Clinical Review Coordinator

Job Summary

A company is looking for a Clinical Review Coordinator to support their Specialty Infusion Pharmacy remotely.

Key Responsibilities

• Completes prior authorization reviews by evaluating patient clinicals and payer criteria
• Reviews patient documentation to identify necessary medical information for payer compliance
• Constructs clinical cases for appeal submissions in response to authorization denials

Required Qualifications

• Bachelor's degree in a healthcare field or 3 years in a qualified position
• Preferred experience with patients requiring specialty infusion services
• Proficient in Microsoft Word, Excel, and PowerPoint
• Experience with denial support and clinical reviews for infusions
• Ability to work effectively in a remote environment during specified hours