Case Management Processor
Reference Code: 4592
Position Title: Case Management Processor
Location: REMOTE, Oak Brook, IL 60523
Duration: 6 months with possible extension
Target start date: 1/4/2021
- 100% remote position, however candidate must be located in IL to qualify for the position.
- Working hours are 8 hours per day between 7:30 am and 5:30pm CST
- HS Diploma, Bachelors Degree, experience in administrative support roles or customer service are preferred
Primary duties for this role are:
- Processing and uploading of documents into our Clinical documentation system
- Processing mail to our membership
- Developing and tracking authorizations for services in conjunction with leadership and clinical staff
Duties and Responsibilities (List all essential duties and responsibilities in order of importance)
- Provides support to the Case Management staff performing non clinical activities and supporting the management of the department.
- Responsible for initial review and triage of Case Management tasks.
- Reviews data to identify principle member needs and works under the direction of the Case Manager to implement care plan.
- Screens members using policies and processes assisting clinical Case Management staff as they identify appropriate medical services
- Coordinates required services in accordance with member benefit plan.
- Promotes communication, both internally and externally to enhance effectiveness of case management services (e.g., health care providers and health care team members).
- Runs reports to assist in coordination of case management needs.
- Provides support services to case management team members by answering telephone calls, taking messages and researching information.
- Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.
- Protects the confidentiality of member information and adheres to company
Knowledge, Skills and Abilities ( List all knowledge, skills and abilities that are necessary to perform the job
- Strong customer service skills to coordinate service delivery including attention to members/customers, sensitivity to concerns, proactive identification and resolution of issues to promote positive outcomes for members
- Demonstrated ability to communicate, problem solve, and work effectively with people
- Working knowledge of medical terminology and abbreviations
- Ability to think analytically and to problem solve.
- Good interpersonal/team skills
- Must have a high regard for confidential information
- Ability to work in a fast paced environment
- Able to work independently and as part of a team.
- PC experience in Windows environment and accurate data entry at 40 WPM minimum.
- Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
- Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers
High School Diploma or G.E.D.
Two or more years experience as a medical assistant, office assistant or other healthcare service administrative support role.