Clinical Financial Case Mgr

Osuphysicians

Columbus, OH, US
Onsite
Prior authorization process management
Electronic medical record navigation
Communication with clinical and payer teams
The PAC is responsible for follow-up on all prior authorization submissions and communication to the clinical team regarding the status of the prior authorization

Job Summary

  • The PAC is responsible for follow-up on all prior authorization submissions and communication to the clinical team regarding the status of the prior authorization.
  • They are also responsible for identifying trends in denials and providing education to clinical staff to reduce these denials along with gathering all clinical and supporting evidence.
  • Communication will also be necessary with physicians, payers, and other customer groups.

Matching Summary

The PAC is responsible for follow-up on all prior authorization submissions and communication to the clinical team regarding the status of the prior authorization.

Skills & Requirements

Must-have

  • Prior authorization process management
  • Electronic medical record navigation
  • Communication with clinical and payer teams
  • Insurance reimbursement knowledge
  • Pharmacy medication access coordination

Nice-to-have

  • Understanding of disease implications and treatment modalities
  • Problem solving for customer issues
  • Use of Windows, Excel, Access, and internet tools

Key Requirements

  • Active OH Board of Pharmacy Certified Pharmacy Technician
  • Associate or bachelor’s degree preferred
  • Minimum of 3 years pharmacy experience preferred
  • Knowledge of Medicare and commercial insurance reimbursement
  • General knowledge of ICD-10 codes
  • Excellent verbal and written communication skills
  • Ability to work onsite at OSUWMC team location

Work Rights

Not specified

Tailored Resume

Cover Letter