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

Job Summary

Our client is seeking a dedicated Medical Case Manager to play a critical role in helping patients gain timely access to prescribed therapies by supporting healthcare providers with insurance benefit investigations and coverage navigation. The chosen candidate will handle benefits requests, verify insurance coverage, and proactively engage with providers regarding clinical documentation and prior authorizations.

Key Responsibilities

• Conduct benefits investigations for requests submitted by medical offices (MDOs).
• Contact insurance companies to verify medical, specialty pharmacy, and prescription benefits.
• Communicate with medical offices to obtain or follow up on clinical documentation, prior authorizations, and transfers.
• Collaborate with Field Access Managers and Key Account Managers to ensure alignment for program objectives.
• Assist 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 healthcare patient access, case management, or reimbursement support.
• Experience in a healthcare hub or specialty pharmacy support setting.
• Strong knowledge of benefit investigations, prior authorizations, and insurance verification.
• Proficient in Microsoft Office and case management tools; HIPAA-compliant with sensitive info.
• High school diploma or GED.

Preferred Skills

• Bilingual (Spanish/English).
• Certified Medical Assistant (CMA) or Certified Pharmacy Technician (CPhT).
• Familiarity with EMR or CRM systems (e.g., Salesforce, Zendesk).
• Experience supporting field access or pharmaceutical sales teams.

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.

Flexibility and adaptability are key, as this is a pilot program and processes may still be evolving.

Two shifts are available: Monday-Friday, 9am-5:30pm or 9:30am-6pm.

^*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.

^*As a job position within our Insurance 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 medical and confidential records, verifying financial information, and working within departments that care for 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