OncoHealth · 1 month ago
Case Review Specialist - Atlanta
Georgia, United States
Full-time
Hybrid
Entry, Mid Level
2+ years expOncoHealth is a leading digital health company dedicated to helping health plans, employers, providers, and patients navigate the complexities of cancer through technology-enabled services. The Case Review Specialist ensures accurate and timely determinations by processing cases and maintaining clinical documentation, while collaborating with clinical and non-clinical staff.
AppsHealth CareInformation TechnologyMedicalOncology
Responsibilities
Flexible to work rotational shifts inside our office hours from 8:00 a.m. – 8:00 p.m. EST to cover the operational needs of the company. Shifts can range anywhere between Monday – Friday 8:00 am to 8:00 pm EST and Saturdays 8:30 am - 6 pm EST (Office hours may change/extend upon operational needs)
Periodic on-call responsibilities having availability during the week to travel to the Atlanta, GA office with personal transportation
Process cases and request/maintain clinical documentation and transmit timely determinations via the company’s internal system and/or by phone to the provider and/or member and/or payer, including mailed-in requests from providers and members
Intake Pre-Authorization requests and/or inquiries on existing pre-authorizations via phone, email, fax or by the portal and ensuring they are responded/processed within the established metrics
Work collaboratively with clinical and non-clinical staff to facilitate case discussions
Fax intake and labeling on weekends/Holidays as needed
Qualification
Required
A minimum of 2-4 years' administrative experience and/or customer service or relevant educational attainment required
Implementation of systems for program effectiveness and productivity required
Systems/Tools: MS Office Suite proficient
Reside within 25 miles of the Atlanta office, 7000 Central Parkway, Suite 1750, Atlanta, GA 30328
Reliable personal transportation
Ability to be in the office as required, but not limited to the following situations: Personal power outages, internet disruptions, natural disasters, and to process incoming Prior Authorization requests received via mail from Providers and Members
Flexible to work rotational shifts inside our office hours from 8:00 a.m. – 8:00 p.m. EST to cover the operational needs of the company
Periodic on-call responsibilities having availability during the week to travel to the Atlanta, GA office with personal transportation
Process cases and request/maintain clinical documentation and transmit timely determinations via the company's internal system and/or by phone to the provider and/or member and/or payer, including mailed-in requests from providers and members
Intake Pre-Authorization requests and/or inquiries on existing pre-authorizations via phone, email, fax or by the portal and ensuring they are responded/processed within the established metrics
Work collaboratively with clinical and non-clinical staff to facilitate case discussions
Fax intake and labeling on weekends/Holidays as needed
Preferred
Bachelor's Degree or relevant experience preferred
Knowledge in pre-authorizations and health insurance client services departments are preferred
Benefits
We offer a full benefit package on your first day, along with a company bonus.
You may visit or work from our very modern and engaging offices, and experience a fun, collaborative environment where social activities and community events matter.
Company
OncoHealth
OncoHealth is a digital health company that focuses on navigating the physical, mental, and financial complexities of cancer care.
201-500 employees
Funding
Current Stage
Growth StageTotal Funding
$56.5MKey Investors
Baird CapitalOak HC/FTThe Blue Venture Fund
2022-05-09Private Equity
2020-05-26Series C· $28M
2018-11-05Series B· $21M
Leadership Team
Rick Dean
Chief Executive Officer | Board Member
Cliff Culver
Chief Operating Officer
Recent News
Company data provided by crunchbase