Clinical Review Coordinator

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