The Ohio State University · 1 month ago
Clinical Financial Case Mgr
Ackerman Rd, 600 (2435)
Full-time
Onsite
Mid Level
3+ years expThe Ohio State University is a prominent educational institution, and they are seeking a Clinical Financial Case Manager. This role involves managing prior authorization submissions and communications, identifying trends in denials, and educating clinical staff to improve the authorization process.
EducationHigher EducationUniversities
Responsibilities
Follow-up on all prior authorization submissions and communication to the clinical team regarding the status of the prior authorization
Identify trends in denials and provide education to clinical staff to reduce these denials
Gather all clinical and supporting evidence
Understand and verify benefits, obtain prior authorization for outpatient medications, and collect and interpret patient clinical information
Contact patients/families during the authorization process to gather information
Communicate with physicians, payers, and other customer groups
Navigate the electronic medical record system to obtain and interpret pertinent medical information for the prior authorization process
Solve routine customer problems related to prior authorization work
Qualification
Required
Active OH Board of Pharmacy Certified Pharmacy Technician required
Excellent verbal and written communication skills required
Proficient in the use of computer-based research and medical record documentation required
Ability to satisfy expectations of onsite work at an OSUWMC team location facility
Preferred
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 is expected
General knowledge of ICD-10 codes
Company
The Ohio State University
The Ohio State University is a public research university based in Columbus, Ohio.
10001+ employees
H1B Sponsorship
The Ohio State University has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (311)
2024 (295)
2023 (236)
2022 (149)
2021 (111)
2020 (125)
Funding
Current Stage
Late StageTotal Funding
$52.28MKey Investors
AmeriCorps Public AlliesNational Safety CouncilFederal Aviation Administration
2024-07-09Grant· $0.81M
2024-04-29Grant
2024-03-05Grant· $0.35M
Leadership Team
Bill Diffenderffer
Director of Entrepreneurship
Nicole Kraft
Professor
Recent News
Sports Business Journal
2025-10-24
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