- US Tech Solutions (New York, NY)
- …that conducts clinical reviews of medical data collected to perform prior authorization for specialty medications. The clinical pharmacist will apply ... Handles inbound phone calls and escalations from physicians or patients regarding Prior Authorization (50%) 4. Establishes and maintains communication, health… more
- University of Rochester (Rochester, NY)
- …data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical ... applying prior insurer decisions and specialty/sub-specialty knowledge of general medical experience and terminology, specialty and sub specialty medical … more
- Apicha Community Health Center (New York, NY)
- …as needed and report outcome to PCP and multidisciplinary care team. + Obtain prior - authorization for pharmacy or medical services that are not covered ... welcoming environment for underserved and vulnerable populations. We are seeking a Medical Case Manager for our Manhattan location. Position Summary: Provide direct… more
- Molina Healthcare (Syracuse, NY)
- …and its members. + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests ... a compact licensure. The ideal candidate will have experience with UM and prior authorization , within both Physical Health and Behavioral Health. Candidates with… more
- SUNY Upstate Medical University (Syracuse, NY)
- …Educates patients and clinic staff regarding requirement for insurance plan to complete prior authorization . Answers inbound inquires related to prior ... daily tasks. + Shows knowledge and understanding of insurance billing and prior authorization requirements demonstrating analytical thinking. + Monitors all… more
- 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
- CDPHP (Latham, NY)
- …and external customers. + Must be conscientious, efficient and accurate in prior authorization , exception and medical /Rx necessity review processing. ... coverage and CDPHP initiatives. The pharmacy tech will support initiatives including prior authorization work under the guidance of a licensed pharmacist.… more
- Centene Corporation (New York, NY)
- …Network Provider. + Provides first level RN review for all outpatient and ancillary prior authorization requests for medical appropriateness and medical ... for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering… more
- SUNY Upstate Medical University (Syracuse, NY)
- …of education and experience. Preferred Qualifications: Experience with electronic medical records preferred Experience with Referral authorization and ... and procedures. Position reports to the Upstate University Medicine Medical Office Supervisor. Duties and Responsibilities: Obtain insurance eligibility… more
- Weill Cornell Medical College (New York, NY)
- …billing system. + Verifies patient insurance eligibility and obtains necessary pre- authorization numbers, if required, prior to appointment date. Facilitates ... Title: Medical Secretary Location: Upper East Side Org Unit: Medical Records Work Days: Weekdays and some weekends Weekly Hours: 35.00 Exemption Status:… more