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Remote Case Management Processor Jobs in Pennsylvania

County of Chester, PA

ID Supports Coordinator

PA · On-site +1

$51K/yr

Government Services Center - Westtown, PA Job Type: Full Time, Non Exempt Remote Employment ... The position provides case management services to a group of clients with intellectual disabilities ...

Harris

$10/hr

Remote Care Manager Location: Remote The Care Manager will be assigned a patient panel based on ... A minimum of two (2) years of clinical experience in a clinic setting, Med/Surg, Case Management ...

Harris

$10/hr

Remote Care Manager Location: Remote The Care Manager will be assigned a patient panel based on ... A minimum of two (2) years of clinical experience in a clinic setting, Med/Surg, Case Management ...

Veterans Health Administration

Social Worker

Altoona, PA · On-site +1

$66K - $104K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... processes. * The HV Case Manager will develop a working relationship with the designated Contracted Emergency Residential Services (GERS) / Low Demand Safe Havens (LOSH) point of contact to ...

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All JobsCase Management Processor JobsRemote Case Management Processor JobsRemote Case Management Processor Jobs in Pennsylvania

Remote Case Management Processor information

What is the difference between Remote Case Management Processor vs Remote Claims Processor?

AspectRemote Case Management ProcessorRemote Claims Processor
CredentialsTypically requires case management certifications or healthcare-related credentialsOften requires insurance or claims processing certifications
Work EnvironmentHealthcare or social services settings, remote or office-basedInsurance companies, healthcare providers, remote or office-based
Industry UsageHealthcare, social services, insuranceInsurance, healthcare, financial services
Job FocusManaging patient or client cases, coordinating servicesProcessing insurance claims, verifying coverage

While both roles involve processing information remotely, the Remote Case Management Processor focuses on managing client cases and coordinating services, often in healthcare or social services. In contrast, the Remote Claims Processor primarily handles insurance claims, verifying coverage and processing payments. Understanding these differences helps job seekers identify the right role based on their credentials and career interests.

What cities in Pennsylvania are hiring for Remote Case Management Processor jobs?

Cities in Pennsylvania with the most Remote Case Management Processor job openings:

Remote Case Management Processor jobs near you

Client Success Associate - Remote

Care Options for Kids

State College, PA • On-site, Remote

$23 - $25/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 28 days ago

Job description

At Care Options for Kids, we are committed to providing the highest quality of service, delivering excellence in everything we do, and maintaining integrity in every interaction.
The Client Success Associate is responsible for managing the end-to-end referral and admission process for patients requiring private duty nursing services in the home. This role ensures timely, accurate, and compliant intake operations while serving as a key liaison among referral sources, patients and families, clinical teams, and payers.
Client Success Associate responsibilities include, but are not limited to:
  • Receive and manage incoming referrals from hospitals, physicians, case managers, managed care organizations, and community partners.
  • Coordinate and manage all new patient intakes from referral through admission and service activation.
  • Review referral documentation for completeness and accuracy, and enter all required information into the EMR.
  • Verify patient eligibility, benefits, and insurance coverage, including Medicaid and commercial insurance plans.
  • Obtain, submit, and track authorization requests and Single Case Agreements from initiation through execution.
  • Serve as the primary point of contact for patients, families, and referral sources regarding services, rates, admission status, and available community resources.
  • Maintain ongoing communication and provide timely updates to referral sources, families, and internal team members regarding intake status and service readiness.
  • Ensure compliance with agency policies, regulatory requirements, payer guidelines, and documentation standards.
  • Complete assigned Intake Workflow tasks within the EMR and identify opportunities to improve intake processes and operational efficiency.
  • Track and maintain accurate intake records, metrics, and reporting data to support departmental performance goals.

Qualifications:
  • Associate degree required; bachelor's degree preferred.
  • Minimum of two years of experience in healthcare intake, admissions, care coordination, home health, private duty nursing (PDN), or managed care preferred.
  • Knowledge of insurance verification, authorization processes, Medicaid programs, managed care organizations, Single Case Agreements, and health plans related to PDN services preferred.
  • Strong organizational, communication, and interpersonal skills.
  • Proficiency with EMR systems and Microsoft Office applications, including Outlook and Excel.
  • Ability to communicate effectively in English, both verbally and in writing; bilingual skills are a plus but not required.
  • Ability and willingness to travel occasionally (up to 10%) for team meetings, training, conferences, and other business-related events as needed.
Care Options for Kids offers benefits to variable paid employees based on certain measurement periods. These benefits are available to eligible employees and are designed to support the health and well-being of you and your family.
Location:Remote in Pennsylvania, New Jersey or Delaware
Wage:$23.00 to $25.00/hour
Benefits include:
  • Paid time off
  • Medical, dental and vision
  • 401K
  • Other voluntary products

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