Case Manager

🔥 0 minutes ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $23 / hour

⏳ Contract/Temporary

🟢 Junior

🟡 Mid-level

👔 Manager

👻 Ghost score 0%

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TEKsystems

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1983

💼 Consulting

🎯 Recruiter

🏢 Enterprise

Consulting • Recruitment • Enterprise

TEKsystems is a global IT and business services firm that provides technology consulting, talent solutions, managed services and workforce recruitment to enterprise clients. The company delivers cloud, digital and data services (including AI/ML and automation), application innovation, Agile/DevOps transformation, technology operations and digital experience work, and operates large-scale talent and managed service programs. TEKsystems works across industries (financial services, healthcare, public sector, telecommunications, retail/manufacturing, energy and more), maintains technology partnerships with major cloud and software providers, and reports more than $7B in annual revenue and 100+ locations worldwide.

📋 Description

• Provide expertise on insurance coverage and common access and reimbursement challenges affecting patients, healthcare providers and clients • Educate patients, healthcare providers and clients on Valeris access and reimbursement support tools and participating programs • Advise HCPs, patients and caregivers on benefits and program eligibility for specific patients • Educate HCP offices on payer processes and procedures • Build trusted relationships with patients, prescribers and client stakeholders regarding reimbursement inquiries and challenges • Manage relationships in compliance with relevant laws, regulations, program procedures and industry standards • Support inbound and outbound calls to patients, caregivers, specialty pharmacies and healthcare professionals • Perform post-Benefits Investigation calls explaining coverage options and next steps • Manage client inquiries, including case-specific statuses • Manage HCP inquiries pursuant to business rules • Ensure communications with client field teams comply with agreed ways-of-working protocols • Manage inbound calls according to program-approved FAQs • Triage patients to internal or external resources • Provide personalized case management to patients and HCPs through outbound communications

🎯 Requirements

• Completion of Bachelor's degree (or higher) required • A degree in healthcare administration, social science or similar related fields is strongly preferred • Minimum two years of experience in healthcare access delivery or management is strongly preferred • 5-10 years of experience in insurance reimbursement, patient access, direct patient care, and/or patient education experience will be considered in lieu of degree • Other certifications and five or more consecutive years of experience in a relevant field may be considered • Certification examples include PACS (Prior Authorization Certified Specialist), CHES (Certified Health Education Specialist) or CCM in healthcare or social science (Certified Case Manager) • Strong understanding of medical terminology, coding systems (ICD-10, CPT, HCPCS), and insurance processes • Ability to comply with relevant laws, regulations, program-specific operating procedures and industry standards, including HIPAA and insurance guidelines • Ability to support inbound and outbound calls to patients, caregivers, specialty pharmacies and healthcare professionals

🏖️ Benefits

• Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan with pre-tax and Roth post-tax contributions • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

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