Case Review Specialist

Job Summary

A company is looking for a Case Review Specialist who ensures accurate case documentation and facilitates discussions among clinical and non-clinical staff.

Key Responsibilities

• Work flexible rotational shifts to meet operational needs
• Process cases and maintain clinical documentation for timely determinations
• Intake and respond to pre-authorization requests and inquiries

Required Qualifications

• Bachelor's Degree or relevant experience preferred
• 2-4 years of administrative or customer service experience required
• Knowledge of pre-authorizations and health insurance services preferred
• Experience in implementing systems for program effectiveness
• Proficiency in MS Office Suite