Clinical Financial Case Mgr

The Ohio State University

Columbus, Ohio, US
Onsite
Prior authorization submission management
Electronic medical record navigation
Patient benefit verification skills
The role is responsible for following up on all prior authorization submissions and communicating status to the clinical team

Job Summary

  • The role is responsible for following up on all prior authorization submissions and communicating status to the clinical team.
  • Candidates must be able to navigate electronic medical records to interpret pertinent medical information including lab results and genetic testing.
  • The position requires identifying trends in denials and providing education to clinical staff to reduce these occurrences.

Matching Summary

The role is responsible for following up on all prior authorization submissions and communicating status to the clinical team.

Skills & Requirements

Must-have

  • Prior authorization submission management
  • Electronic medical record navigation
  • Patient benefit verification skills
  • Clinical evidence gathering
  • Physician and payer communication

Nice-to-have

  • Understanding of disease implications
  • Knowledge of treatment modalities
  • Trend analysis for denial reduction
  • Education delivery to clinical staff

Key Requirements

  • Active OH Board of Pharmacy Certified Pharmacy Technician
  • Minimum 3 years pharmacy experience preferred
  • Associate or bachelor's degree preferred
  • Knowledge of Medicare and commercial insurance reimbursement
  • General knowledge of ICD-10 codes

Work Rights

Not specified

Tailored Resume

Cover Letter