- Kelly Services (Rochester, NY)
- …Authorization Technician performs initial-level processing and review of prior authorization requests for both pharmacy and medical specialty drug reviews ... authorization process. **Essential Responsibilities/Accountabilities** + Conduct initial medication prior - authorization , exception, and medical necessity… more
- Centene Corporation (New York, NY)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of ... to assess medical necessity of care of member + Escalates prior authorization requests to Medical Directors as appropriate to determine appropriateness… more
- University of Rochester (Rochester, NY)
- …Management, Social Work, Patient Accounts, Medical Records, Home Care Coordinators, Prior Authorization Teams, Contracting and Finance. + Works closely with ... the quality, productivity, and efficiency of the Health Insurance and Authorization teams and identifying ongoing opportunities for process improvements and… more
- Sanofi Group (Albany, NY)
- …billing and coding, financial assistance offerings, patient support, access, payer medical policy, prior authorization , specialty pharmacy operations, ... with complex medical payer policy requirements and coordination of multiple prior authorization needs + Infusion therapy experience + Home care coordination… more
- SUNY Upstate Medical University (Syracuse, NY)
- …Upstate Medical University Hospital retail pharmacy revenue through provision of prior authorization services at Upstate Medical University Hospital ... medical necessity of medication use based on established criteria. Obtain prior authorization from intermediaries and payers, including managed care… more
- Saratoga Hospital (Saratoga Springs, NY)
- Summary of Position: The Referral and Prior Authorization Specialist is responsible for obtaining referrals and authorizations to ensure reimbursement for ... gathering and patient data. Meets turnaround expectations for majority of prior authorization approvals. Primary Job Responsibilities: Processes all referrals… more
- Glens Falls Hospital (Glens Falls, NY)
- …& coordination of benefit . Prepare and compile necessary documentation to secure prior authorization . . Collect clinical information regarding service to be ... patient financial obligations / secure payment arrangements . Contact provider/payer to obtain prior authorization . Gather additional clinical and / or coding… more
- Glens Falls Hospital (Saratoga Springs, NY)
- …coordination of benefit * Prepare and compile necessary documentation to secure prior authorization . Collect clinical information regarding service to be ... patient financial obligations / secure payment arrangements * Contact provider/payer to obtain prior authorization * Gather additional clinical and / or coding… more
- Trinity Health (Syracuse, NY)
- …for hours Suite 1001 MOC Summary This position is responsible for ensuring appropriate prior authorization for designated specialty. The scope of prior ... knowledge of the patient population and types of services patients receiving. Prior authorization experience involving service line drugs and ancillary testing… more
- Rochester Regional Health (Rochester, NY)
- …to the front end staff. + Identify and report trends as well as prior authorization and finance issues relating to billing and reimbursement + Proactively ... via phone call, email, or MyCare channels + Obtain prior - authorization on both internal and external department...and established patients. + Review Oncology infusion orders for medical necessity per CMS, Manufacturer, or NCCN guidelines. Work… more