Talent.com
Clinical Review Coordinator
Clinical Review CoordinatorSoleo Health Inc • Frisco, TX, US
serp_jobs.error_messages.no_longer_accepting
Clinical Review Coordinator

Clinical Review Coordinator

Soleo Health Inc • Frisco, TX, US
job_description.job_card.variable_days_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
job_description.job_card.job_description

Job Description

Job Description

Description :

Soleo Health is seeking a Clinical Review Coordinator to support our Specialty Infusion Pharmacy and work Remotely (USA) . Join us in Simplifying Complex Care!

Must be able to work 8am-5pm, Monday-Friday 40 hours per week Pacific or Mountain Time zone.

Soleo Health Perks :

  • Competitive Wages
  • Flexible schedules
  • 401(k) with a match
  • Referral Bonus
  • Paid Time Off
  • Annual Merit Based Increases
  • No Weekends or Holidays
  • Affordable Medical, Dental, and Vision Insurance Plans
  • Company Paid Disability and Basic Life Insurance
  • HSA and FSA (including dependent care) options
  • Education Assistant Program

The Position :

The Clinical Review Coordinator works closely with all departments to research and provide accurate and timely clinical review on complex, patient cases to ensure that approval is secured and to mitigate risk of technical and clinical denials. The Clinical Review Coordinator attempts to resolve denials by utilizing nationally recognized criteria for appeal submission. Responsibilities include :

  • Completes prior authorization reviews in a timely manner through their clinical expertise evaluating patient clinicals and payer clinical criteria to determine if the service meets medical necessity of the payer
  • Reviews and comprehends patient progress notes, lab reports, infusion summaries, imaging reports, and plan of care. Identifies appropriate medical documentation that satisfies payer medical policy criteria.
  • Request additional clinical information when needed to render a decision and / or determine next steps
  • Assists with creation of clinical support packets to be used for the initial prior authorization and / or subsequent appeals
  • In cases of authorization denials, constructs and documents a succinct and fact-based clinical case to support appeal utilizing appropriate medical necessity criteria and other pertinent clinical facts.
  • Creates and maintains, a library of clinical support resources to include templates for appeals, journal articles, other reference tools that can be used to support medical necessity. When existing resources are unavailable search for supporting clinical evidence to support appeals.
  • Provides program support by staying current on the top payer covered services, medical necessity requirements and formulary details. Also, must be proficient in locating payer resources related to medical policies.
  • Assist with post service insurance denials & appeals
  • Participates in outcome programs including but not limited to data entry, reporting functions, and patient calls with necessary to complete denial support tasks
  • Provides inter-departmental training to increase teams’ knowledge for top disease states and specialty drugs, clinical requirements, and prior authorization & appeal best practices
  • Schedule :

  • Must be able to work Remote, Monday-Friday between the hours of 8am-5pm Pacific or Mountain Time.
  • Must have experience with denial support, clinical reviews, and appeals for Infusions
  • Requirements :

  • Bachelor’s degree in healthcare field or 3 years in a qualified position
  • Preferred experience with patients with specialty infusion needs and challenges
  • Excellent communication skills (written, oral, and presentation), excellent customer service and interpersonal skills
  • Flexible communication style, highly motivated team player with excellent listening skills
  • Able to handle stress to meet identified program objectives and manages time effectively
  • Self-starter that takes responsibility, is comfortable with accountability and results oriented
  • Competent in the use of Word, Excel, and Power Point
  • Must be able to communicate effectively with all levels of organization within Soleo Health.
  • Must enthusiastically support Soleo Health’s philosophy and goals.
  • About Us : Soleo Health is an innovative national provider of complex specialty pharmacy and infusion services, administered in the home or at alternate sites of care. Our goal is to attract and retain the best and brightest as our employees are our greatest asset. Experience the Soleo Health Difference!

