Texas Licensed Medical Case Manager
Job Summary
To support a Fortune 500 pharmaceutical client, the remote Medical Case Manager will manage prior-authorizations, insurance verification, and patient communications, requiring a minimum of one year of recent case management experience in a call center environment.
Key responsibilities
- Handle prior-authorizations and insurance verification while communicating with patients, providers, and insurance payers
- Manage inbound and outbound calls related to claims, denials, and appeals
- Utilize multiple internal system programs to ensure compliance with company policies and procedures
Required qualifications
- Minimum of 1 year of recent case management experience in a call center
- Experience with medical insurance, including prior authorizations and claims adjudication
- Knowledge of Medicare/Medicaid program administration
- Familiarity with ICD-10, HCPCS, or CPT coding is a significant advantage
- High school diploma or equivalent
Complete Job Description
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