Talent.com
Insurance Case Management Specialist
Insurance Case Management SpecialistAccessia Health • Midlothian, VA, US
No longer accepting applications
Insurance Case Management Specialist

Insurance Case Management Specialist

Accessia Health • Midlothian, VA, US
30+ days ago
Job type
  • Full-time
Job description

Job Description

Job Description

POSITION TITLE : Insurance Case Management Specialist

REPORTS TO : Patient Services Supervisor

POSITIONS MANAGED : None

STATUS : Non-Exempt

SUMMARY :

The Insurance Case Management Specialist is responsible for acting as a bridge between healthcare resources and patients to promote health and improved health outcomes. Assist patients with access to health insurance benefits and resources.

SALARY

This role has a target salary of $50,000 to $58,000 annually, based upon various factors including location, experience, and education.

JOB RESPONSIBILITIES

Assist individuals in obtaining health insurance to meet their healthcare needs

  • Assess patient's current and historical insurance status, healthcare needs, and resource availability
  • Use extensive knowledge of health insurance, including pharmacy benefit plans and plan formularies, to determine insurance needs of the patient.
  • Partner with patients to secure health insurance coverage and benefits with the patient ultimately choosing a plan that best meets their needs.
  • Advocate and act in the best interest of the patient with insurance and COBRA administrators, when applicable
  • Follow up as necessary with patient until eligibility for insurance coverage is determined or awarded
  • Stay current on various health insurance related legislation
  • Provide status updates in accordance with the program parameters
  • Monitor cases on an ongoing basis and provide additional resources, developing a schedule to follow up with patients
  • Develop and maintain partnership with ACCESS team to ensure referral for eligible services

Conduct benefits investigations

  • With proper consent, direct contact with insurance providers and pharmacy benefit managers to identify and verify patient insurance coverage
  • Identify payer coverage restrictions while maintaining high quality customer service standards in compliance with federal and state regulations
  • Maintain a repository of payer coverage information or case studies
  • Proactively update patient-related information to patient record in the respective data platform to check ongoing status of case management
  • Provide program statistical data to the leadership team on an established basis
  • Educate and empower patients on healthcare topics

  • Partner with the leadership and executive team to plan and host health information and education sessions through several platforms
  • Provide daily assistance to patients and providers with questions regarding health insurance and other resources
  • Create educational health information such as videos and handouts in partnership with the Marketing team
  • Represent the organization in meetings and conferences, as requested
  • Perform other duties as directed
  • Maintain a Caseload of Individuals for contracted programs

  • Meet with external grantors providing updates on case load regarding health insurance status, payments made on individual's behalf, and other communications necessary
  • Continue follow up with all patients to ensure required documentation is received for continued assistance
  • Provide updates to Patient Services Supervisor to allow for continued awareness of current status of individuals at all times.
  • Provide assistance in locating health insurance plan options for referred individuals based on contracted program guidelines.
  • Compile reporting data for supervisory review.
  • QUALIFICATIONS

  • Bachelor's degree in Social Work, Human Services, or equivalent experience, plus 3+ years in case management.
  • In-depth knowledge of private and public health insurance plans (Medicare, Medicaid, COBRA, Marketplace) and related terminology.
  • Ability to obtain Certified Case Manager (CCM) credential within one year of hire.
  • Strong customer service, active listening, and interpersonal skills with the ability to address complex questions and present to diverse audiences.
  • Proven organizational skills to manage multiple priorities, meet deadlines, and ensure accuracy in documentation and claims processing.
  • Compassion for patients with chronic conditions and commitment to delivering empathetic, high-quality support.
  • Proficiency in Microsoft Word, Excel, PowerPoint, and Outlook, with experience in data tracking and reporting outcomes.
  • Accessia Health is an Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other legally protected characteristic. We are committed to fostering a diverse and inclusive workplace where all team members feel valued and respected.

    Create a job alert for this search

    Case Management Specialist • Midlothian, VA, US

    Related jobs
    Insurance Follow Up Specialist

    Insurance Follow Up Specialist

    Universal Health Services, Inc. • Richmond, VA, United States
    Full-time
    One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. UHS) has built an impressive record of achievement and performance.Growi...Show more
    Last updated: 30+ days ago • Promoted
    Insurance Follow Up Specialist - MILLENNIUM

    Insurance Follow Up Specialist - MILLENNIUM

    Universal Health Services, Inc. • Richmond, VA, United States
    Full-time
    One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. UHS) has built an impressive record of achievement and performance.Growi...Show more
    Last updated: 30+ days ago • Promoted
    Insurance Follow Up Representative

    Insurance Follow Up Representative

    Universal Health Services, Inc. • Richmond, VA, United States
    Full-time
    One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. UHS) has built an impressive record of achievement and performance.Growi...Show more
    Last updated: 30+ days ago • Promoted
    Medical Only Workers' Compensation Claims Adjuster

    Medical Only Workers' Compensation Claims Adjuster

    Argonaut Management Services, Inc • Richmond, VA, United States
    Full-time
    Argo Group International Holdings, Inc.American National, US based specialty P&C companies, (together known as BP&C, Inc. Brookfield Wealth Solutions, Ltd.BWS"), a New York and Toronto-listed public...Show more
    Last updated: 19 days ago • Promoted
    Mortgage Foreclosure Case Manager Liaison

    Mortgage Foreclosure Case Manager Liaison

    Truist • Richmond, VA, US
    Full-time
    Responsible for ensuring all foreclosure milestones are met once a loan is referred to foreclosure.Also, responsible for communicating with the foreclosure attorneys, attending vendor calls, and po...Show more
    Last updated: 24 days ago • Promoted
    Team Nexa Insurance Solutions - Partner with Us.