    Soleo’s Core Values :

  • Improve patients’ lives every day
  • Be passionate in everything you do
  • Encourage unlimited ideas and creative thinking
  • Make decisions as if you own the company
  • Do the right thing
  • Have fun!
  • Soleo Health is committed to diversity, equity, and inclusion. We recognize that establishing and maintaining a diverse, equitable, and inclusive workplace is the foundation of business success and innovation. We are dedicated to hiring diverse talent and to ensuring that everyone is treated with respect and provided an equal opportunity to thrive. Our commitment to these values is evidenced by our diverse executive team, policies, and workplace culture.

    Soleo Health is an Equal Opportunity Employer, celebrating diversity and committed to creating an inclusive environment for all employees. Soleo Health does not discriminate in employment on the basis of race, color, religion, sex, pregnancy, gender identity, national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an organization, parental status, military service or other non-merit factor.

    Keywords : Now Hiring, Hiring Now, Immediately Hiring, Hiring Immediately, Clinical Review Coordinator, Infusion Clinical Review Coordinator, Patient Access, Patient Access Clinical Review Coordinator, Denial Support Clinical Review Coordinator, Appeals Clinical Review Coordinator

    serp_jobs.job_alerts.create_a_job

    Clinical Coordinator • Frisco, TX, US

    Job_description.internal_linking.related_jobs
    Inpatient DRG Sr. Reviewer

    Inpatient DRG Sr. Reviewer

    Zelis Healthcare, LLC • Plano, TX, United States
    serp_jobs.job_card.full_time
    Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers.We serve more than 750 payers, including the top five national health plans, regional hea...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Sr. Clinical Data Coordinator

    Sr. Clinical Data Coordinator

    TradeJobsWorkForce • 75237 Dallas, TX, US
    serp_jobs.job_card.full_time
    Clinical Data Coordinator Job Duties : Support laboratory data management procedures including authoring and reviewi...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Sr. Supervisor, Clinical Chart Review

    Sr. Supervisor, Clinical Chart Review

    Zelis Healthcare, LLC • Plano, TX, United States
    serp_jobs.job_card.full_time
    Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers.We serve more than 750 payers, including the top five national health plans, regional hea...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Director, Clinical Review

    Director, Clinical Review

    SmithRx • Plano, TX, US
    serp_jobs.job_card.full_time
    SmithRx is a rapidly growing, venture-backed Health-Tech company.Our mission is to disrupt the expensive and inefficient Pharmacy Benefit Management (PBM) sector by building a next-generation drug ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Clinical Research Coordinator

    Clinical Research Coordinator

    IntraCare • Dallas, Texas, United States, 75254
    serp_jobs.job_card.full_time
    IntraCare Health Center (DFW Healthcare MSO).Worth and Phoenix, Arizona areas with a decade of excellence in value-based care and clinic operations. Our outstanding leadership and commitment to serv...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days
    Clinical Research Coordinator

    Clinical Research Coordinator

    PRIME CLINICAL RESEARCH INC • Lewisville, TX, US
    serp_jobs.job_card.full_time
    We are seeking a skilled and dedicated full-time clinical research coordinator to join our research team at Prime Clinical Research. The ideal candidate should have a strong background as a clinical...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Clinical Research Coordinator II

    Clinical Research Coordinator II

    ALLIANCE CLINICAL LLC • Dallas, TX, US
    serp_jobs.job_card.temporary
    ESSENTIAL DUTIES AND RESPONSIBILITIES include the following.Comply with all company policies, procedures, and conduct.Strictly adhere to confidentiality and compliance standards.Communicate effecti...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Clinical Research Coordinator

    Clinical Research Coordinator

    Actalent • Dallas, TX, US
    serp_jobs.job_card.full_time
    Job Title : Clinical Research Coordinator.The Clinical Research Coordinator will work on dermatology industry-initiated clinical trials, managing 11-15 studies per coordinator and interacting with 2...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Senior Clinical Administrative Coordinator

    Senior Clinical Administrative Coordinator

    UnitedHealth Group • Dallas, TX, United States
    serp_jobs.job_card.full_time
    This position is Remote in CST, MST, PST.You will have the flexibility to work remotely • as you take on some tough challenges. Optum is a global organization that delivers care, aided by technology ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Inpatient DRG Reviewer

