Insurance Case Manager

Join to apply for the Insurance Case Manager role at HCA Florida North Florida Hospital
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Introduction:
Do you have the career opportunities as a Insurance Case Manager you want with your current employer? We have an exciting opportunity for you to join HCA Florida North Florida Hospital which is part of the nation's leading provider of healthcare services, HCA Healthcare.

• Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free Air Med medical transportation.
• Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long‑term care coverage, moving assistance, pet insurance and more.
• Free counseling services and resources for emotional, physical and financial wellbeing
• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
• Employee Stock Purchase Plan with 10% off HCA Healthcare stock
• Family support through fertility and family building benefits with Progyny and adoption assistance.
• Referral services for child, elder and pet care, home and auto repair, event planning and more
• Consumer discounts through Abenity and Consumer Discounts
• Retirement readiness, rollover assistance services and preferred banking partnerships
• Education assistance (tuition, student loan, certification support, dependent scholarships)
• Colleague recognition program
• Time Away From Work Program (paid time off, paid family leave, long‑ and short‑term disability coverage and leaves of absence)
• Employee Health Assistance Fund that offers free employee‑only coverage to full‑time and part‑time colleagues based on income.

Note:

Eligibility for benefits may vary by location.

• Oversee all aspects of transplant authorization and medical management authorization.
• Manage the transplant authorization process for assigned cases.
• Act as a liaison between clinical staff, physicians, and hospital departments to address escalated financial clearance matters.
• Completely and accurately obtains/maintains transplant benefits and insurance verification on patients presenting for transplant services and/or organ failure services during all phases of transplant care.
• Consistently meet deadlines and turn‑around times to ensure authorizations are obtained timely.
• Manages all aspects of the transplant authorization process for assigned cases, which includes periodic re‑verification of patients managed by the transplant program.
• Maintains and updates clinic and case management personnel on patient status, including patients who require additional testing for continued authorization, communication about authorization, and case closures with the insurance company.
• Assists with the development of processes and procedures related to the financial coordinator and/or counselor role in collaboration with the Department Director.
• Coordinates with clinicians to obtain authorizations for complex medical cases requiring additional clinical documentation or peer‑to‑peer review.
• Provides direction and support to Financial Coordinators and/or Financial Counselors on interpreting and understanding payor medical coverage policies and authorization requirements.
• Acts as a liaison to assist in maintaining effective relationships with clinical staff, physicians, and hospital departments by addressing escalated financial clearance matters.
• Supports the patient financial counseling process, which may include conducting patient education classes, financial counseling, and/or attending patient tracking meetings as designated.
• Coordinates with clinical case management, patient access, insurance case management, clinic personnel, and physicians to ensure transplant‑related cases are reviewed for financial clearance, insurance selection, and authorization.
• Demonstrates proficiency in all areas related to Global Billing/Reimbursement for cross‑coverage on duties that are not equally shared.
• Support…