About Careertakes

👉 Important disclosure: Careertakes is a third-party recruiting platform supporting this hiring process. If selected, you will be employed directly by our client, Healthcare & Nursing.

Applicants for this role may also receive access to additional matched opportunities through the Careertakes platform.

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About the Role

The confidential client is seeking an Entry-Level Surgical Case Manager to support coordination and oversight of surgical patients across Workers' Compensation (WC), No-Fault (NF), and Medical Lien cases. This is an excellent opportunity for a motivated candidate to begin a career in medical case management within a fast-paced, multi‑specialty clinical environment. The Surgical Case Manager will work with clinical teams, billing, legal representatives, and payors to ensure timely authorizations, accurate documentation, and continuity of care from pre‑authorization through post‑operative discharge.

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Responsibilities

• Manage and track a caseload of surgical patients across Workers' Compensation, No‑Fault, and Medical Lien claims from initial evaluation through post‑operative care.
• Submit and follow up on Prior Authorization Requests (PARs) for surgical procedures, DME, and post‑operative physical therapy through the NY Onboard portal and carrier‑specific platforms.
• Review and interpret denial letters and utilization review determinations; coordinate with clinicians and legal staff to prepare appeal documentation and supporting clinical records.
• Ensure clinical documentation is complete, accurate, and submitted within required timeframes to support authorization and billing.
• Communicate with WC carriers, No‑Fault insurers, and lien holders regarding claim status, authorizations, and treatment updates.
• Coordinate scheduling of pre‑operative appointments, surgical procedures, and post‑operative follow‑up visits.
• Liaise with attorneys, adjusters, and third‑party administrators on case status, legal holds, and lien resolution as needed.
• Monitor patient compliance with prescribed therapy and follow‑up appointments; document and report non‑compliance where appropriate.
• Maintain organized and up‑to‑date case files in the practice management system, ensuring all authorizations, denials, appeals, and correspondence are documented.
• Assist providers in preparing Statements of Medical Necessity and other supporting documents as requested.

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Qualifications

• High school diploma or GED required; Associate's or Bachelor's degree in Health Sciences, Healthcare Administration, or related field preferred.
• 0–2 years of experience in a medical office, case management, or healthcare administrative role; experience with WC or NF cases a plus.
• Familiarity with medical terminology, surgical CPT codes, and ICD‑10 diagnosis codes preferred.
• Knowledge of the NY Onboard prior authorization portal and NYS Workers' Compensation Board processes is a plus.
• Strong organizational skills with the ability to manage multiple cases and meet deadlines.
• Excellent written and verbal communication skills.
• Proficiency in Microsoft Office (Word, Excel, Outlook); experience with practice management or EMR software preferred.
• Ability to work collaboratively with clinical, administrative, and legal teams.

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Required Skills

• Strong organizational skills
• Excellent written and verbal communication
• Proficiency in Microsoft Office
• Ability to work collaboratively across teams

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Preferred Skills

• Familiarity with medical terminology
• Knowledge of NY Onboard prior authorization portal
• Bilingual (English/Spanish)

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Compensation

• Estimated base salary: $66,921 per year (estimated)

Note: This posting follows applicable pay‑transparency rules for New York. Exact compensation and benefits will be provided by the confidential client during the hiring process.

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Equal Opportunity Statement

The confidential client and Careertakes are committed to building a diverse and inclusive workforce and are equal opportunity employers. We prohibit discrimination or harassment of any kind.

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Equal Opportunity & Hiring Transparency

Careertakes and our client are Equal Opportunity Employers committed to building a diverse and inclusive workforce. We prohibit discrimination or harassment of any kind. To support a fair and efficient hiring process, AI tools may be used to assist with application review or resume screening. These tools do not replace human decision-making. Final hiring decisions are made by people.

If you have questions about how your data is used, please contact us directly.