Clinical Review Coordinator
MedOne Pharmacy Benefit Solutions
1 Positions
ID: 2118
Posted On 12/01/2021
Job Overview
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