- Highmark Health (Buffalo, NY)
- …research to fulfill the call, such as verifying benefit coverage, creation of a prior authorization case in Highmark's Utilization Management system for Prior ... all inbound phone requests from providers or pharmacy for all inbound Prior Authorization requests.Use multiple software systems and various resource sites… more
- US Tech Solutions (New York, NY)
- …based role 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
- Bassett Healthcare (Cooperstown, NY)
- …learning to the team, and is a go to person for coworkers. + Obtains prior approval or prior authorization as needed. Communicates referral appointment and ... signatures and form processing to meet Medicare regulations. + Obtains prior approval or prior authorization as needed. Communicates referral appointment and… more
- KPH Healthcare Services, Inc. (Oneonta, NY)
- …improvement initiatives. + Responsible for monitoring adjudication queue(s) and facilitate prior authorization process for customers + Responsible for ensuring ... appropriateness of therapy, labs or other questions/concerns and provide support for prior authorization , financial assistance, and prescription fill and renewal… more
- SUNY Upstate Medical University (Syracuse, NY)
- …in a timely manner. Primary functions include: contact payers to determine if authorization for services is required prior to rendering services. Minimum ... written/oral communication, analytical and computer skills required. Preferred Qualifications: Prior working experience with ambulatory patient care administrative functions,… more
- Molina Healthcare (NY)
- …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
- Northwell Health (Lake Success, NY)
- …timeline for dispensing. + Resolves insurance related issues and coordinates prior authorization requirements. + Exhibits exceptional customer service during ... pharmacy benefits investigation, oversees financial assistance and facilitation of prior authorizations, as required. Job Responsibility + Collaborates with… more
- Molina Healthcare (Yonkers, NY)
- …stay for requested treatments and/or procedures. * Conducts reviews to determine prior authorization /financial responsibility for Molina and its members. * ... 2 years experience, including experience in hospital acute care, inpatient review, prior authorization , managed care, or equivalent combination of relevant… more
- Akumin (Mount Kisco, NY)
- …responsibility. + May be responsible for verifying insurance coverage and obtain prior authorization . Patient Assistance: + May perform preliminary screening of ... patients prior to procedures, which may include medical history. +...May schedule patient appointments and obtain insurance verification and/or authorization . + May prepare medical records for physicians, patients… more
- Molina Healthcare (NY)
- …team of medical directors and behavioral health clinicians responsible for prior authorization , inpatient concurrent review, discharge planning, care management, ... develops medical director staff and team members as needed. + Ensures authorization decisions are rendered by qualified personnel without influence from fiscal or… more