Case Manager

Are you a compassionate, detail-oriented healthcare professional looking for a rewarding, fully remote case management opportunity? We are seeking a dedicated Patient Access Case Manager to guide patients through their healthcare journey and ensure seamless access to vital therapies!

In this key remote position, you will support patient access through reimbursement services, guiding healthcare providers and patients through intake, insurance benefit investigations, prior authorizations, and step-therapy reviews. Working flexible 8-hour shifts during normal business hours (Monday through Friday, 7:00 AM – 7:00 PM CT), you will proactively collaborate with insurance carriers, specialty pharmacies, and care teams to resolve complex payer issues and facilitate timely product delivery. You will handle inbound and outbound calls with exceptional customer support while maintaining detailed electronic records and meeting daily benefit investigation goals. If you bring strong problem-solving capabilities, clear communication skills, and a commitment to patient advocacy, this fully remote role offers a fantastic platform to showcase your talents.

salary: $19.99 - $20 per hour shift: First work hours: 8 AM - 5 PM education: High School

Responsibilities

Position Summary:

Guide healthcare providers and patients through insurance benefit investigations, prior authorizations, and reimbursement processes to ensure timely access to specialty therapies.

Key Responsibilities:

• Perform patient referral intake and investigate health insurance benefits across commercial and government payers.
• Identify, initiate, and track prior authorization and step-therapy review requests.
• Conduct inbound and outbound calls with healthcare providers, payers, and specialty pharmacies to resolve coverage barriers.
• Proactively follow up on open cases to facilitate timely drug delivery while maintaining HIPAA compliance and call quality standards.
• Document all case interactions and benefit investigation details accurately in system applications.

Requirements:

• High School Diploma or GED required; additional education preferred.
• 1–2 years of experience conducting health insurance benefit investigations, prior authorizations, or appeals.
• Knowledge of Medicare, Medicaid, and commercial insurance coverage policies and billing/coding practices preferred.
• strong written and verbal communication, organizational, and critical-thinking skills.
• Private, quiet remote setup with hardwired high-speed broadband internet (15 Mbps download / 5 Mbps upload minimum).
• Full availability for mandatory virtual new-hire training (Monday – Friday, 8:00 AM – 5:00 PM CT).

Skills

• Business operations
• Problem Solving
• Prioritizing
• Microsoft Office

Qualifications

• Years of experience: 2 years
• Experience level: Experienced

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.