Managed Care Case Manager
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Required work experience: 2-4 years
Location: 100% Remote - Open to All Applicants in the Philippines.
Who Are We
Touch Support, a multinational Business Process Optimization company, is rapidly expanding its finance and support teams. We are seeking a motivated, detail-oriented individual in the Philippines to join our team as a Managed Care Case Manager. With over 350 employees across the US and Europe and a proven track record of successful remote onboarding, we are excited to offer this long-term opportunity to talented professionals like you.
What We're Looking For
- 2–4 years of experience as an RN, LPN, USRN, or Healthcare Virtual Assistant with clinical nursing education
- Knowledge of US healthcare insurance, Medicare Advantage, Medicaid MCOs, commercial payors, and criteria such as InterQual/MCG is a plus
- Experience with PointClickCare, MatrixCare, Availity, NaviHealth, or similar systems
- Strong English communication , organization, attention to detail, and time-management skills
- Ability to manage high-volume authorization workflows independently
- Shift & Schedule - full-time, five days per week (US business hours align - 7 AM - 3 PM CDT), including dedicated Weekend Coverage
What You'll Do
- Manage pre-admission and prior authorizations with MCOs, Medicare Advantage, and commercial insurers
- Conduct concurrent reviews and clinical chart audits to support continued stays
- Track authorizations, length of stay, and expiration dates to prevent coverage gaps and lost revenue
- Communicate with insurance case managers, medical directors, and facility clinical teams
- Support Peer-to-Peer reviews and appeals when coverage is denied
- Coordinate with intake, nursing, social work, and billing teams
- Maintain accurate authorization records in the EHR
- Provide weekend/high-volume coverage and ensure smooth team handoffs
What We Offer:
- Starting salary: 665 USD gross monthly
- Comprehensive Training: We provide extensive initial training and ongoing mentorship to set you up for success
- A Clear Career Ladder: This role is just the beginning. We offer a clear promotional path with competitive salary increases as you grow with us
- A Supportive Global Team: Even though we work from home, our team is tightly connected. You will have a dedicated Team Lead and supervisor
- A Dynamic Work Environment: You will be in constant communication with native English speakers, helping you to further enhance your language skills in a professional setting
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