• Care Review Clinician, Prior Auth (RN) Pega…

    Molina Healthcare (NY)
    …and its members. + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests ... benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina… more
    Molina Healthcare (07/12/25)
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  • Finance and Authorization Specialist - Lead

    Rochester Regional Health (Rochester, NY)
    …findings to patient via phone call, email, or MyCare channels. Obtain prior - authorization on both internal and external department orders for ... JOB TITLE: Lead Finance & Authorization Specialist DEPARTMENT: Finance LOCATION: Lipson Cancer Institute Rochester General Hospital - 1425 Portland Avenue,… more
    Rochester Regional Health (08/12/25)
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  • Pharmacy Access Rep III - Home Infusion

    University of Rochester (Rochester, NY)
    …hospital and clinical employees at various levels including pharmacists, pharmacy technicians, medical /clinical staff, and central prior authorization staff. ... insurance coverage determination, patient out of pocket determination, determination of prior authorization requirements. The PAR will communicate with the… more
    University of Rochester (08/07/25)
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  • Authorization Specialist

    WMCHealth (Port Jervis, NY)
    …. Utilize multiple patient information related systems to obtain/ secure authorization , verify benefits, perform medical necessity checks. . Obtain, ... Authorization Specialist Company: Bon Secours Community Hospital City/State:...case is assessed for clinical related concerns and resolved prior to patients presenting to the hospital to ensure… more
    WMCHealth (08/19/25)
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  • Health Insurance & Authorization Specialist…

    Highland Hospital (Rochester, NY)
    …insurance eligibility and coverage verification using the three patient identifiers, confirming prior authorization is on file for correct level of care, ... **16923BR** **Title:** Health Insurance & Authorization Specialist I **Department/Cost Center:** 846 - Business...inquires on prior auth denials and works with the Provider's office… more
    Highland Hospital (07/05/25)
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  • Medication Authorization Specialist

    Rochester Regional Health (Rochester, NY)
    …communication across the care team. RESPONSIBILITIES: + Coordinate and submit prior authorization requests for cardiology medications, and monitor approvals, ... Job Title: Medication Authorization SpecialistDepartment: SCHI Brighton Location: 1445 Portland Avenue,...+ 2 years work experience in a healthcare settings, medical billing, pharmacy, or insurance verification. PREFERRED QUALIFICATIONS: +… more
    Rochester Regional Health (07/23/25)
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  • Pharmacy Access Rep III - Community Pharmacy

    University of Rochester (Rochester, NY)
    …hospital and clinical employees at various levels including pharmacists, pharmacy technicians, medical /clinical staff, and central prior authorization staff. ... information to submit prescriptions to the patient's insurance for approval including prior authorization and helping enroll patients in financial assistance… more
    University of Rochester (08/07/25)
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  • Referral & Prior Auth Rep III

    University of Rochester (Rochester, NY)
    …considerations._ **Responsibilities:** GENERAL PURPOSE Serves as the patient referral and prior authorization specialist, with oversight of data and compliance ... to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non-clinical staff,… more
    University of Rochester (08/07/25)
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  • Health Insur & Auth Rep III

    University of Rochester (Albany, NY)
    …Registration and Insurance Management, Utilization Management, Social Work, Patient Accounts, Medical Records, Surgeon offices, Prior Authorization Teams, ... of activities with multiple areas within the University of Rochester Medical Center System: Health Insurance Counseling, Medicaid Enrollment & Outreach, Financial… more
    University of Rochester (08/25/25)
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  • Intake Manager

    Heath System Services (Niagara Falls, NY)
    …Compliance: + Ensure all orders meet payer requirements, including benefit verification, medical necessity qualification, and prior authorization . + Maintain ... You Get - Benefits That Go Beyond the Basics + Comprehensive Health Coverage - Medical , Dental, and Vision insurance to keep you and your family well + Future-Ready… more
    Heath System Services (08/22/25)
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