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paycor

Case Review Specialist

OncoHealth
Remote, USA
Full-time
Mid Level
Remote
Discovered 1 months ago

Full Job Posting

  • Flexible to work rotational shifts inside our office hours from 8:00 a.m. – 8:00 p.m. EST to cover the operational needs of the company. Shifts can range anywhere between Monday – Friday 8:00 am to 8:00 pm EST and Saturdays 8:30 am - 6 pm EST (Office hours may change/extend upon operational needs)
  • Process cases and request/maintain clinical documentation and transmit timely determinations via the company’s internal system and/or by phone to the provider and/or member and/or payer
  • Intake Pre-Authorization requests and/or inquiries on existing pre-authorizations via phone, email, fax or by the portal and ensuring they are responded/processed within the established metrics
  • Work collaboratively with clinical and non-clinical staff to facilitate case discussions
  • Fax intake and labeling on weekends/Holidays as needed
  • Bachelor’s Degree or relevant experience preferred
  • Experience working remote independently
  • A minimum of 2-4 years’ administrative experience and/or customer service or relevant educational attainment required
  • Knowledge in pre-authorizations and health insurance client services departments are preferred
  • Implementation of systems for program effectiveness and productivity required
  • Systems/Tools: MS Office Suite proficient

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