You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

As a Medical Case Manager, you will play a critical role in helping patients gain timely access to prescribed therapies by supporting healthcare providers with insurance benefit investigations and coverage navigation. You will be responsible for handling benefits requests submitted by medical offices, contacting insurance carriers to verify medical, specialty pharmacy, and prescription benefits, and proactively following up with providers regarding clinical documentation and prior authorizations. You will serve as a key point of contact for field access managers, key account managers, and sales representatives to ensure program needs are met and support is aligned across all stakeholders.

Key Responsibilities

• Conduct benefits investigations for requests submitted by medical offices (MDOs)
• Contact insurance companies to verify medical, specialty pharmacy, and/or prescription benefits
• Communicate with medical offices to obtain or follow up on clinical documentation, prior authorizations, transfers, and other case needs
• Collaborate regularly with Field Access Managers (FAMs) and Key Account Managers to ensure alignment and support for program objectives
• Assist and support sales representatives with case-related updates or provider needs
• Maintain accurate and timely documentation of all case activities in accordance with program and HIPAA guidelines
• Serve as a liaison between providers, insurance carriers, and internal teams to facilitate patient access to therapy
• Respond promptly and professionally to case inquiries, escalating issues as necessary

Qualifications

• 2+ years of experience in patient access, case management, or reimbursement support
• Strong knowledge of benefit investigations, prior authorizations, and insurance verification
• Excellent communication, attention to detail, and ability to manage multiple cases
• Proficient in Microsoft Office and case management tools; HIPAA-compliant with sensitive info
• High school diploma or GED
• Bilingual (Spanish/English) preferred
• Experience in a healthcare hub or specialty pharmacy support setting preferred
• Certified Medical Assistant (CMA) or Certified Pharmacy Technician (CPhT) preferred
• Familiarity with EMR or CRM systems (e.g., Salesforce, Zendesk) preferred
• Experience supporting field access or pharmaceutical sales teams preferred

Additional Requirements

On site 100%, Monday-Friday, 9:30am-6pm

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

Required Employment / Compliance Language

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

^*This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

^*As a job position within our Care Management division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, access and handling of patient medical records, providing medical care inside a patient’s residential address, driving, prescription and other drug access and administration, and working with vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.