Case Manager in Juneau, Alaska

 Track any payer/plan issues and report any changes, updates, or trends to management

• Search insurance options and explain various programs to the patient while helping them to select the best coverage option for their situation

• Handle all escalations based upon region and ensure proper communication of the resolution within required time frame agreed upon by the client

• Serve as a liaison between client sales force and applicable party

• Mediate situations in which parties are in disagreement and facilitate a positive outcome

• Concurrently handle multiple outstanding issues and ensure all items are resolved in a timely manner to the satisfaction of all parties

• Responsible for reporting any payer issues by region with the appropriate team

• As needed conduct research associated with issues regarding the payer, physician’s office, and pharmacy to resolve issues swiftly

What is expected of you and others at this level

• Effectively applies knowledge of job and company policies and procedures to complete a variety of assignments

• In-depth knowledge in technical or specialty area

• Applies advanced skills to resolve complex problems independently

• May modify process to resolve situations

• Works independently within established procedures; may receive general guidance on new assignments

• May provide general guidance or technical assistance to less experienced team members

Qualifications

• Previous customer service experience is required

• High School diploma or equivalent preferred

• Patient Support Service experience, preferred

• Clear knowledge of Medicare (A, B, C, D), Medicaid & Commercial payers policies and guidelines for coverage, preferred

• Knowledge of DME, MAC practices if preferred