Florida Licensed Medical Case Manager

Job Summary

To support a Fortune 500 Pharmaceutical Client, the remote Medical Case Manager will manage prior authorizations, communicate with patients and providers, and verify insurance coverage while working Monday to Friday between 7am-8pm CST.

Key responsibilities

• Handle prior authorizations and insurance verification for patients
• Communicate with patients, providers, and insurance payers via phone and email
• Manage inbound and outbound calls related to claims, denials, and appeals

Required qualifications

• Minimum of 1 year of recent experience with medical insurance, specifically prior authorizations
• Experience with Medicare/Medicaid program administration
• Knowledge of insurance verification, claim adjudication, or medical billing
• Familiarity with ICD-10, HCPCS, or CPT coding is a significant plus
• High School Diploma or equivalent required