Remote Oncology Case Review Specialist

OncoHealth; United States; Hybrid; USD 45,000 - 70,000; Full time

Job summary

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 role ensures case documentation is provided by providers for accurate determinations and communicates with clinical and non-clinical staff to facilitate discussions. The position offers remote, hybrid or in-office options with flexible shifts within 8:00 a.m.

– 8:00 p.m. EST.

Qualifications

• Bachelor’s Degree or relevant experience preferred.
• Experience working remote independently.
• Minimum of 2–4 years of administrative experience and/or customer service or relevant educational attainment.
• Knowledge in pre-authorizations and health insurance client services departments are preferred.
• Implementation of systems for program effectiveness and productivity required.

Responsibilities

• 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.

Skills

Remote work independently

Administrative experience

Customer service

Education

Bachelor’s degree or relevant experience

Job description

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 role ensures case documentation is provided by providers for accurate determinations and communicates with clinical and non-clinical staff to facilitate discussions. The position offers remote, hybrid or in-office options with flexible shifts within 8:00 a.m.

– 8:00 p.m. EST.