- Henry Ford Health System (Troy, MI)
- …GENERAL SUMMARY: Unit Description: Health Alliance Plan (HAP) is looking to grow our Prior Authorization Team with experienced Registered Nurses! We are a team ... RN REFERRAL MANAGEMENT COORDINATOR (VIRTUAL) - PRIOR AUTHORIZATIONS - 40 HOURS - DAY SHIFT...that review medical necessity and medical criteria for all prior authorizations within our system in partnership with our… more
- Henry Ford Health System (Troy, MI)
- …with high risk of denial or with high charges are verified for accuracy prior to claim submission Managing authorization related denied claims to ensure the ... working relationships with departments to resolve patient inquiries. Central Authorization : Supervisor is responsible for functions related to timely procurement… more
- Henry Ford Health System (MI)
- …with high risk of denial or with high charges are verified for accuracy prior to claim submission + Managing authorization related denied claims to ensure ... Central Authorization : Supervisor is responsible for functions related to...work load to ensure referrals and authorizations are secured prior to patient arrival + Monitoring and adjusting workflow… more
- Highmark Health (Lansing, MI)
- …claims history, clearly defines the medical necessity of non-formulary and prior authorization medication exception requests. Interacts with pharmacy network ... Prioritize requests for drug authorizations or denials. + Review of prior authorization criteria for drug products. + Recommend staffing adjustments necessary to… more
- Actalent (Lansing, MI)
- Actively Screening for Remote Pharmacy Technicians - Prior Authorization Specialists to join a top managed care and healthcare company based out of Orlando, FL! ... Job Description We are seeking a dedicated Pharmacy Technician - Prior Authorization Specialist to join our team. This role involves managing coverage… more
- CenterWell (Lansing, MI)
- …problems or questions and act as facilitator to resolve them with regard to prior authorization or obtaining medications. + Attend scheduled team meetings and ... plan limitations, drug utilization review overrides, requesting and completing prior authorization , and/or communicating with plan representatives and/or… more
- Trinity Health (Grand Rapids, MI)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** ** Prior Authorization - Ambulatory Pharmacy Technician 40 Hours** **Pharmacy Technician Full ... services. **Position Summary:** The Pharmacy Technician will primarily support a centralized prior authorization clinic in West Michigan, MI. Pharmacy technician… more
- Trinity Health (Spring Lake, MI)
- …testing in timely fashion with proper documentation. + Works denied claims for missing prior authorization or referral within the EMR system. + Confirms payer is ... office required. + Extensive knowledge of the insurance market & prior authorization requirements. + Billing and coding knowledge and experience preferred. +… more
- University of Michigan (Ann Arbor, MI)
- …of medical insurances as they pertain to a specialty department. + Previous prior authorization experience. + Knowledge of University Policies and Procedures. + ... procedure as appropriate. + Call Insurance company to verify benefits and authorization requirements. + Help with any charge entry and/or questions regarding charge… more
- Molina Healthcare (Detroit, MI)
- …Job Duties** * Performs initial receipt and review of non-formulary or prior authorization requests against pharmacy plan approved criteria; requests additional ... requests. * Accurately enters approvals or denials of requests. * Facilitates prior authorization requests within established pharmacy policies and procedures. *… more
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