Clinical Finance Case Management Specialist 2

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Job Title:
Clinical Finance Case Management Specialist 2

Department:
James un-jobs.net Pharmacy Medication Access

Scope of Position          

The Ohio State University Wexner Medical Center is committed to improving access and service to customers.  The Prior Authorization Coordinator (PAC) functions as an integral member of the health care team to reflect a culture of cooperation, enthusiasm and mutual respect.  This position ensures the coordination of the insurance verification and prior authorization process for outpatient medications. This process includes, but is not limited to, assisting in defining pharmacy co-pay information, benefit design, and coverage. This information is important to both patient and physician planning as well as ensures the appropriate information is available and used for successful billing.

Position Summary       

The PAC’s responsibilities include understanding and verifying benefits, obtaining prior authorization for outpatient medications, collecting and interpreting patient clinical information. In addition, the PAC may be required during the authorization process to contact patients/families in order to gather information while also informing patients of medication co-pays or co-insurances. Communication will also be necessary with physicians, payers, and other customer groups.  PACs must be able to navigate the electronic medical record system to obtain and interpret pertinent medical information for the prior authorization process, including the determination of whether a medication is being used within or outside FDA labeling, relevant lab results, genetic testing and pathology. PACs will solve routine customer problems.

Additional Information:

Location:
Ackerman Rd, 600 (2435)

Position Type:
Regular

Scheduled Hours:
40

Shift:
First Shift

Final candidates are subject to successful completion of a background check.  A drug screen or physical may be required during the post offer process.

Thank you for your interest in positions at The Ohio State University and Wexner Medical Center. Once you have applied, the most updated information on the status of your application can be found by visiting the Candidate Home section of this site. Please view your submitted applications by logging in and reviewing your status. For answers to additional questions please review the frequently asked questions .

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