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OncoHealth · 4 days ago

Case Review Specialist

United States

Full-time

Remote

Entry, Mid Level

2+ years exp

OncoHealth 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 case documentation and facilitates discussions between clinical and non-clinical staff.

AppsHealth CareInformation TechnologyMedicalOncology

Growth Opportunities

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)

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

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