Bilingual Case Management Specialist

Tenderness Health Care | Milwaukee
Full-Time

Office locations:
Milwaukee — 823 S Layton Blvd, Milwaukee, WI 53215

Shorewood — 3569 N Oakland Ave, Suite B, Shorewood, WI 53211

For more than 15 years, Tenderness Health Care has been committed to providing quality care while building a workplace where employees feel valued, respected, and supported.

As we continue to experience rapid growth and expand our healthcare services, we are creating new opportunities for talented professionals who want to grow with us.

We are looking for an A+ team player who takes pride in their work, values teamwork and accountability, and is excited to build a long-term career with an established and growing healthcare organization.

At Tenderness, your work matters, your contributions are appreciated, and there is opportunity to grow as we grow.

Position Summary:

The Bilingual Case Management Specialist is responsible for coordinating medical documentation, client records, service authorizations, Plans of Care, recertifications, and communication among clients, physicians, nurses, insurance entities, and internal departments.

This position helps ensure required documentation is complete, accurate, properly maintained, and processed within required timeframes to reduce delays or interruptions in services.

The ideal candidate is highly organized, detail-oriented, comfortable working in a healthcare environment, and able to manage multiple time-sensitive responsibilities while maintaining professionalism and confidentiality.

Client & Medical Documentation Coordination

Communicate professionally with clients, physicians, medical offices, nurses, and internal departments regarding documentation and processing updates
Coordinate with nursing staff regarding assessments, medical documentation, and administrative service requirements
Request medical records from physician offices, clinics, schools, and other appropriate entities
Maintain consistent follow-up until required documentation is received
Review received records for completeness and required administrative information
Identify documentation relevant to authorization and service-processing requirements
Escalate clinical questions or determinations to the appropriate licensed clinical staff
Verify physician information, insurance information, and other required client information through approved systems
Scan, upload, organize, and maintain medical documentation within the electronic health record
Ensure documentation is associated with the correct client record
Electronic Health Records

Complete accurate data entry into applicable healthcare systems
Maintain current client demographic, insurance, physician, and service information
Upload medical records, assessments, authorizations, Plans of Care, and supporting documentation
Review electronic records for missing, outdated, or incomplete documentation
Follow up with appropriate team members regarding outstanding items
Maintain organized records to support authorizations, recertifications, audits, and ongoing service delivery
Help ensure documentation is processed according to internal timelines and applicable program requirements
Nursing & Assessment Coordination

Request RN assessments when required
Coordinate with nursing staff regarding pending assessments and documentation
Track completion of nursing assessments
Enter information from completed nursing assessments into approved systems or forms as directed, without changing clinical findings
Follow up regarding incomplete or outstanding documentation
Assist with coordinating documentation for new clients, amendments, recertifications, and service changes
Escalate clinical documentation questions to the appropriate licensed nurse or clinical supervisor
Plan of Care Processing

Prepare and process Plans of Care and related documentation based on approved clinical and authorization information
Ensure Plans of Care accurately reflect information provided by appropriate clinical and authorization sources
Route Plans of Care for required clinical review and signatures
Track outstanding physician signatures and follow up as needed
Upload completed Plans of Care into the appropriate electronic record
Monitor Plan of Care effective dates and renewal requirements
Maintain accurate documentation related to Plan of Care processing
Authorizations & Recertifications

Assist with preparing and submitting authorization-related documentation
Track pending authorizations and follow up on outstanding requests
Monitor authorization effective dates, expiration dates, and approved services
Coordinate required documentation for recertifications
Track recertification deadlines and initiate administrative follow-up in advance
Communicate missing documentation to clients, physicians, nurses, or internal departments as appropriate
Help prevent service interruptions caused by incomplete or expired administrative documentation
Maintain detailed notes regarding authorization and recertification activity
Case Management Support

Maintain an assigned administrative caseload
Track clients through applicable documentation, authorization, assessment, and recertification processes
Provide appropriate status updates to clients and internal teams
Identify outstanding items and follow through until resolved or appropriately escalated
Coordinate across departments to help ensure timely processing
Maintain professional and courteous communication with clients and families
Protect confidential information and handle protected health information in accordance with HIPAA and company policies
QualificationsRequired

High school diploma or equivalent
Bilingual English/Spanish
Strong written and verbal communication skills in both English and Spanish
Strong attention to detail and accuracy
Excellent organizational and time-management skills
Ability to manage multiple time-sensitive assignments and deadlines
Ability to communicate professionally with clients, physicians, nurses, insurance representatives, and internal staff
Comfortable using computers, electronic records, email, web-based systems, and document management
Ability to maintain confidentiality and appropriately handle protected health information
Ability to work independently while collaborating effectively with multiple departments
Preferred

Healthcare administration, medical records, patient services, insurance authorization, home care, or related experience
Medical Assistant training, certification, or related healthcare education preferred
Experience working with electronic health records
Knowledge of medical terminology and healthcare documentation
Experience with Medicaid, managed care, or insurance authorization processes
Familiarity with personal care or home care services
Experience with Plans of Care, recertifications, or medical-record coordination
Experience managing an administrative healthcare caseload
We are looking for a Team Player:

Wants to grow with an established and rapidly expanding healthcare organization
Takes ownership of their responsibilities
Pays close attention to detail
Follows through until tasks are completed
Does not allow important items to fall through the cracks
Communicates proactively and professionally
Is comfortable following up persistently when documentation is outstanding
Supports coworkers and contributes to a positive team environment
Is organized and able to manage multiple deadlines
Looks for ways to improve processes
Takes pride in accurate, high-quality work
Values accountability, teamwork, respect, and continuous improvement
Benefits we and What we offer

401(k)
Health insurance
Dental insurance
Vision insurance
Life insurance
Paid time off
Paid holidays, where applicable
Opportunities for professional growth and advancement
Training and professional development opportunities
Exposure to multiple areas of healthcare administration, case management, and patient services
Supportive and collaborative team environment
Leadership that values initiative, accountability, and continuous improvement
Opportunity to contribute ideas and help improve company processes
Opportunity to grow alongside an organization experiencing rapid growth and expansion
An A+ work culture focused on respect, teamwork, accountability, excellence, and continuous improvement
A workplace where your work matters and your contributions are valued and appreciated
Work Location

In person – Milwaukee, Wisconsin

Pay: $21.00 - $23.00 per hour

Expected hours: 40.0 per week

Benefits:

401(k)
Dental insurance
Health insurance
Life insurance
Paid time off
Vision insurance
Work Location: In person