PROVE Partners Case Manager Remote · Full time

The Patient Care Manager will be responsible for managing a caseload of medical lien clients from initial intake to resolution. This includes communication with clients, medical providers, and attorneys to ensure timely and accurate processing of medical lien claims.

Description

ABOUT US:


PROVE Partners, LLC, founded in 2003 and based in Las Vegas Nevada, is a patient-centric complex claims administration and healthcare finance company that provides innovative services and financial products to injury victims, medical providers and law firms in the United States.


PROVE is primarily engaged in a fast-growing form of specialty reimbursement commonly referred to as medical lien funding that enables victims of third-party liability accidents (e.g., motor vehicle collisions) to access healthcare in their greatest time of need.


PROVE is more than a medical lien funder—we offer patients a full-suite of financial products including co-pay and deductible finance and pre-settlement loans, providers with comprehensive revenue cycle solutions including outsourced complex claims administration, and attorneys with patient concierge services and technology solutions to manage caseloads, reduce overhead and most importantly, maximize the outcome for their clients.


PROVE maintains a fortressed balance sheet, supported by a group of institutional capital partners that manage more than $16 billion in assets under management.


PROVE is backed by C9 Partners, LLC, a Los Angeles-based private equity firm focused on making investments in US-based businesses at intersection of financial services, specialty finance, and healthcare services.


JOB SUMMARY:


  • We are seeking an experienced Patient Care Manager to join our team. The Patient Care Manager will be responsible for managing a caseload of medical lien clients from initial intake to resolution. This includes communication with clients, medical providers, and attorneys to ensure timely and accurate processing of medical lien claims. The Patient Care Manager will also be responsible for maintaining client files, documenting case activity, and ensuring compliance with all company policies and procedures.


DUTIES:


  • You will communicate and build rapport with law firms to facilitate a seamless process for their clients to access medical care required as a result of an injury.
  • The Patient Care Manager will be responsible for gathering all information necessary to present the underwriter with a complete file for determination of funding.
  • The Patient Care Manager will be responsible for underwriting to the level of authorized funding.
  • If the case is authorized for funding or declined for funding, the Patient Care Manager is responsible for communicating this status with the provider and the attorney.
  • The Patient Care Manager is responsible for updating CORE as required for ongoing medical lien funding.
  • The Patient Care Manager will be responsible to ensuring that all documents received are saved into the appropriate locations.
  • The Patient Care Manager will schedule patients with medical providers in the PROVE Provider Network and follow up with the patient and attorney for each medical encounter.
  • The Patient Care Manager will provide education for attorney firms and providers on the PROVE Portal.
  • The Patient Care Manager will correspond with attorney offices and providers to obtain all relevant case information.
  • The Patient Care Manager will develop and maintain productive customer relationships.
  • The Patient Care Manager will maintain HIPAA compliance with all correspondence.
  • The Patient Care Manager will deliver optimal customer satisfaction through timely, accurate case processing.
  • The Patient Care Manager will perform other related duties as assigned by the Operations Manager.


SKILLS AND QUALIFICATION:

  • Bachelor’s or associate degree is preferred but not required.
  • Experience in case management in the medical lien or healthcare industry is preferred.
  • Strong communication and interpersonal skills.
  • Excellent organizational and time-management skills.
  • Ability to work independently and as part of a team.
  • Strong problem-solving and critical thinking skills.
  • Excellent customer service skills.
  • Knowledge of medical terminology is preferred.
  • Bilingual or multilingual preferred.
  • The candidate must live in the Denver Metropolitan area, with a preference towards South Denver/Castle Rock.


IDEAL CANDIDATE PROFILE:

  • Experience in personal injury cases.
  • Experience in case management.
  • Experience in medical appointment scheduling.


DISCLOSURES:

  • Prove Partners is an Equal Employment Opportunity and Affirmative Action Employer committed to diversity in the workplace. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status.


Salary

$50,000 - $50,000 per year