Reimbursement Case Manager. Will serve as an expert on reimbursement issues and be responsible for handling the day-to-day activities within reimbursement services (benefits investigation, prior authorizations and appeals support). Complete medical and/or pharmacy benefit investigations, identify and facilitate submission of required documentation for payer/plan review for prior authorization, step edit identification and appeals according to pro...
. Purpose. The Reimbursement Case Manager (RCM) is a professional client facing role responsible for various functions, including accurate and timely response to client inquiries regarding specific referral status or escalation. The RCM serves as a primary point of contact for payers. The RCM will manage the benefits investigation process to determine patient eligibility and coverage per their plan along with prior authorization and appeal suppor...
