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Case Management Processor

Location : Edinburg, TX
Job Type : Contract
Reference Code : 7870
Hours : Full Time
Travel : No
Relocation : No

Job Description :
Excellent opportunity with a Healthcare provider in Edinburg, TX.  


Provides support to the Case Management staff performing non clinical activities and supporting the management of the department.
Responsible for initial review and triage of Case Management tasks.
Reviews data to identify principle member needs and works under the direction of the Case Manager to implement care plan.
Screens members using Client policies and processes assisting clinical Case Management staff as they identify
appropriate medical services
Coordinates required services in accordance with member benefit plan.
Promotes communication, both internally and externally to enhance effectiveness of case management services
Runs reports to assist in coordination of case management needs.
Provides support services to case management team members by answering telephone calls, taking messages and researching information.
Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.
Protects the confidentiality of member information and adheres to company


Desired Skills

Strong customer service skills to coordinate service delivery including attention to members/customers, sensitivity to concerns, proactive identification and resolution of issues to promote positive outcomes for members
Demonstrated ability to communicate, problem solve, and work effectively with people
Working knowledge of medical terminology and abbreviations
Ability to think analytically and to problem solve.
Good interpersonal/team skills
Must have a high regard for confidential information
Ability to work in a fast paced environment
Able to work independently and as part of a team.
PC experience in Windows environment and accurate data entry at 40 WPM minimum.
Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers




High School Diploma or G.E.D.


Two or more years of experience as a medical assistant, office assistant or other healthcare service administrative support role. Spanish bilingual highly desired, call center experience a big plus, work experience in Health Care preferred

Day to day responsibilities: Complete Basic Health Risk Screeners over the phone, Inbound/Outbound Calls, Faxing, Letter generation and mailing, Basic use of Microsoft Office, Other various Office Duties.

For immediate consideration, please email resume to



Required Qualifications :
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* Your eligibility for benefits depends upon your placement, hours billed and length of service. Your recruiter can identify the programs for which you are eligible. The Company reserves the right to modify or eliminate any of its non-legally mandated benefits at any time.