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Full-time
high school
Medical Insurance, Dental Insurance, Vision Insurance, Professional Development Opportunities, Employee Assistance Programs, Company Paid Life Insurance
Posted 31d ago
~40 hrs/week
Responsibilities
The Case Manager coordinates patient referrals, secures insurance authorizations, and manages referral workflows to ensure continuity of care. They also serve as a liaison between patients, providers, and specialists while identifying community resources to help patients overcome barriers to care.
Requirements
Candidates must have a high school diploma or equivalent and at least one year of experience in insurance verification and referrals. Proficiency in Microsoft Office and the ability to operate standard office equipment are required.
Full job description
Description
Shape Your Future. Serve Your Community. Build Your Career with Palms!
What Life Working at Palms Looks Like:
Mission and Meaningful Work: PMG is a not for profit, Federally Qualified Health Center (FQHC). That means it’s focused on serving underserved populations, offering affordable primary care and preventative services. For many people, that makes the work feel meaningful.
Stability & Growth: PMG has been around for a long time (since 1971) and we are still expanding!
Comprehensive Services & Variety: We offer a wide array of services – family medicine, pediatrics, dental, behavioral health, prenatal care, etc. – So working here gives exposure to different patient populations, conditions and settings.
Patient-Centered, Community Focus: PMG emphasizes accessible care (same day scheduling, weekend appointments, bilingual staff) and works in communities throughout North Florida. It is also a Patient Centered Medical Home (PCMH), meaning there’s an emphasis on continuity of care, relationships with patients, etc.
Culture & Community: Many reviews say that PMG has a “friendly, compassionate, professional” environment. There is pride among the staff in giving back to the community.
Perks:
Competitive Wages
Comprehensive Health Coverage: Medical, Dental and Vision Insurance
Professional Development Opportunities
Employee Assistance Programs
Company Paid Life Insurance
401k with 5% Match
11 Paid Holidays
20 Days PTO
Recognition and Rewards
Community Impact .
Position Summary
The Case Manager is responsible for delivering exceptional customer service and ensuring the accurate, timely, and thorough coordination of patient referrals. This role supports continuity of care by managing referral workflows, securing authorizations, and serving as a liaison between patients, providers, and external specialists. The Case Manager also identifies community resources and supports patients in overcoming barriers to care.
Description of Primary Responsibilities
1) Customer Service
a) Provide professional and courteous support to patients in accordance with Palms Medical Group within his/her field of training in accordance with stated policies and procedures of PMG.
c) Answer, screen and route telephone calls promptly and professionally (within 3 rings)
e) Operate a multi-line phone system efficiently, including transferring calls, managing voicemail and navigating queues).
f) Document phone interactions in the EHR.
g) Maintain a working knowledge of all PMG departments and services.
2) Referral Coordination
a) Follow standardized referral policies and workflows
b) Prioritizes referrals based on urgency and organizational goals.
c) Ensures complete and accurate demographic, insurance information and clinical information is submitted to specialists
d) Communicate referral details and expectations to both providers and patients. including next steps and contact
e) Ensure all necessary consents are obtained or coordinated
f) Process incoming and outgoing patient data to support continuity of patient care
3) Community Resource Utilization
a) Identify and maintain relationships with local service providers and community resources.
b) Assist patients in navigating to language or social barriers that may impact referral completion.
4) Referral Tracking
a) Follow EHR protocols for referral tracking.
b) Retrieve and document from the inbox.
c) Record all reports received and close open orders per PMG policy and procedure
d) Ensure timely processing of all referrals.
5) Insurance Authorizations
a) Contact insurance companies to verify and obtain prior authorizations.
b) Present necessary medical information to prove medical necessity of services
c) Maintain knowledge of insurance-specific authorization requirements and document accordingly.
6) Administrative Duties
a) Adhere to the Referrals Policy Manual, Medical Records Policy Manual and HIPAA Policy Manual
b) Check and respond to emails at least twice daily.
c) Maintain patient confidentiality in compliance with HIPAA regulations.
d) Assist with audits and surveys as directed by the Case Manager Coordinator
e) Perform any other duty assigned by the Case Manager Coordinator, Executive VP of Patient Services or CEO to improve the efficiency of PMG
Requirements
Description of Primary Attributes
General Development:
1) Must be organized, a self-starter and detailed oriented
2) Job duties require the ability to work independently and as part of a team
3) Expected to multitask
4) Know referral sources in one’s geographical area
5) Assist in the training and mentoring of coworkers by sharing knowledge, providing guidance, and supporting skill development.
Professional & Technical Knowledge:
1) Employee will have a Working Knowledge of the following office equipment:
Multiline Telephone
Copier
Computer
Email
Scanner
Fax Machine
2) Employee will be expected to navigate and operate Microsoft Office suite products, including Word, Excel and Teams
Education & Experience:
1) High School Diploma or Equivalent
2) 1-year prior experience in insurance verification and referrals
Communications Skills:
Effectively communicates complex and/or technical information to co-workers, patients and/or vendors
Physical/Mental/Emotional Demands:
Standing for long periods of time
Sitting for long periods of time
Viewing a computer monitor for long periods of time
Bending
Stretching / Reaching
Walking short distances
Lifting up to 50 pounds
Operating office equipment (computer, fax machines, telephones and copy machines)
Reading forms / Instructions / Patients Charts
Communicating well to people of various ages, educational levels, cultural backgrounds in person or by telephone
Exposure to potentially violent / irate patients
Health / Safety Consideration of Position
Exposure to chemical infectious / contagious illness
Exposure to chemical and inhalation of antibiotics during reconstitution
Exposure to X-Ray radiation
Exposure to a variety of scents and odors
Must utilize universal precaution in clinical or exposure situations as prescribed by federal state, and local guidelines and /or laws
Related keywords
Case ManagementReferral CoordinationInsurance VerificationPrior AuthorizationEHRPatient CareHIPAAMedical RecordsCustomer ServiceCommunity ResourcesMicrosoft WordMicrosoft ExcelMicrosoft TeamsHealthcareFQHCPatient Centered Medical Home
We exist to enhance the health and well-being of our communities.
Industry
Medical Practices
Company size
201-500 employees
Founded
1971
Headquarters
High Springs, Florida
LinkedIn followers
995
Palms Medical Group is a not-for-profit health care provider committed to bringing quality, accessible primary care and preventative services to you. We take great pride in offering our patients a full range of evidence-based, healthcare services for all the stages of life. With multiple locations throughout North Florida, same-day scheduling, flexible hours, and bilingual staff, Palms Medical Group gives patients the care they need, when and where they need it.
Offices: 23476 W U.S. Hwy 27, High Springs, Florida 32643, US · 1830 N Main St, Bell, Florida 32619, US · 103 US Highway 27 SW, Branford, Florida 32008, US · 410 N Main St, Suite 1 and 2, Chiefland, FL 32626, US · 200 Southwest 62nd Boulevard, Gainesville, FL 32607, US
Pharmacy Non ProfitFQHCDental XrayMedical ClinicPediatricsNurseProviderGME
How many Social Services jobs are open in Gainesville, FL right now?
There are currently 204 open social services positions in Gainesville, FL listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Social Services roles in Gainesville, FL?
Companies currently hiring include Florida Department of Agriculture and Consumer Services, UF Health, Goodwill of North Florida, Pace Center for Girls, Rite of Passage, among others. Browse the listings above to see every active employer.
Are there remote or hybrid Social Services jobs in Gainesville, FL?
Yes — 20 of the 204 open social services positions offer remote or hybrid work (7 remote, 13 hybrid).
How do I apply for Social Services jobs in Gainesville, FL?
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.