The representative will respond to member and provider inquiries regarding health benefits and precertification while negotiating rates with out-of-network providers. They are also responsible for documenting calls, managing electronic web-certs, and verifying patient and provider information.
The Case Manager Assistant supports the RN Case Manager by reviewing treatment plans, verifying medical necessity, and coordinating care across the healthcare team. They are responsible for maintaining patient records, preparing reports for payers, and facilitating communication between providers, patients, and caregivers.
The Case Manager Assistant supports the RN Case Manager by reviewing medical data, authorizing services, and maintaining ongoing communication with the healthcare team. They are responsible for documenting case actions, coordinating care arrangements, and negotiating with providers to maximize patient benefits.
The Senior Account Executive is responsible for maximizing client satisfaction, retention, and revenue growth through proactive support and upselling. They manage a block of clients, facilitate meetings, and coordinate internal departments to resolve issues and ensure smooth service delivery.
The Case Manager manages an individual caseload to meet customer needs, including authorizing services and reviewing treatment plans for medical necessity. They coordinate care transitions, collaborate with healthcare teams, and maintain accurate documentation within the computer system.
The Case Manager manages an individual caseload by assessing patient needs, developing care plans, and coordinating with healthcare providers and payers to ensure quality care. They are responsible for documenting case actions, maintaining billing, and negotiating with providers to maximize medical benefits.
The Case Manager manages an individual caseload by assessing patient needs, developing care plans, and coordinating with healthcare providers and payers. They are responsible for reviewing medical necessity, maintaining case documentation, and ensuring quality care through ongoing communication and resource navigation.
