Case Review Specialist

Job Summary

A company is looking for a Case Review Specialist to ensure accurate case documentation and facilitate communication among staff.

Key Responsibilities

• Process cases and maintain clinical documentation while providing timely determinations
• Intake pre-authorization requests and inquiries, ensuring responses are within established metrics
• Collaborate with clinical and non-clinical staff to facilitate case discussions

Required Qualifications

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