Clinical Financial Case Mgr

The Clinical Financial Case Mgr is responsible for follow-up on prior authorization submissions and communication with the clinical team regarding status. They must understand benefits, obtain prior authorization, and collect and interpret patient clinical information.

Requirements

• Active OH Board of Pharmacy Certified Pharmacy Technician required
• Associate or bachelor's degree is preferred
• Experience with Windows, Excel, Access, and Intranet/internet navigation tools
• Minimum of 3 years' pharmacy experience preferred
• Knowledge of Medicare and commercial insurance reimbursement
• General knowledge of ICD-10 codes
• Excellent verbal and written communication skills
• Proficient in the use of computer-based research and medical record documentation

Benefits

• Prior authorization experience
• Benefits understanding
• Patient clinical information collection and interpretation
• Communication with physicians, payers, and other customer groups