- The County of Los Angeles (Los Angeles, CA)
- …criteria set forth by pharmacy services chief. + Submits or troubleshoots prescription prior authorization requests as directed by a licensed pharmacist. + ... Corresponds with pharmacy staff at dispensing pharmacies, patients and prescribers in regards to prescription status. + Assists a licensed pharmacist to process prescription refill requests and obtains prescription fill histories. + Replenishes the drugs in… more
- Banner Health (CA)
- …and dental plan inquiries, and services of staff such as utilization review, prior authorization , billing and contract management. 6. Services inbound and ... outbound customer and staff communications for all facilities in the states in which they operate. Works with various departments and staff to provide accurate managed care information. MINIMUM QUALIFICATIONS High school diploma/GED or equivalent working… more
- John Muir Health (Walnut Creek, CA)
- …Required** **2 years of call center experience - Preferred** **2 years of prior authorization - Preferred** **Additional Experience:** **3 years experience in ... working with the public** **Excellent public relations and telephone communication skills** **Certifications/Licensures:** **Epic - Proficiencies required for this position must be passed within 90 days of the start date** **Skills:** **Knowledge of… more
- Providence (Anaheim, CA)
- …schedules appointments as necessary. Responsible for processing and follow up of prior authorization requests for medical group providers. Provides excellent ... customer service to patients, pharmacy personnel, clinical staff, and providers. Providence caregivers are not simply valued - they're invaluable. Join our team at Providence Medical Foundation and thrive in our culture of patient-focused, whole-person care… more
- Polaris Pharmacy Services, LLC (Covina, CA)
- …does not achieve a settlement. + Complete necessary payer paperwork, including prior authorization forms and manual billing. + Handle non-standard order ... entry situations as required. + Support training needs within the team. + Duties may vary depending on business needs and operational context. Qualifications QUALIFICATIONS/COMPETENCIES: To perform this job successfully, an individual must be able to perform… more
- Amgen (San Jose, CA)
- …reimbursement regulations and processes (ie, eligibility and benefit verification, prior - authorization , billing, coding, claims, and appeals/denials), Medicare ... and Medicaid rules and regulations, and OSHA and HIPAA compliance as related to Amgen products. + Consistently meets or exceeds corporate sales goals. + Communicates territory activity in an accurate and timely manner as directed by management. + Provides… more
- Stanford Health Care (Palo Alto, CA)
- …Hour (United States of America) Strongly Preferred Qualifications: - Insurance knowledge - Prior Authorization experience **This is a Stanford Health Care job.** ... **A Brief Overview** As a foundational level, the PCC II, is expected to learn and apply job skills, policies, and procedures to complete moderate assignments and tasks. They should exercise judgment within defined guidelines to determine appropriate actions.… more
- UCLA Health (Los Angeles, CA)
- …collection of accurate demographic information, soliciting for insurance information and prior authorization requirements and follow up. Provide general ... information to incoming callers regarding the referral intake process. Process managed care authorizations. Typing, faxing and maintain daily/weekly records regarding internal and incoming transplant program referrals. Delivering CICARE World Class Care… more
- Cedars-Sinai (Los Angeles, CA)
- …and holidays, ensures outside lab kits are available, refills medications and submits for prior authorization if needed. Acts as the super trainer for Point of ... Care urine and glucometer and performs NST testing in the Prenatal Diagnostic Center when coverage is needed. **Qualifications** **Qualifications:** Education: + GED or Highschool Diploma **License/Certifications:** + Current, unrestricted California LVN… more
- University of Southern California (Newport Beach, CA)
- The Clinical Authorization Specialist will take the lead in securing medical authorizations from third party payers (commercial and government) for outpatient ... documentation, submitting tracking, reporting and documenting outcomes of each authorization request. The Specialist will be in a position...on items and provide outcomes to the Supervisor daily, prior to end of shift. + Follow-up on outstanding… more