    Team Nexa Insurance Solutions - Partner with Us.

    Team Nexa Insurance Solutions • Henrico, VA, US
    Full-time
    Life Insurance Agent – National Team | High Commissions | Daily Live Training | No Cost Lead System.Join Team Nexa Insurance Solutions – Where Agents Come First.Are you tired of outrage...Show more
    Last updated: 30+ days ago • Promoted
    Medical Only Claims Specialist

    Medical Only Claims Specialist

    CorVel • Glen Allen, VA, US
    Full-time
    Medical Only Claims Specialist.The Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers' compensation claims under close supervisi...Show more
    Last updated: 11 hours ago • Promoted • New!
    Insurance Follow Up Specialist- East

    Insurance Follow Up Specialist- East

    Universal Health Services, Inc. • Richmond, VA, United States
    Full-time
    One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. UHS) has built an impressive record of achievement and performance.Growi...Show more
    Last updated: 30+ days ago • Promoted
    Insurance Agent (Base salary + Uncapped commissions)

    Insurance Agent (Base salary + Uncapped commissions)

    Comparion Insurance Agency • Richmond, Virginia, US
    Full-time
    Schedule : Full-Time Salary Range : USD $55000.Job Category : Sales - Comparion The typical starting salary range for this role is determined by a number of factors including skills, experience, educa...Show more
    Last updated: 15 days ago • Promoted
    Manager of Case Management Operations

    Manager of Case Management Operations

    SOAR365 • Richmond, VA, US
    Full-time
    Are you passionate about empowering individuals with disabilities and leading high-performing teams that make a real difference? SOAR365 is seeking a dynamic and compassionate Manager of Case Manag...Show more
    Last updated: 8 days ago • Promoted
    Insurance Follow Up Specialist - Central

    Insurance Follow Up Specialist - Central

    Universal Health Services, Inc. • Richmond, VA, United States
    Full-time
    One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. UHS) has built an impressive record of achievement and performance.Growi...Show more
    Last updated: 30+ days ago • Promoted
    Team Nexa Life Insurance Agent-No Lead Costs

    Team Nexa Life Insurance Agent-No Lead Costs

    Team Nexa Insurance Solutions • Richmond, VA, US
    Full-time
    THIS POSITION REQUIRES THAT YOU HOLD A VALID INSURANCE PRODUCERS LICENSE • •.Our Agency is currently seeking Life Insurance Agents to work in our Loyalty Sales Group at Security National Life Insuran...Show more
    Last updated: 30+ days ago • Promoted
    Insurance Sales

    Insurance Sales

    LIBERTY NATIONAL • Richmond, VA, US
    Full-time
    Are you looking for a career in Insurance Sales? Do you want to build your own business? Globe Life Liberty National Division is seeking candidates who are ready to build their own business by help...Show more
    Last updated: 30+ days ago • Promoted
    Appeals Specialist

    Appeals Specialist

    Universal Health Services, Inc. • Richmond, VA, United States
    Full-time
    One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. UHS) has built an impressive record of achievement and performance.Growi...Show more
    Last updated: 30+ days ago • Promoted
    Senior General Liability Bodily Injury Technical Claims Specialist

    Senior General Liability Bodily Injury Technical Claims Specialist

    Argonaut Management Services, Inc • Richmond, VA, United States
    Full-time
    Argo Group International Holdings, Inc.American National, US based specialty P&C companies, (together known as BP&C, Inc. Brookfield Wealth Solutions, Ltd.BWS"), a New York and Toronto-listed public...Show more
    Last updated: 30+ days ago • Promoted
    Medical Only Claims Specialist

    Medical Only Claims Specialist

    CorVel Enterprise Claims, Inc. • Glen Allen, VA, US
    Full-time
    The Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers’ compensation claims under close supervision, supporting the goals ...Show more
    Last updated: 18 hours ago • Promoted • New!
    Insurance Product Development Specialist

    Insurance Product Development Specialist

    Richmond National • Glen Allen, VA, US
    Full-time
    Insurance Product Development Specialist.Location : On-site in Glen Allen, VA.Lead the development of new commercial lines insurance products and enhance existing products.Translate underwriting str...Show more
    Last updated: 15 days ago • Promoted
    Case Manager-"Create Connections. Transform Lives."

    Case Manager-"Create Connections. Transform Lives."

    Hope Unity Freedom Center Inc • Richmond, VA, US
    Full-time
    The Hope Unity and Freedom Center is a diverse team of professionals providing psychosocial day support to male and female adults with a primary mental health diagnosis, dual diagnosis, and / or a co...Show more
    Last updated: 22 days ago • Promoted