Case Manager - Remote

Overview

Guided Care is seeking a full time Case Manager, to provide coverage for our Prior Auth and Clinical Case Management teams. This individual obtains prior authorizations and authorization extensions for clients with the goal of ensuring insurance coverage for patient stays and low turnaround times for auth obtainment. The Case Manager reports to their Supervisor of Case Management.

In Short

• Full-time position for a Case Manager.
• Responsible for obtaining prior authorizations for clients.
• Must respond to authorization requests within 20 minutes.
• Maintain accuracy in data input using Guided Care software.
• Provide updates to clients on pending cases at least three times a day.
• Complete census verification by 11 AM.
• Communicate with supervisor about new developments in prior auth processes.
• Ensure correct documentation is submitted to insurance.
• Follow up with insurance for determination within 72 business hours.
• Maintain high customer service standards.

Requirements

• High School Diploma or GED.
• 3+ years of experience in healthcare authorization.
• Skilled nursing admissions or business office experience preferred.
• Independent and self-motivated.
• Strong research and organizational skills.
• Thrives in fast-paced environments.
• Strong time management skills.
• Collaborative skills with team and clients.
• Ability to work remotely and autonomously.
• Ability to establish positive relationships.

Benefits

• Competitive salary.
• Remote work flexibility.
• Training and development opportunities.
• Supportive team environment.