Clinical Review Coordinator

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

Key Responsibilities

Conducts prior authorization reviews to evaluate patient clinicals against payer criteria for medical necessity

Reviews patient documentation and requests additional clinical information as needed for decision-making

Creates and maintains clinical support resources and assists with denials and appeals processes

Required Qualifications

Bachelor's degree in a healthcare field or 3 years of relevant experience

Preferred experience with specialty infusion patients

Proficient in Microsoft Word, Excel, and PowerPoint

Experience with denial support, clinical reviews, and appeals

Ability to work effectively in a remote environment and manage time efficiently