Patient Access Case Manager

Job Summary

A company is looking for a Patient Access Case Manager.

Key Responsibilities

• Manage patient cases through the insurance authorization and appeal process
• Draft appeals and communicate with health plans regarding authorization requests
• Document case activities and monitor payer trends related to approvals and denials

Required Qualifications

• 2+ years of experience in pain management or spine prior authorization roles
• Experience in reviewing clinical records and submitting prior authorization requests
• Ability to interpret procedure denials and draft appeals
• Familiarity with payer coverage criteria
• 2+ years of experience utilizing software systems for task management