What are the responsibilities and job description for the Case Manager position at Aston Carter?
Benefits Specialist/Case Manager Job Opportunity:
- long-term job opportunity
- competitive pay, retention bonuses
- can work hybrid after 6 months, pending performance/attendance/etc.
- Mon-Fri, different shift options
Description:
Job Responsibilities for Benefit Specialist:
- Performing patient level benefits verifications for all major medicals and pharmacy benefit plans
- Completion of template forms that provide patent level benefits Coverage Determination Summary
- Coordination of prior authorizations based on payer guidelines and in compliance with law, regulation or guidance
- Review of patient assistance enrollment forms and any supporting documentation to assess patient eligibility for participation as per SOP's and program guidelines
- Determination of patient's eligibility based upon program criteria for qualification
- Communicating the patient's eligibility to the patient, healthcare provider and/or consignment pharmacy.
- Answer and assist inbound callers through resolution utilizing answers to frequently asked questions or by warm transferring callers to other appropriate individuals
- Actively listen to each customer, assess needs and respond with demonstrated patience and courtesy
- Review and identify information that is missing and/or incorrect within program service requests
Job Responsibilities for Case Manager:
- Compassionately deliver an exceptional experience to many patients per day always remembering that every prescription or document belongs to a real person who is looking for thorough efficient management of their records.
- Adjust your approach to their needs by communicating clearly, focusing on the accuracy of the details of their medical records and your mastery of the program requirements, and ensuring their prescriptions or cases are handled timely.
- Reporting of Adverse Events/Product Complaint inquiries received in accordance with SOP and good manufacturer practices
- Provides timely feedback to the company regarding service failures r customer concerns
- Effectively uses internal technology platform to complete claims processing and keep workflows moving
- Communicate with key medical practice accounts, sales representatives regarding the status of cases
- Provide consultative services where issues arise on how obstacles can be overcome to get patient on paid therapy
Skills:
Customer service, Benefits administration, Prior Authorization, Benefit verification, Call center, Health insurance, Pharmacy, Insurance, Health care, Microsoft office
Qualifications:
- Bachelor's degree strongly preferred or equivalent experience required; completion of high school diploma or GED is required
- Healthcare experience required - unless candidate has bachelors degree & Strong customer service experience/tenure
- 2-3 years of office/administrative experience, and customer service experience
- Medical terminology - strongly preferred
- 6 months of payer benefits experience (reimbursement, prior auth, etc), healthcare industry experience or healthcare related experience is required
- Bilingual is a plus
About Aston Carter:
Please Note: Scammers are posing as Aston Carter. We'll never contact you via Gmail, Telegram, or WhatsApp and we'll never solicit money from you.
At Aston Carter, we’re dedicated to expanding career opportunities for the skilled professionals who power our business. Our success is driven by the talented, motivated people who join our team across a range of positions – from recruiting, sales and delivery to corporate roles. As part of our team, employees have the opportunity for long-term career success, where hard work is rewarded and the potential for growth is limitless.
Established in 1997, Aston Carter is a leading staffing and consulting firm, providing high-caliber talent and premium services to more than 7,000 companies across North America. Spanning four continents and more than 200 offices, we extend our clients’ capabilities by seeking solvers and delivering solutions to address today’s workforce challenges. For organizations looking for innovative solutions shaped by critical-thinking professionals, visit AstonCarter.com. Aston Carter is a company within Allegis Group, a global leader in talent solutions.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please call 888-237-6835 or email astoncarteraccommodation@astoncarter.com for other accommodation options. However, if you have questions about this position, please contact the Recruiter located at the bottom of the job posting. The Recruiter is the sole point of contact for questions about this position.
Salary : $37,440 - $41,600
