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Clinical Account Specialist - Nursing Graduates

Clinical Account Specialist - Nursing Graduates

Neolytix
  • Posted 9 hours ago
  • Be among the first 10 applicants

Job Description

REMOTE (WFH) | FULL-TIME | 9PM-6AM PHT (FIXED SCHEDULE)

Neolytix is specifically looking for people who've already done hybrid clinical-operations work and been both things at once: have completed a nursing degree, and who also knows how to work on queues, productivity targets, multiple systems, and service-level expectations.

WHAT YOU WILL DO:

  • Review clinical documentation and chart notes for completeness, medical necessity, and accuracy in support of authorization, utilization review, or documentation workflows
  • Apply clinical judgment to prior authorization, precertification, or utilization review requests, working within established clinical and payer review criteria
  • Navigate structured, high-volume queues and multiple systems — EHR/EMR, payer portals, and case management or workflow tools — while meeting daily productivity and turnaround expectations
  • Document findings, decisions, and communications completely and accurately, keeping records audit-ready
  • Coordinate with physicians, nurses, and other clinical staff on cases that need additional information or a peer-to-peer review
  • Escalate complex or time-sensitive cases appropriately and track them through to resolution
  • Maintain compliance with HIPAA, payer requirements, and internal quality standards
  • Required: A completed nursing degree, combined with healthcare BPO experience

WHY APPLY This role allows you to do work that actually uses your clinical training! If you've done clinical work inside a structured, queue-driven operations environment before, you got what we need!

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Key Skills

precertification

payer portals

workflow tools

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