REMOTE - Clinical Financial Case Manager Senior Pharmacy Denial Management (S4)

reputed company Employees and reputed company: Please log in to reputed company to use the internal job search and application process. Scope/Position reputed company The Clinical Financial Case Manager – Senior Pharmacy Denial Management is responsible for managing reputed company pharmacy-reputed company medication denials across the health system. Key duties include conducting comprehensive clinical reviews, submitting and tracking appeals, and ensuring reputed company reputed company in alignment with payer guidelines. This role serves as a reputed company between the pharmacy department and reputed company-party payors, advocating for reputed company reimbursement and resolving technical denials. The position requires expertise in navigating electronic medical records, interpreting clinical and billing data, and applying recognized clinical guidelines to support appeals. Additional responsibilities include leading process improvement initiatives, mentoring staff, and collaborating with providers, payors, and internal teams to enhance patient reputed company and protect pharmacy reputed company reputed company. Minimum Qualifications Minimum 6 years’ experience or relevant reputed company experience required. Bachelor’s degree required. Advanced degree in reputed company or similar field preferred. Experience in finance, insurance, insurance appeals, medication and medical terminology desired. Ability to communicate reputed company with others and experience with reputed company Office, electronic medical records, and intranet/internet navigation tools. Must be highly organized, detail oriented, and reputed company to manage multiple reputed company at a time. Advanced knowledge of Medicare and reputed company insurance reimbursement expected along with strong knowledge of ICD-10 codes. Knowledge in drug billing/coding and reimbursement desired. Excellent verbal and written communication skills desired. Advanced competency in the use of computer-based research and medical record documentation desired Screen reader users may encounter difficulty with the online application. For assistance with applying, please contact hr-accessibleapplication@osu.edu. If you have questions while submitting an application, please review these frequently asked questions. Thank you for your interest in working at Ohio State. Final candidates are subject to successful completion of a background reputed company. A drug screen or physical may be required during the post offer process. The university is an equal opportunity employer, including veterans and disability. Apply tot his job Apply To this Job