Case Manager

Discover your 100% YOU with MicroSourcing!

Position: Case Manager

Location: Eastwood, Libis. Quezon City

Work setup & shift: Hybrid, Night shift

Why join MicroSourcing?

You'll Have

Competitive Rewards: Enjoy above-market compensation, healthcare coverage on Day 1 for you and one or more dependents, paid time off with cash conversion, group life insurance, and performance bonuses.

A Collaborative Spirit: Contribute to a positive and engaging work environment by participating in company-sponsored events and activities.

Work-Life Harmony: Enjoy the balance between work and life that suits you with flexible work arrangements.

Career Growth: Take advantage of opportunities for continuous learning and career advancement.

Inclusive Teamwork: Be part of a team that celebrates diversity and fosters an inclusive culture.

Your Role

The Case Manager is responsible for managing assigned cases from Intake hand-off through to successful equipment delivery, ensuring all clinical, insurance, and procedural requirements are met. This role requires strong coordination skills to manage clinical documentation collection, authorization processes, equipment ordering, and patient scheduling.

Case Managers are also the primary point of communication for patients and referral sources throughout the case, providing timely updates at every stage and resolving issues that could delay delivery. In addition, they coordinate complex PT/OT assessments with Assistive Technology Professionals (ATPs), working closely with the ATP Liaison, Telehealth providers, in-person clinics, or 3rd party facilities when required by insurance guidelines.

Specifically, You Will

• Case Ownership & Progression
• Independently manage and oversee a high-volume caseload from Intake hand-off through equipment delivery, ensuring timely progression across all operational and clinical stages.
• Serve as the primary case owner responsible for maintaining workflow continuity, preventing delays, and driving successful case completion while meeting operational and payer timelines.
• Exercise autonomy and sound judgment in prioritizing urgent, complex, and high-impact cases based on authorization deadlines, patient needs, and business priorities.
• Proactively monitor case progression, identify workflow barriers, and implement corrective actions to minimize stalled cases, denials, reschedules, or fulfillment delays.
• Maintain accountability for all assigned cases by ensuring documentation, authorizations, scheduling, and fulfillment activities are completed accurately and within expected turnaround times.
• Coordinate cross-functionally with Intake, ATP Liaisons, PAR Specialists, Purchasing, Delivery, PT/OT providers, and referral sources to ensure seamless case movement across departments.
• Act as the central communication owner for patients, providers, and referral sources by delivering timely updates, resolving escalations, and managing expectations throughout the case lifecycle.
• Manage case queues strategically to balance productivity, patient satisfaction, operational efficiency, and revenue cycle impact.
• Independently resolve case-related issues involving insurance eligibility, authorization requirements, scheduling conflicts, missing documentation, and payer-related barriers with minimal supervision.
• Maintain detailed and accurate case tracking within internal systems to support compliance, workflow transparency, and departmental reporting.
• Clinical Documentation Management
• Independently review and evaluate clinical documentation to ensure compliance with insurance medical necessity requirements and company standards.
• Take ownership of documentation completion by proactively coordinating with providers, referral sources, and clinical teams to obtain missing or corrected records.
• Analyze documentation quality and identify potential authorization risks that may impact approval timelines or reimbursement.
• Maintain organized, audit-ready documentation records while ensuring accuracy, completeness, and timely system updates.
• Reduce workflow aging and prevent unnecessary case delays by actively monitoring documentation-related WIP stages and executing timely follow-up actions.
• PT/OT Assessment Coordination
• Independently coordinate complex PT/OT assessment workflows involving ATPs, telehealth providers, in-person clinics, and third-party facilities based on payer-specific requirements.
• Manage scheduling logistics, appointment coordination, and communication between patients, ATPs, providers, and referral sources to ensure timely evaluations and uninterrupted case progression.
• Exercise problem-solving and decision-making skills in identifying alternative PT/OT solutions when payer restrictions or scheduling barriers arise.
• Maintain accountability for assessment completion timelines and proactively address issues that may delay evaluations or authorization submission.
• Prior Authorization Coordination
• Oversee and track prior authorization workflows to ensure timely payer submission, status monitoring, and approval progression.
• Proactively communicate authorization updates, payer requirements, and next steps to patients, providers, and internal stakeholders.
• Ensure insurance eligibility and authorization accuracy are validated prior to fulfillment to minimize billing risks and payment delays.
• Equipment Ordering & Fulfillment
• Coordinate fulfillment readiness by validating insurance status, authorization approval, and documentation completion prior to equipment ordering.
• Actively monitor fulfillment timelines and collaborate with operational departments to prevent delays affecting patient delivery schedules.
• Provide proactive guidance to patients regarding insurance maintenance and coverage responsibilities during the fulfillment process.
• Escalate operational or payer-related concerns that may negatively impact reimbursement, delivery completion, or patient satisfaction.
• Resolution SLA Compliance
• Respond to tickets, callback requests, and internal inquiries within agreed SLA timelines.
• Assist internal teams with insurance or case-related questions.
• Log all resolutions and communications accurately in internal systems.
• Quality & Compliance
• Maintain high accuracy in case documentation, communication logs, and system updates.
• Follow company SOPs, payer guidelines, and compliance standards to reduce denials and rework.
• Pass quality audits with minimal errors or corrections needed.
  
  

What You Need

Non-negotiables

• Bachelor’s Degree or equivalent work experience.
• 3-5 year’s of relevant work experience.
• Healthcare Knowledge - Familiarity with healthcare processes, insurance coverage, and durable medical equipment (DME). Prior knowledge or experience is an advantage but not a strict requirement, as relevant knowledge can be developed through training.
• Sales Background - Previous experience in sales, upselling, cross-selling, or identifying customer needs and recommending appropriate products or solutions is a definite plus. This can help support revenue opportunities while maintaining a customer-focused approach.
  
  

Preferred Skills/expertise

• Strong knowledge of insurance plan types, coverage verification, and prior authorization processes.
• Proficiency in healthcare software systems (Brightree experience is a plus).
• Excellent organizational skills with the ability to multitask.
• Strong decision-making and problem-solving abilities.
• Exceptional attention to detail and accuracy in documentation.
• Effective verbal and written communication skills.
• High level of professionalism, reliability, and cooperation.
• Familiarity with HIPAA compliance and patient confidentiality requirements.
  
  

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About MicroSourcing

With over 9,000 professionals across 13 delivery centers, MicroSourcing is the pioneer and largest offshore provider of managed services in the Philippines.

Our commitment to 100% YOU

MicroSourcing firmly believes that our company's strength lies in our people's diversity and talent. We are proud to foster an inclusive culture that embraces individuals of all races, genders, ethnicities, abilities, and backgrounds. We provide space for everyone, embracing different perspectives, and making room for opportunities for each individual to thrive.

At MicroSourcing, equality is not merely a slogan – it's our commitment. Our way of life. Here, we don't just accept your unique authentic self - we celebrate it, valuing every individual's contribution to our collective success and growth. Join us in celebrating YOU and your 100%!

For more information, visit https://www.microsourcing.com/

• Terms & conditions apply

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