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Case Management Processor (Full Remote)

Work from home Full-time role Hiring

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 Apply Job!

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