Case Manager

The Case Manager investigates and resolves complex insurance coverage issues for patients in Skilled Nursing Facilities, specifically handling cases with incomplete, unverified, or unbillable coverage. The role involves negotiating direct billing arrangements, verifying eligibility for various payers including Medicare and Medicaid, and managing insurance denials and appeals. Additionally, the position ensures compliance with HIPAA and CMS guidelines while collaborating with internal teams and external facilities to secure viable billing solutions.