Insurance Case Manager

4 weeks ago


St Louis, Missouri, United States SSM Health Full time
Job Summary

Screens and interviews patients without insurance for Medicaid, Medicaid CAU, private insurance through the state health exchange, and Social Security Disability and completes applications for eligible patients.

Key Responsibilities
  • Completes applications and follow-up documentation, including obtaining verification, submitting applications in person or electronically, attending appointments with or for the patient and constructing medical history, in an effort to establish disability as required by Medicaid and Social Security Disability.
  • Manages the appeal process by following up on appeals in a timely manner.
  • Sets appropriate goals with every patient and contacts patients in a timely manner to update goals.
  • Connects patients with appropriate public and private assistance programs based on needs identified during the initial assessment, re-assessment, and goal planning with the patient.
  • Communicates patient and family needs to outside agencies.
  • Communicates with billing and local providers that the patient is approved so proper billing can take place.
  • Follows up regularly on applications with patients and the Medicaid, state health insurance exchange, and Social Security Disability offices to ensure the application process is completed.
Requirements
  • Bachelor's degree
  • Three years experience in case management and/or insurance
Work Environment

Works in a constant state of alertness and safe manner.

About SSM Health

SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law.


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