Case Manager

• Monitor system accounts for new Patient cases • Conduct outbound calls to patients to confirm approval/denials of coverage, co-pays and verification of specialty pharmacies dispensing medication(s) • Contact insurance companies as required to obtain / enter accurate benefit information related to patient coverage • Mediate effective resolution for complex payer/pharmacy issues toward a positive outcome • Maintain quality while providing an empathetic and supportive experience to the patients, providers, and physician offices • Resolve patient's questions and concerns regarding status of their request for assistance • Enter detailed information into company proprietary software while conversing via telephone • Steward patient accounts from initial contact through final approval/denial • Process all patient applications in accordance to set policy, procedures, and PHI compliance • Works with / provides updates to team members and leadership on patients' cases • Ability to identify, document and compliantly submit Adverse Events during customer contact or via received documentation • Conduct research associated with alternative funding / foundations to determine patient eligibility to receive product • Effectively applies knowledge of job and company policies and procedures to complete a variety of assignments • Applies advanced skills to resolve complex problems independently • Works independently within established procedures


Skills: • Ability to multitask, utilizing specific software programs while speaking with patients and/or healthcare staff.
• Ability to type a minimum of 40 WPM.
• Ability to transcribe (type) accurate notes while speaking to customer.
• Strong Microsoft Products experience required.
• Ability to navigate video conferencing tools such as Microsoft Teams and Zoom.
• Strong video conferencing experience.
• Must have the ability to work via video conferencing as required by leadership.
• Organized with the ability to prioritize multiple, concurrent assignments and work with a sense of urgency • Exceptional communication skills both verbally and written • Strong attention-to-detail and quality documentation • Exceptional, professional verbal communication skills with friendly, empathetic, and patient centric focus • Independent worker and self-starter with solid time management skills and ability to work with high volume production teams • Continuous learner with a desire to move into a senior level role • Solid work-ethic and driven to achieve daily/weekly metrics • Strict adherence to company attendance policies • Self-starter with demonstrated initiative, creativity and a willingness to be a team player


REMOTE DETAILS: All U.S. residents are eligible to apply to this position. You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with access to high-speed internet. We will provide you with the computer, technology and equipment needed to successfully perform your job. You will be responsible for providing high-speed internet. Internet requirements include the following: Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. Dial-up, satellite, WIFI, Cellular connections are NOT acceptable. Download speed of 15Mbps (megabyte per second) • Upload speed of 5Mbps (megabyte per second) • Ping Rate Maximum of 30ms (milliseconds) • Hardwired to the router • Surge protector with Network Line Protection for CAH issued equipment Inability to meet these requirements at any time may result in termination of the contract / employment.


Keywords:


Education: • Minimum of HS diploma; additional education preferred • Previous healthcare experience with insurance or in pharmaceutical industry, preferred • Pharmacy benefits management experience preferred with specific knowledge of Medicare, Medicaid and commercially insured payer common practices and policies, preferred • Previous prior authorization and appeals experience highly desired # of Positions: 2


Location:


Lewisville, TX


2730 S Edmonds Ln, TX-Lewisville:Suite 300:USCentral


EEO:- Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of - Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans