Deskripsi Pekerjaan
Are you a compassionate healthcare professional seeking a meaningful career? Virtual Champs Global is looking for a detail-oriented Medical Case Manager to join our dynamic team. In this pivotal role, you will serve as the bridge between patients, healthcare providers, and insurance companies, ensuring seamless care delivery and accurate financial reconciliation. You will manage patient cases from intake to final resolution, reviewing medical records, processing billing claims, and resolving discrepancies with insurance carriers.
As a Medical Case Manager, you will utilize your expertise in medical terminology and healthcare regulations to advocate for patients and ensure they receive the benefits they are entitled to. We offer a collaborative environment where your organizational skills and attention to detail will directly impact our operational success. If you are passionate about improving healthcare outcomes and have the administrative skills to back it up, we invite you to apply.
Tanggung Jawab
- Review and analyze patient medical records and billing statements to ensure accuracy.
- Coordinate with healthcare providers to verify treatment plans and authorize services.
- Communicate effectively with insurance carriers to resolve claim denials and underpayments.
- Manage patient cases from initial intake through resolution, maintaining detailed documentation.
- Ensure strict compliance with healthcare regulations, HIPAA standards, and company policies.
- Collaborate with the billing team to identify trends and improve revenue cycle management.
- Provide exceptional customer service to patients regarding their medical and financial concerns.
Kualifikasi
- Bachelor’s degree in Nursing, Healthcare Administration, or a related field is required.
- Minimum of 2-3 years of experience in medical case management or billing is preferred.
- Strong knowledge of medical terminology, ICD-10, and CPT coding is highly desirable.
- Excellent verbal and written communication skills with a focus on patient advocacy.
- Proficient in Microsoft Office Suite and medical billing software.
- Ability to work independently in a remote/hybrid setting with strict attention to detail.
- Strong problem-solving skills and the ability to handle sensitive information with confidentiality.