Market Access Case Manager

Job Summary

Market Access Case Manager is a full-time role responsible for managing the prior authorization process for insurance coverage of a rehabilitation system, including reviewing medical records, submitting applications, and negotiating agreements.

Key Responsibilities

• Review and compile medical documentation for prior authorization requests and negotiate Single Case Agreements
• Serve as the primary contact for insurance companies to ensure timely processing of requests and collaborate with cross-functional teams
• Maintain compliance with payer requirements and HIPAA guidelines while documenting case-related information accurately

Required Qualifications, Training, and Education

• High School Diploma or GED required; AA, BA, or BS desirable
• Minimum three years of experience in a healthcare environment, preferably with medical devices or insurance
• Experience in prior authorization submissions and appeals
• Competency in SalesForce, Google Suite, and Microsoft Office
• Understanding of market access, reimbursement, and payer landscapes