- Molina Healthcare (FL)
- …Medicare and Medicaid Services (CMS) standards. * Provides coordination and processing of pharmacy prior authorization requests and/or appeals. * Explains ... including but not limited to: formulary information, copay amounts, pharmacy location services and prior authorization...information, copay amounts, pharmacy location services and prior authorization outcomes. * Assists members and… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- Position Type Full Time Category Pharmaceutical Description PRIOR AUTHORIZATION SPECIALIST (REMOTE) WHO WE ARE At Polaris Pharmacy Services, we're more than ... those who need it most, we invite you to grow with us. OVERVIEW The Prior Authorization Specialist is responsible for managing and identifying a portfolio of… more
- Highmark Health (Tallahassee, FL)
- …clearly defines the medical necessity of non-formulary and prior authorization medication exception requests. Interacts with pharmacy network providers to ... requests for drug authorizations or denials. + Review of prior authorization criteria for drug products. +...billing practices through paid clams review. + Participate as pharmacy representative in onsite member appeals and… more
- Cardinal Health (Tallahassee, FL)
- …care and timely access to necessary services + Assist in obtaining insurance, prior authorization , and appeal requirements and outcomes + Help patients ... streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas,… more
- Immigration and Customs Enforcement (Miami, FL)
- …accordance with the Prompt Payment Act. Identifies and addresses discrepancies prior to validation. Collaborates with the headquarters contracting officer ... representative (COR) to ensure compliance with Federal Acquisition Regulations...records management, clinical services, nursing services, mental health services, pharmacy services, dental services, medical records, and administration; quality… more