Case Manager

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  Are you passionate about health care and helping patients receive access to care?


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  Do you get excited about opportunities that allow you to build programs from the ground up?


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  Do you want to be a part of a dynamic, growing company where teamwork flourishes and is not just talked about?


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  Are you energized by a work environment in which individual contributions are valued and appreciated?

If so, DK Pierce & Associates wants you to consider our case manager position!

Located in Zionsville, Indiana, DK Pierce & Associates strives to earn the respect and trust of our clients. Our success is built by creative, productive employees who challenge the status quo and who focus on enhancing our capabilities and increasing our level of excellence.

We are looking for a case manager to respond to customer inquiries, research answers to questions, and develop reports and written deliverables in support of third-party payer reimbursement issues that affect patient access to care. This position analyzes customer issues and strategically eliminates barriers in order to solve problems and acquire answers. It plays a critical role in coordinating health care provider and payer resources to ensure patient access to care.

Key Responsibilities

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  Provides high-quality, customer-focused support for care management programs; identifies and resolves interruptions or barriers to care (e.g., insurance/medical issues, life changes, provider and/or payer issues).


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  Investigates payer authorization processes and submits prior authorizations; assists with appeal processes by building appeal strategies, creating claim appeal letters, and requesting support documentation from patients and physicians.


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  Screens patients for patient assistance programs and foundation eligibility using alternative funding resources; enrolls qualified patients in programs and conducts follow-up activities.


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  Attends patient advocacy meetings, conferences, and trade shows; educates patients, providers, and/or payers regarding disease/product information and care management services.


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  Communicates daily with insurance companies, physician offices, patients, pharmacies, etc.; conducts provider and/or patient follow-up; develops and maintains professional relationships with all contacts.


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  Addresses billing and coding issues related to customer care; obtains patient consent in accordance with HIPAA privacy rules and conducts insurance benefit investigations on behalf of patients and their providers.


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  Conducts intake interviews, insurance verifications, and alternative funding searches; coordinates with payers, providers, and internal staff members.


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  Maintains a database of payer coverage policies, coding, and payments.

Qualifications

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  Bachelor’s degree in health care, life sciences, nursing, or social work, or equivalent; RN or LCSW credential is preferred.


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  Three to five years’ recent case management experience with a strong, successful record of accomplishment.


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  Excellent oral and written communication skills to effectively receive, interpret, and disseminate information in a manner that is clear, concise, and actionable; must be able to demonstrate empathy and communicate with patients, customers, clients, and staff at all levels.


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  Superior analytical, probing, and problem-solving skills, with a proven ability to make decisions and accept accountability; must be able to handle sensitive issues and to multitask.


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  A high level of customer focus and service; must be able to approach customer issues in a emphathetic, consultative, and professional manner.


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  Strong knowledge of health-care compliance and regulatory requirements; knowledge of progressing practices in the areas of health benefits, insurance, and other related fields.


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  In-depth knowledge of Medicare, Medicaid, commercial insurance, coding, and billing.


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  Proficient computer skills in Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Microsoft Outlook, Internet browsers, and e-mail systems; must be technologically savvy and possess the ability to learn new systems as necessary.


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  Must have a flexible work schedule to support our clients across the country.

To apply go to www.flashpointhr.com and click on the “Careers” link in the upper-right corner!