Case Manager (Benefit Investigation)

Location: Atlanta
Posted on: June 23, 2025

Job Description:

Job Title: Case Manager (Benefit Investigation) Location: Remote BUT schedule is based in CST time zone. TRAINING: M-F 8:00am-5:00pm CST , mandatory virtual attendance is required. Must attend 100% of training and pre-planned appointments/time off will not be accepted. Schedule: Must be able to work any 8hr. shift between 7am-7pm CST (as assigned) Pay: $20.00/hr. Benefits: Health, Dental, Vision, Life Insurance, and short-term disability after 90 days For more information, please contact Breanna D. directly at bdrollinger@alinestaffing.com Case Manager (Benefit Investigation) Description/Duties · Manage the entire care process with a sense of urgency from benefit investigation and verification to medication delivery, ensuring an exceptional patient experience · Conduct benefit verifications and collaborate with various healthcare providers, including physicians, specialty pharmacies, and insurance companies, to ensure seamless coordination of patient care and timely access to necessary services · Assist in obtaining insurance, prior authorization, and appeal requirements and outcomes · Help patients understand their insurance plan coverage, including out-of-pocket costs, and provide guidance on the appeals process if needed · Resolve patient's questions and any representative for the patient’s concerns regarding status of their request for assistance · Demonstrate expertise in payer landscapes and insurance processes. Remain knowledgeable about long and short-range changes in the reimbursement environment including Medicare, Medicaid, Managed Care, and Commercial medical and pharmacy plans while planning for various scenarios that may impact prescribed products · Process enrollments via fax, phone, and electronically as needed · Scrutinize forms and supporting documentation thoroughly for any missing information or new information to be added to the database · Support inbound phone que from patients, healthcare provider offices, SPs, and customers, striving for one-call resolution

Keywords: , Smyrna , Case Manager (Benefit Investigation), Healthcare , Atlanta, Georgia