Medical Case Manager Assistant / WC Scheduler

Role overview

This is a remote opportunity, with a preference for candidates based in Texas. The position supports case management operations by helping the Supervisor and Manager with administrative and coordination tasks. It does not involve any clinical review or clinical decision-making.

The role focuses on ensuring referrals are entered into the utilization review/case management platform and assigned to the appropriate case manager without delay. The assistant also handles incoming calls, screens and routes inquiries, and supports the team with timely follow-up and documentation. Strong independence, a professional phone presence, medical terminology knowledge, and an understanding of referral criteria by client and/or jurisdiction are important.

Responsibilities

• Receive and direct phone calls from providers, patients, case managers, peer reviewers, and other relevant parties to the correct contact or workflow.
• Serve as the first point of contact for case management support requests.
• Reach out to providers initially to collect clinical information.
• Support case management workflow and documentation, including drafting routine correspondence for case managers, physicians, and patients.
• Assess each caller's or patient's needs and decide the next action, such as referral to a clinic or escalation when required.
• Coordinate with case managers, physicians, claims staff, and outside vendors or agencies to keep patient information accurate, complete, and up to date.
• Print and mail correspondence to the required parties in line with state rules and regulations.
• Manage incoming calls for the case management department and monitor assigned queues and email inboxes.
• Complete determinations and related correspondence within 24 hours of receipt.
• Work collaboratively with the team and support other staff members as needed.
• Meet assigned deliverable and billable-hour expectations each week, as directed by the supervisor.
• Spot referral-pattern trends or issues and share them with management.
• Carry out any other tasks assigned by the supervisor.
• Maintain productivity, time management, and quality assurance standards.
• Follow documentation rules consistent with URAC standards and company policies.
• Protect confidentiality and comply with HIPAA and PHI-related laws and regulations.

Requirements

• High school diploma is required.
• Background in medical or managed care settings is preferred.
• Certified Medical Assistant credential is preferred.
• At least 1 year of experience in a healthcare or managed care environment is preferred.
• Medical terminology knowledge is preferred.
• Prior experience in healthcare-related roles is needed.
• Excellent verbal and written communication skills, with a strong customer-service focus and team-oriented mindset.
• Professional conduct with adherence to ethics, company policies, and department procedures.
• Commitment to continuous quality improvement, service excellence, and teamwork.
• Typing speed of 35–40 words per minute.
• Ability to work efficiently across multiple computer systems.
• Comfort working in Windows, Outlook, Microsoft Word, and Microsoft Excel.
• Ability to operate effectively in a paperless environment.
• Must be able to work independently, handle routine repetitive work, and follow simple written or verbal instructions.
• Preferred experience includes medical assistant work, case management work, and medical claims support.
• Bilingual English/Spanish is preferred.

Additional information

The employer states that it is not a staffing agency and does not directly hire for these roles; instead, it sources and verifies opportunities from established employers.

Equipment commonly used in the role includes a desk, telephone/fax, computer, keyboard, mouse, and system applications. Tools include pens and pencils. No vehicle is required. Professional attire must follow the company dress code.

Mental demands include the ability to follow one- or two-step instructions, perform routine repetitive work, and carry out detailed but uncomplicated written or verbal directions.

Billing and scheduling expectations are part of the role, along with maintaining administrative standards and supporting the department's operational needs.

There are no stated stipend, salary, or vacancy details in the source information.

No internship duration or start date is specified.

This role is offered as a full-time remote position.

Eligibility

Candidates with a high school diploma and experience in healthcare, managed care, medical assistance, or medical claims support are preferred. Applicants with case management experience and bilingual English/Spanish ability may be especially well suited. The role is remote, with preference given to applicants located in Texas.