Clinical Account Specialist
Virtual Vocations Inc
Combining clinical expertise with operational efficiency, the full-time Clinical Account Specialist will review clinical documentation, apply clinical judgment to authorization requests, and navigate high-volume queues in a remote work environment. Key responsibilities: Review clinical documentation for completeness and accuracy to support authorization and utilization review workflows Apply clinical judgment to prior authorization and utilization review requests while adhering to established criteria Document findings and coordinate with clinical staff on cases requiring additional information or peer reviews Required qualifications: A completed nursing degree Experience in a healthcare BPO environment Familiarity with EHR/EMR systems and payer portals Understanding of HIPAA compliance and payer requirements Ability to work within structured, high-volume operational environments
Vacancy posted 1 day ago
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