- AssistRx (Orlando, FL)
- …and details on how to expedite patient access + Document and initiate prior authorization process and claims appeals + Report any reimbursement trends ... and navigating complex reimbursement issues. This position also provides support for Prior Authorizations (PA) for an assigned caseload and helps navigate the… more
- Evolent (Tallahassee, FL)
- …learning models and algorithms to primarily improve the performance of our prior authorization platforms + Construct advanced SQL queries, perform preprocessing, ... systems into production environments + Healthcare experience, particularly using administrative and prior authorization data, with a passion for solving problems… more
- Walgreens (St. Petersburg, FL)
- …all external billing practices including but not limited to third party adjudications, prior authorization , and patient financial assistance programs in order to ... to maximize generic substitution opportunities. + Manage and collect patient balances prior to prescription dispensing, or in accordance with company policy. +… more
- Centene Corporation (Tallahassee, FL)
- …pharmacy program. + Receive and respond to provider and pharmacy calls regarding the prior authorization and formulary process + Perform review of pharmacy and ... Track and trend overrides to ensure criteria have been met, audit for prior authorizations, analyze cost and determine utilization patterns + Resolve complaints and… more
- Prime Therapeutics (Tallahassee, FL)
- …may be in use in a Pharmacy Benefit Management setting (Claims Processing, Prior Authorization , Telephony, Membership, etc.). + Consideration will be given as ... what is typical of individuals with 2+ years of work experience. + Prior experience as a Business Intelligence Developer/Analyst or Data Analyst supporting business… more
- Actalent (Orlando, FL)
- …Pharmacy Technician. In this role, you will be responsible for reviewing prior authorization requests and making initial determination decisions-approving or ... communicate outcomes to providers or members. + Address client inquiries related to authorization decisions and PBM system usage. + Refer specialty drug requests to… more
- HCA Healthcare (Trinity, FL)
- …experience is required, scheduling preferred. + Insurance verification and gaining prior authorization experience preferred. + Medical terminology is preferred. ... then monitor, audit and distribute the schedule. + You will obtain precertification/ authorization numbers and enter them in the scheduling or registration system. +… more
- Evolent (Tallahassee, FL)
- …with healthcare claims, reimbursement methodologies, and cost/utilization KPIs, including prior authorization data and key performance indicators (eg, ... Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, and population health… more
- AssistRx (Orlando, FL)
- …preferred. + Familiarity with PSP workflows including hub services, copay programs, prior authorization , and nurse support. + Strong understanding of data ... employment eligibility verification document form upon hire. Sponsorship and/or work authorization is not available for this position. AssistRx does not accept… more
- University of Miami (Miami, FL)
- …+ Assists in scheduling imaging appointments at UM facility. + Assists in prior authorization paperwork for specialty medications. + Contact patients as directed ... and referral numbers. + Reviews clinical records for completeness including authorization , signatures, missing data, and other patient information. + Answers… more