The mission of the Cystic Fibrosis Foundation (CFF) is to cure cystic fibrosis and to provide all people with the disease the opportunity to lead full, productive lives by funding research. We have invested hundreds of millions of dollars into CF research and drug development, the results of these bold investments have been astonishing. A few decades ago, most people with CF didn’t live long enough to attend elementary school. Today, many people born with CF are living into their 30s, 40s, and beyond.
Would you like to go to work every day knowing that your work is important and effective? Do you want to go home every day knowing that you have made a difference?
The Cystic Fibrosis Foundation, the world’s leader in the search for a cure for cystic fibrosis, and one of the most innovative and successful organizations of its kind is seeking a Case Manager to join our Compass team in our Policy & Advocacy department.
- Conduct intake, screening, assessment, coverage and reimbursement/prior authorization/appeal research and triage to appropriate resources for customers who contact CFF Compass
- Enter customer information and track disposition of cases into the database. Position serves as subject-matter expert in area of coverage and reimbursement and requires ability to work on cases independently with minimal supervision.
- Collaborate with internal and external customers and to properly triage cases to the appropriate groups as needed
- Demonstrate ability to multitask -- working on primary responsibilities while participating in ongoing and ad hoc projects
- Perform the above job functions from the local CF Foundation chapter, and report to and coordinate with the National Office Compass staff for daily responsibilities
- Follows department standard operating procedures and internal policies
- Exhibits and maintains confidentiality pertaining to patient health information
- Reviews & evaluates patient cases with support from lead case manager to educate callers regarding how to determine insurance benefits for coverage of drug(s) and/ or devices
- Assists callers with initiating and/or completing prior authorizations or appeals for insurance denials. Provides support documents as needed
- Assesses whether patients qualify for co-pay assistance programs or programs for the uninsured and triages callers to the appropriate program(s) as needed
- Assesses whether patients qualify for federal/state programs, provides guidance and triages as appropriate.
- Enters customer information into the database and creates appropriate service requests and designates to the appropriate agent as needed
- Two years minimum experience in a healthcare or patient support services environment
- Knowledge of Medicare coverage and reimbursement
- Experience determining Medicaid/SSI/SSDI eligibility
- Knowledge of third party payers, private (both local and national), federal, and state
- Experience with co-pay Foundations and patient assistance programs
- Experience conducting benefit investigations, prior authorizations, and appeals
- Basic computer skills necessary, including Internet, Oracle/Microsoft Dynamics CRM, MS Word, Excel, and Microsoft Outlook
The Cystic Fibrosis Foundation recognizes the importance of employees taking care of their health and safety needs and those of their families. The Foundation strives to create and maintain a balanced work schedule for its employees and promotes quality of life through its varying benefits.
- Comprehensive benefits package which includes medical, dental, and vision healthcare insurance
- Competitive salaries with incentive plans
- 401(k) plan with generous employer matching contributions
- Exciting learning and development programs to support professional growth
- Employee discounts – computers, phone plans, travel, theme parks
- Tuition Reimbursement
- Generous paid holidays and shortened workdays on Fridays in the summer and before major holidays
- Employee wellness programs
- Business casual work environment