Case Review Specialist

Job Summary

A company is looking for a Case Review Specialist.

Key Responsibilities

• Process cases and maintain clinical documentation to ensure timely determinations
• Intake and respond to pre-authorization requests and inquiries within established metrics
• Collaborate with clinical and non-clinical staff to facilitate case discussions

Required Qualifications

• Bachelor's Degree or relevant experience preferred
• A minimum of 2-4 years' administrative or customer service experience required
• Knowledge in pre-authorizations and health insurance client services preferred
• Experience in implementing systems for program effectiveness and productivity
• Proficiency in MS Office Suite