- 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
- Catholic Health Services (Melville, NY)
- …through an online system to secure authorizations for scheduled procedures requiring an authorization , prior to the date of service. Responsibilities: + Utilize ... needed and understand payer specific criteria to appropriately secure authorization and clear the account prior to...appropriately secure authorization and clear the account prior to service where possible. + Ensure that initial… more
- Elevance Health (Latham, NY)
- …eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization , and post service requests. + Obtains intake ... utilizing scripts to screen basic and complex requests for precertification and/or prior authorization . + Verifies benefits and/or eligibility information. + May… more
- Albany Medical Center (Albany, NY)
- …(ICU or floor admitting MD/Pharmacy/Nurse Manager/Clinical Nurse Specialist/Consulting MD), prior authorization , protocols for inpatient oral food ... (ICU or floor admitting MD/Pharmacy/Nurse Manager/Clinical Nurse Specialist/Consulting MD), prior authorization , protocols for inpatient oral food… more
- J&J Family of Companies (New City, NY)
- …billing. + Reimbursement or relevant managed care experience (revenue cycle, buy-and-bill, prior authorization , coding, and appeals processes) + Ability to ... disease state experience + Advanced degree and/or relevant certifications in prior authorization and/or billing and coding + Strong market access acumen as… more
- Molina Healthcare (Yonkers, 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
- Molina Healthcare (Buffalo, NY)
- …stay for requested treatments and/or procedures. * Conducts reviews to determine prior authorization /financial responsibility for Molina and its members. * ... health care experience, including experience in hospital acute care, inpatient review, prior authorization , managed care, or equivalent combination of relevant… 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 (Rochester, NY)
- …benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina ... its members. + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests additional… more
- Mount Sinai Health System (New York, NY)
- …exclusive and may not be performed by the same employee._ 8.Facilitates prior authorization and appointment scheduling for diagnostic testing requested by ... demographic and insurance information, determining insurance/payment source, identifying necessary authorization or referral requirements, and assisting with determining and… more