Medical Case Manager

6 days ago


Miami, Florida, United States Medical Audit Professionals Full time
Job Description

We are seeking a highly skilled Medical Case Manager to join our team at Medical Audit Professionals. As a Medical Case Manager, you will be responsible for managing medical benefits verification and medical pre-authorization services, inpatient care review, and itemized bill review.

Key Responsibilities:
  • Answer inbound calls and respond to customer inquiries in a timely and professional manner.
  • Monitor and respond to emails, with an average of 70 emails per day.
  • Handle provider inquiries for benefit verification and resolve customer complaints in a fair and efficient manner.
  • Provide customers with pre-authorization for medical services and ensure that all necessary documentation is completed.
  • Review medical records and assess for pre-existing conditions and relevant exclusions on the policy.
  • Document all activities and call information according to standard operating procedures.
Requirements:
  • Foreign Medical Graduate with excellent verbal and written communication skills in English and Spanish (other languages welcomed).
  • Proficiency in MS Access, Word, and Excel.
  • Strong listening and problem-solving skills, with a customer service-oriented approach.
  • Ability to work in a fast-paced environment and adapt to changing priorities.
  • Team player with excellent organizational and detail-oriented skills.
  • Resilience and ability to work in a dynamic environment.
Working Conditions:
  • Full-time, contract hourly-paid position with a competitive hourly rate of $16.00-$24.00 per hour.
  • Availability to work night shifts, day shifts, and on-call shifts, with a requirement to be on-call remotely 2 nights a week and 2 weekends a month.
Language:
  • Spanish and English (required) and Portuguese (preferred), with any other languages welcomed in addition to the required ones.


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