Care Management Support Specialist I

This is a fully remote position, open to applicants in United States.

📋 Description

• Accurately and promptly review and respond to service requests from both internal and external clients.

• Enter and manage case data while ensuring records are thorough and ready for audits.

• Generate monthly reports, maintain logs, and create flyers and data summaries.

• Create, manage, and extract invoices to verify payments, revenue, and expenses.

• Organize project folders and documentation efficiently.

• Strategically plan and execute assignments to fulfill productivity, quality, and turnaround goals.

• Maintain documentation and processes in preparation for URAC and NCQA external audits.

• Appropriately escalate any departmental or employee concerns.

• Engage in regular meetings and keep shared task lists and project trackers updated.

• Ensure HIPAA compliance, maintain confidentiality standards, and complete all mandatory annual training.

⛳️ Requirements

• A high school diploma or equivalent (GED) is required.

• Previous experience in a medical front office, hospital patient intake, or medical claims processing, or a comparable combination of education and experience.

• Familiarity with claims, utilization management, care management, or revenue cycle data.

• Experience in handling healthcare administrative data, including claims, eligibility, benefits, billing, or authorizations.

• Proficient in preparing reports, summaries, or dashboards for operational or leadership review.

• Strong skills in Microsoft Office (Excel, Word, PowerPoint, Outlook) and Adobe products.

• Experience with Airtable and Power BI.

• Accurate data entry capabilities (40 WPM).

• Ability to perform data analytics and analysis.

• Knowledge and skills in finance or bookkeeping terminology.

• Understanding of medical terminology.

• Familiarity with ICD-10, CPT, and HCPCS coding is advantageous.

🏝️ Benefits

• Competitive base salary and benefits starting from day one.

• Comprehensive medical and dental coverage through our own health solutions.

• Paid Time Off.

• Access to mental health support.

• Retirement planning assistance.

• Financial protection options.

• Opportunities for professional development with clear career progression and learning budgets.

• A mission-driven culture where diverse perspectives contribute to significant impacts on health.

• Wellness programs available.

• Additional employee perks.