Case Management Processor (Full Remote)

Remote Full-time
Job Title: Case Management Processor

Pay Range: $24.00 per hour

Temp-to-Permanent - permanent eligible after 13 weeks

Schedule: Full-time, Monday to Friday, 8:30 am - 5:00 pm PST

Location: 100% Remote

Position Overview:

Eligible candidates must live in PST Time Zone. We are seeking a Case Management Processor to join a national Managed Care Organization on a temporary-to-permanent basis. The Case Management Processor will provide non-clinical support to the Case Management team, ensuring that tasks are managed efficiently and that members receive timely and effective care.

Duties and Responsibilities:
• Provide administrative support to the Case Management staff, performing non-clinical activities and assisting in managing department tasks.
• Conduct initial review and triage of Case Management tasks, helping to prioritize case needs.
• Review data to identify key member needs and work under the direction of the Case Manager to implement care plans.
• Screen members using organizational policies and procedures, assisting the clinical team in identifying appropriate medical services.
• Coordinate necessary services based on the member’s benefit plan.
• Foster communication internally and externally to improve the effectiveness of case management services (including communication with healthcare providers and team members).
• Generate and review reports to assist in the coordination of case management activities.
• Provide telephone support, take messages, and research information to support the Case Management team.
• Maintain accurate and complete documentation that complies with risk management, regulatory, and accreditation requirements.
• Ensure the confidentiality of member information in line with company and regulatory standards.

Knowledge, Skills, and Abilities:
• Excellent customer service skills with the ability to coordinate service delivery, paying close attention to member needs and proactively resolving issues.
• Demonstrated ability to effectively communicate and problem-solve while working with diverse individuals.
• Working knowledge of medical terminology and abbreviations.
• Strong analytical and problem-solving skills.
• Strong interpersonal and team collaboration skills.
• High regard for confidential information and adherence to HIPAA compliance.
• Ability to work independently in a fast-paced environment as well as part of a team.
• Proficient in PC usage with experience in a Windows environment and accurate data entry (minimum 40 WPM).
• Ability to establish and maintain positive work relationships with coworkers, clients, members, and providers.

Education and Experience:
• Required Education: High School Diploma or G.E.D.
• Required Experience: 1-3 years of experience in an administrative support role in healthcare.
• MUST LIVE IN CST Time Zone

Apply Now

Apply Now →

Similar Jobs

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote

USPS Office Helper

Remote

**Experienced Work-at-Home Data Entry Specialist – Part-Time Opportunity with arenaflex**

Remote

Marketing Operations Manager

Remote

Remote Home-Based Data Entry Typist – Full‑Time Accurate Transcription & Document Management Specialist at arenaflex

Remote

Desarrollador/a Bantotal

Remote

Sr. Anlst, Cyber Security

Remote

Entry Level Sales - Training Provided

Remote

Accepting Talent for Future Roles - Marketing

Remote

Experienced Part-Time Data Entry and Customer Service Representative – Flexible Remote Work Opportunity at careerzynith

Remote

Golang Developer (Golang, NodeJS, Networking, Kafka)

Remote

Experienced Full Stack Remote Data Entry Specialist – Enjoy a Competitive $25/Hour Salary and Flexible Work Hours at blithequark

Remote
← Back