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Clinical Review Coordinator

MedOne, Dubuque, IA
Position Description:
· Support operations of MedOne Clinical Services
· Initiate Prior Authorization requests
· Review incoming Prior Authorization documentation for completeness
· Prepare clinical review documentation for review by a MedOne Clinical Pharmacist
· Communicate clinical review decision to pharmacies and providers
· File completed Prior Authorization documentation
· Enter Clinical Review determination into the claims processing system(s) 
· Communicate the status of Clinical Reviews with patients
· Schedule Clinical Review Denial Calls with a Clinical Pharmacist 
· Update Clinical Authorization Criteria and Clinical Review Request Forms under the direction of a Clinical Pharmacist
Position Requirements:
· Must be registered with the state/Iowa Board of Pharmacy as a Pharmacy Technician/Trainee within 30 days of accepting employment
· Employee must be in good standing with the state board
· Working knowledge of medical terminology, HIPAA regulations, ICD-10, NCPDP standards (highly advantageous)
· Must be detail-oriented and precise
· Must have excellent interpersonal, written, and verbal skills
· Strong customer service and teamwork skills
· Must have a strong understanding of Microsoft Office (Word, Excel, PowerPoint)
· Must be able to work independently, meets deadlines, establish priorities and be flexible
Work Hours:
· Full-time, salaried position, minimum of 40 hours per week
· Corporate Office – Dubuque
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Job Details

ID 769422
Dubuque, IA
Positions 1
Full Time
Pay --
Clerical/Office Administration
Customer Service
Health Care
EMSI Skills Clinical Pharmacy
Customer Service
Detail Oriented
ICD Coding (ICD-9/ICD-10)
Medical Terminology
Microsoft Excel
Microsoft PowerPoint
Microsoft Word
First Shift
Health Insurance
Dental Insurance
Vision Insurance
Life Insurance
Retirement Plan
Paid Vacation
Paid Holidays
Tuition Reimbursement

Preferred Candidates

Years of Experience --
Education --

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