Care Management Support Assistant – Part Time

November 9, 2026

Job Description:

Review inbound referrals and correspondence for processing, fulfilment, or resolution
Screen physician orders and documentation for required medical information
Request additional information from referring entities when necessary
Verify benefits coverage and eligibility for services
Review referral data against medical terms, diagnoses, and procedure codes
Approve requests or refer them for further review according to established procedures
Provide referral management education to members and providers
Communicate with patients to confirm demographics and explain requested services and care
Coordinate timely delivery of care and services with providers
Communicate final referral determinations to referring entities, providers, and members
Maintain detailed documentation of patient, physician, referral source, provider, and communication interactions
Collaborate with Pre-Authorization, Utilization Management, Billing, Pharmacy, and Home Care
Maintain patient information security and confidentiality
Report issues delaying service delivery to the manager
Provide internal and external customer service while meeting quality standards

Requirements:

1-3 years of Home Health or Infusion Pharmacy experience required
Wound care/Ostomy supplies experience preferred
Microsoft Office technical experience with Word, Outlook, and Excel preferred
Knowledge of Medicare/Medicaid and commercial insurance required
Experience with medical authorizations required
Knowledge of medical billing preferred
Excellent customer service and communication skills
Florida Level 2 background screening through the Care Provider Background Screening Clearinghouse
Knowledge of applicable CPT, HCPC, and ICD-10 codes
Knowledge of insurance contracts, Medicare/Medicaid criteria, and Health Plan policies
Knowledge of applicable federal/state regulations, patient confidentiality, release of information, and HIPAA

Benefits:

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