    Inpatient DRG Reviewer

    Zelis Healthcare, LLC • Plano, TX, United States
    serp_jobs.job_card.full_time
    Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers.We serve more than 750 payers, including the top five national health plans, regional hea...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Clinical Research Coordinator

    Clinical Research Coordinator

    Salma Mazhar MD PA • Mesquite, TX, US
    serp_jobs.job_card.full_time
    EXPERIENCE IN CLINICAL RESEARCH IS A MUST.The Clinical Research Coordinator is responsible for managing the daily operations of a clinical investigation. This position will manage multiple, sponsore...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Registration Coordinator

    Registration Coordinator

    Methodist Health System • Richardson, TX, US
    serp_jobs.job_card.full_time
    Your Job : In this highly technical, fast-paced, and rewarding position, you'll collaborate with multidisciplinary team members to provide the very best care for patients. The primary purpose of the ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Clinical Research Coordinator (CRC) and Regulatory Specialist

    Clinical Research Coordinator (CRC) and Regulatory Specialist

    PRIME CLINICAL RESEARCH INC • Lewisville, TX, US
    serp_jobs.job_card.full_time
    Job title : Clinical Research Coordinator (CRC) with Regulatory Specialist Expertise.Position Overview : Prime Clinical Research seeks a full-time Clinical Research Coordinator with strong regulatory...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Clinical Research Coordinator

    Clinical Research Coordinator

    American Clinical Research Services Opco LLC • Dallas, TX, US
    serp_jobs.job_card.full_time
    The Clinical Research Coordinator (CRC) manages and coordinates clinical research studies, ensuring they are conducted efficiently, ethically, and in compliance with regulatory requirements.The rol...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Clinical Coordinator RN

    Clinical Coordinator RN

    Baylor Scott & White Health • Irving, TX, US
    serp_jobs.job_card.full_time
    BSW Liver Consultants of Texas, Dallas.Worth Street Suite 860, Dallas, TX 75246.Experience with IV starts and / or Phlebotomy is desired •. Prior leadership / charge nurse experience is desired •.The Clin...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Clinical Research Coordinator (Dallas, TX)

    Clinical Research Coordinator (Dallas, TX)

    Syneos Health / inVentiv Health Commercial LLC • Plano, TX, United States
    serp_jobs.job_card.full_time
    Clinical Research Coordinator (Dallas, TX).Illingworth Research Group provides a range of patient focused clinical services to the pharmaceutical, healthcare, biotechnology and medical device indus...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Clinical Research Coordinator

    Clinical Research Coordinator

    Delricht Research • Prosper, TX, US
    serp_jobs.job_card.full_time
    Would you love to be a part of the cutting edge of healthcare and science innovation? Do you want to be an influential part of a rapidly growing team? Are you looking for a position that has sustai...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
    New Patient Coordinator

    New Patient Coordinator

    Insight Global • Dallas, TX, US
    serp_jobs.job_card.full_time
    Insight Global is currently seeking New Patient Coordinators to support the Revenue Cycle Department across five locations in the Dallas area. These coordinators will contribute to providing high-qu...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Senior Clinical Research Coordinator

    Senior Clinical Research Coordinator

    ALLIANCE CLINICAL LLC • Irving, TX, US
    serp_jobs.job_card.temporary
    Travel is Required for this Position.ESSENTIAL DUTIES AND RESPONSIBILITIES : .Partner with Regional Site Director to ensure compliance and productivity of all clinical site staff and operations.Manag...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Sr Central Services Coordinator

    Sr Central Services Coordinator

    ALLIANCE CLINICAL LLC • Irving, TX, US
    serp_jobs.job_card.full_time
    SUMMARY : The Sr Central Services Coordinator oversees the daily function of multi-site clinical research programs on required protocols. The Sr Central Services Coordinator works virtually with the ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted