The Cystic Fibrosis Foundation, located in Minneapolis, MN is currently seeking a Case Manager to join the Compass team in the Policy & Advocacy department.
Areas of Responsibility:
- 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.
Educational Background:
Bachelor’s degree preferred
Skills/Experience:
- 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
- Bilingual in Spanish and English is highly preferred
Job Function:
Organization Info
Listing Stats
Post Date:
Sep 12 2019
Active Until:
Oct 13 2019
Hiring Organization:
Cystic Fibrosis Foundation
industry:
Nonprofit