Besht Wellness Group is a growing medical practice looking for a Case Manager to become a part of our team. The perfect candidate would have previous experience in running insurance eligibility, discussing insurance and Medicare/Medicaid benefits with patients, physician credentialing and be familiar with industry recognized standards. Additionally, the ideal applicant would understand patient placement in assisted living and skilled nursing facilities. Excellent analytical, organizational, and time management skills are also required for this position.

We encourage all serious applicants to send a cover letter describing themselves and why they would be a good fit for this position.

• Required licenses: None. RN, LVN, PA, NP are not required, but can be advantageous for this position.

Essential Job Duties:

• Insurance Eligibility This involves verifying the patient's insurance coverage, benefits, and eligibility, and if need be, working with the patient to discuss options to transition and assist patients in the process. And then following up with the insurance providers to confirm eligibility and that the transition was successful
• Credentialing This involves the responsibility for coordinating and maintaining active status for providers by successfully completing initial and subsequent credentialing packages, forms, and applications, as required by hospitals, surgery centers, commercial payers, Medicare and Medicaid. Additionally, monitor the management of the credentialing data and documents in an organized way.
• Contracting This involves in managing and assisting with the providers to become contracted with different Payers, including Medicare, Medi-Cal, PPO's and HMO's.
• Patient Movement Management This involves managing and truly owning patient movements between facilities including hospitals, SNF’s, ALF’s and home. Additionally, being in touch with the providers caring for those transitional patients to help place them in the right place for their needs.

Required Skills:

• Extensive knowledge of health insurance, benefits, eligibility, specifically Medicare and Medi-Cal in the geriatric space.
• Highly organized and excellent attention to detail with the ability to manage and follow up with various ongoing projects and tasks simultaneously.
• Competent and okay with working independently along with being a valuable team player and assisting colleagues when necessary
• Outstanding communication skills with a strong ambition to pursue potential leads

Job Type: Full-time

Pay: $80,000.00 - $120,000.00 per year

Benefits:

• 401(k)
• Health insurance
• Paid time off

Schedule:

• 8 hour shift
• Monday to Friday

Work Location: In person