-From-Home Requirements (Must Meet) Dedicated, quiet, private workspace (distraction-free) Hardwired broadband internet only (DSL/Cable/Fiber)—No WiFi, satellite, cellular, or hotspot Minimum internet speeds:15 Mbps download / 5 Mbps upload,ping ≤ 30 ms Ability to hardwire to router and use a surge protector with network line protection Apply todayif you have strong healthcare/insurance support experience and enjoy detailed casework that helps patients access therapy.

Case Manager in lewisville at Unknown Company

This position is listed as full time and able to be worked remotely.

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