- Albany Medical Center (Albany, NY)
- …report to the front check in desk. * Coordinate patients' referrals and prior authorization for additional diagnostic testing or procedures. * Schedule surgical ... booking process. + Compile booking sheets, all surgical consents, pre-op orders, prior authorization and pre-admission forms. + Preparing patient disability and… more
- Highmark Health (Albany, NY)
- …**JOB SUMMARY** This job reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review ... RESPONSIBILITIES** + Make coverage determinations by evaluating physician requests for prior authorization or appeals against medical policy through the… more
- Merck (Albany, NY)
- …and/or education to HCP accounts on patient access, including benefit verification, prior authorization process, appeals process, and patient support programs in ... B, Medicaid, commercial) and related access processes, including benefit verification, prior authorization , and appeal processes * Expertise in pharmaceutical… more
- Molina Healthcare (Albany, 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
- Molina Healthcare (NY)
- …Services (CMS) standards. * Provides coordination and processing of pharmacy prior authorization requests and/or appeals. * Explains point-of-sale claims ... not limited to: formulary information, copay amounts, pharmacy location services and prior authorization outcomes. * Assists members and providers with… more
- Healthfirst (NY)
- …oversight and operational management for all utilization management functions, including prior authorization , concurrent review, and service requests + Lead, ... and quality outcomes in a fast-paced, regulated environment **Preferred Qualifications:** + Prior experience leading a team of people leaders + Work experience using… more
- University of Rochester (Rochester, NY)
- …access drugs in assigned clinics. Collaborates with clinical staff to acquire prior authorization for relevant providers, investigates benefits, enrolls patients ... of the major payers for the relevant clinic-administered drugs that require prior authorization (PA) and is responsible for working with the clinic providers,… more
- Rochester Institute of Technology (Rochester, NY)
- …+ Generate special reports/queries from EMR or other sources as requested + Prior authorization + Using information from clinical providers, pursue insurance ... authorization for medications, imaging and specialist referrals as required....with NYS Immunization law + Experience with referrals and prior authorizations + Medical terminology + Excel Fluency **Work… more
- Humana (Albany, NY)
- …service telephone experience desired + Experience with Utilization Review and/or Prior Authorization , preferably within a managed care organization ... Proficient utilizing electronic medical record and documentation programs + Prior experience with CGX and Genesys + Prior... Prior experience with CGX and Genesys + Prior experience with post-acute authorizations + Prior … more
- Albany Medical Center (Albany, NY)
- …the specialty they are assigned. * Schedule follow up appointments, referrals and prior authorization for patient schedule visits as needed. * Communicate ... professionally and timely with all parties, including providers, patients, clinical care team, and insurance companies. * Answer incoming phone calls and direct appropriately to team members. * Conveys professional image by adhering to the established dress… more