Case Management Processor

Job Title: Case Management Processor
Duration: 3 Months (Possibilities of Extension)
Location: Downers, IL 60515
Shift Time: Mon – Fri (8 AM-4:30 PM)
Pay Rate: $30.12/Hr. on W2
Description:

Fully remote: No must be local /Near Downer’s Grove, Illinois.
The expectation is a possibility of travel to the office on a weekly or twice-per-week basis.

Duties:

Provides telephone, clerical and data entry support for the Case Management team.
Responsible for initial review of assigned case levels to assist in Case Management assignment.
Reviews data to identify principal member needs and works under the direction of the Case Manager to implement care plan.
Schedules member visits with team members as needed.
Screens members using Client policies and processes, assisting clinical Case Management staff as they identify appropriate medical services.
Coordinates required services in accordance with member benefit plan.
Promotes communication, both internally and externally to enhance effectiveness of case management services.
Processes member and provider correspondence.

Required Education:

HS Diploma

Experience:

1-3 years in an administrative support role in healthcare

Responsibilities:

Provides support to the Case Management staff performing nonclinical activities and supporting the management of the department.

Responsible for initial review and triage of Case Management tasks.
Reviews data to identify principal member needs and works under the direction of the Case Manager to implement care plan.
Screens members using Client policies and processes assisting clinical Case Management staff as they identify appropriate medical services
Coordinates required services in accordance with member benefit plan.
Promotes communication, both internally and externally to enhance effectiveness of case management services
(e.g., health care providers and health care team members).
Runs reports to assist in coordination of case management needs.
Provides support services to case management team members by answering telephone calls, taking messages and researching information.
Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.
Protects the confidentiality of member information and adheres to company
Knowledge, Skills and Abilities ( List all knowledge, skills and abilities that are necessary to perform the job satisfactorily)
Strong customer service skills to coordinate service delivery including attention to members/customers, sensitivity to concerns, proactive identification and resolution of issues to promote positive outcomes for members
Demonstrated ability to communicate, problem solve, and work effectively with people
Working knowledge of medical terminology and abbreviations
Ability to think analytically and to problem solve.
Good interpersonal/team skills
Must have a high regard for confidential information
Ability to work in a fast-paced environment
Able to work independently and as part of a team.
PC experience in Windows environment and accurate data entry at 40 WPM minimum.
Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
Ability to establish and maintain positive and effective work relationships with coworkers, clients, members,
providers and customers