Medical Case Manager

Immediate vacancy available. We are looking for a foreign medical graduate (ONLY), Spanish, English speaker, and/or other languages with an excellent work ethic in Miami, Florida geographical area. No experience is required. We will train. Computer multitasking skills required to deal with emergencies.

Open position night shift / or day shift schedule available:

• A full‑time job 8 hrs shift m‑f: 05:00 pm EST – 10:00 am EST (40hrs/week).
• A day‑time job 8 hrs shift m‑f: 09:00 am EST – 05:00 pm EST (40hrs/week).
• Both shifts require availability to be on‑call – must be able to be on‑call from 10:00 am EST to 09:00 am EST, 2 nights/week remotely.
• Must be able to be on‑call remotely 2 weekends/month from Friday 10:00 am EST to Monday 09:00 am EST monitoring/answering emergency emails, calls, case‑managing emergencies, etc.
• Any worked hours during on‑call will be paid on an hourly after‑hours rate basis as additional to the base payment.

At the Operation office in the Miami Shores area.

Once the candidate passes the proper paid training (2–3 weeks), the candidate will be working at the office and remotely. If dropped out of training without 30 days' notice, hours spent in training will be voided and paid.

The right candidate must be a foreign medical graduate initially, have the ability to start immediately working and handling medical benefits verification and medical pre‑authorization service, inpatient care review, itemized bill review, and must be able to cover phone calls during their shifts. In addition, the candidate must have excellent verbal communication skills, computer proficiency, and customer service experience.

• Answer inbound calls.
• Monitor email – average 70 emails per day.
• Handle providers’ inquiries for benefit verification.
• Manage and resolve customer complaints.
• Provide customers pre‑authorization for medical services.
• Medical records review.
• Itemized bill review.
• Escalate priority issues.
• Document all activities and call information according to standard operating procedures.
• Review medical records and assess for pre‑existing condition and relevant exclusions on the policy.

• Must be Foreign Medical Graduate.
• Must not have passed USMLE STEP 1 or STEP 2 or CSA.
• Verbal and written communication skills (English & Spanish, other languages) are welcomed.
• MS Access / Word / Excel proficiency.
• Listening skills.
• Problem‑solving.
• Customer‑service oriented.
• Organizational skills.
• Detail‑oriented.
• Adaptability.
• Team player.
• Resilience.

• Full‑time, contract hourly‑paid $16.00–$24.00/hr.

• Spanish and English (required) and Portuguese (preferred); any other languages welcomed in addition to the required ones.