Case Management Processor (Full Remote)

Job Title: Case Management Processor

Pay Range: $24.00 per hour

Temp-to-Permanent - permanent eligible after 13 weeks

Schedule: Full-time, Monday to Friday, 8:30 am - 5:00 pm PST

Location: 100% Remote

Position Overview:

Eligible candidates must live in PST Time Zone. We are seeking a Case Management Processor to join a national Managed Care Organization on a temporary-to-permanent basis. The Case Management Processor will provide non-clinical support to the Case Management team, ensuring that tasks are managed efficiently and that members receive timely and effective care.

Duties and Responsibilities: ?? Provide administrative support to the Case Management staff, performing non-clinical activities and assisting in managing department tasks. ?? Conduct initial review and triage of Case Management tasks, helping to prioritize case needs. ?? Review data to identify key member needs and work under the direction of the Case Manager to implement care plans. ?? Screen members using organizational policies and procedures, assisting the clinical team in identifying appropriate medical services. ?? Coordinate necessary services based on the member??s benefit plan. ?? Foster communication internally and externally to improve the effectiveness of case management services (including communication with healthcare providers and team members). ?? Generate and review reports to assist in the coordination of case management activities. ?? Provide telephone support, take messages, and research information to support the Case Management team. ?? Maintain accurate and complete documentation that complies with risk management, regulatory, and accreditation requirements. ?? Ensure the confidentiality of member information in line with company and regulatory standards.

Knowledge, Skills, and Abilities:
?? Excellent customer service skills with the ability to coordinate service delivery, paying close attention to member needs and proactively resolving issues.
?? Demonstrated ability to effectively communicate and problem-solve while working with diverse individuals.
?? Working knowledge of medical terminology and abbreviations.
?? Strong analytical and problem-solving skills.
?? Strong interpersonal and team collaboration skills.
?? High regard for confidential information and adherence to HIPAA compliance.
?? Ability to work independently in a fast-paced environment as well as part of a team.
?? Proficient in PC usage with experience in a Windows environment and accurate data entry (minimum 40 WPM).
?? Ability to establish and maintain positive work relationships with coworkers, clients, members, and providers.

Education and Experience:
?? Required Education: High School Diploma or G.E.D.
?? Required Experience: 1-3 years of experience in an administrative support role in healthcare.
?? MUST LIVE IN CST Time Zone

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