Healthcare Case Manager

1 week ago


Dallas, Texas, United States CornerStone Staffing Full time
Job Summary

CornerStone Staffing is seeking a skilled Healthcare Case Manager - Reimbursement Specialist to join our team. As a key member of our organization, you will play a vital role in delivering exceptional customer service and ensuring seamless reimbursement processes for our clients.

Key Responsibilities:
  • Customer Service: Provide timely and effective support to patients, healthcare providers, and manufacturers, addressing inquiries and resolving issues in a professional and courteous manner.
  • Reimbursement Management: Coordinate with patients, providers, and payers to ensure accurate and efficient reimbursement processes, including benefit investigations, prior authorizations, and appeals.
  • Case Management: Act as a single point of contact for patients and providers, demonstrating empathy and compassion while ensuring HIPAA compliance.
  • Communication: Maintain frequent phone contact with patients, providers, and other stakeholders to provide reimbursement information and resolve issues.
  • Problem-Solving: Analyze complex reimbursement issues and exercise judgment to determine appropriate actions, escalating complaints when necessary.
Requirements:
  • Experience: 3+ years in healthcare case management, specialty pharmacy, medical insurance, reimbursement hub, physician's office, or healthcare setting.
  • Education: Bachelor's Degree preferred.
  • Skills: Excellent verbal and written communication skills, ability to multi-task, adapt to changing priorities, and work independently or as a team member.
  • Knowledge: HIPAA regulations, pharmacy and medical benefits, commercial and government payers, and MS Word and Excel.


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