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Winston-Salem, North Carolina

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Jenison, Michigan

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Los Angeles, California

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Clinical Financial Case Mgr
Scope/Position SummaryThis position uses clinical knowledge for the management of the complex process of coordinating insurance verification and prior authorization of outpatient medications; provides evidence to support cutting edge therapies; provides clinical education to payers regarding current standard of care treatment. Identifies trends, and areas for needed clinical education, to decrease denials where applicable. Submission of test claims proactively supporting clinicians in efforts to identify areas where risk of denial is high to mitigate that risk. Responsibilities also include understanding and verifying benefits and obtaining prior authorization for outpatient medications. In addition, the position will at times contact patients/families in order to as


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