Case Manager

Job description

The Case Manager – SNF & Insurance Coordination is responsible for investigating and resolving complex insurance coverage issues for patients receiving care in Skilled Nursing Facilities. This role focuses on situations where coverage is incomplete, unverified, or unbillable through standard processes — including patients with Medicare Part A only, no insurance, or placement in hospital-owned or county facilities — and works directly with facilities and payers to identify viable billing solutions. Essential Duties and Responsibilities: Facility Outreach & Direct Billing Coordination - Negotiate and establish direct billing agreements or arrangements with facilities where applicable - Document all outreach, agreements, and billing resolutions in the appropriate systems - Serve as the primary point of contact between the billing department and SNF facilities for unresolved or problematic accounts Insurance Verification & Issue Resolution: - Verify insurance eligibility and coverage details for patients with unclear or unspecified payer information - Identify patients who have Medicare Part A only and determine appropriate next steps for coverage or billing - Work with payers, Medicai...