- CDPHP (Albany, NY)
- …coverage and CDPHP initiatives. The pharmacy tech will support initiatives including prior authorization work under the guidance of a licensed pharmacist. ... and external customers. + Must be conscientious, efficient and accurate in prior authorization , exception and medical/Rx necessity review processing. +… more
- Amgen (New York, NY)
- …order to reimbursement, supporting the entire reimbursement journey through payer prior authorization to appeals/denials requirements and forms + Review ... coverage/utilization management criteria, insurance forms & procedures, benefits investigation, prior authorization , appeal, and/or claims resolution + Educate… more
- Bassett Healthcare (Cooperstown, NY)
- …manner as observed by direct supervisory observation and chart documentation Obtains prior authorization for treatment/ therapy plans, and medications to ensure ... adherence to the prescribed plan of care. Documentation of authorization is completed in the patient record/referral Coordinates on time delivery of cancer drugs to… more
- Evolent (Albany, NY)
- …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
- CDPHP (Albany, NY)
- …professionalism. This position supports timely determination turnaround times on all prior authorization requests and inpatient notifications received via ... decision making to determine the appropriate action to take prior to logging and routing requests for authorization... prior to logging and routing requests for authorization to the appropriate clinical reviewer. CSS reviews clinical… more
- Mount Sinai Health System (New York, NY)
- …rejected claims, conducting and completing necessary third party (insurance) prior authorization requests (when applicable), and verifies prescriptions ... with appropriate follow up on rejected claims. 2. Completes third party prior authorization requests and verifies prescriptions. 3. Provides a high level of… more
- Independent Health (Buffalo, NY)
- …Management, departments. The UMA is the first line of review in the UM prior authorization process, reviewing for eligibility and benefit. The UMA is responsible ... the onboard of new staff as needed. + Research and correction of authorization discrepancies received through Siebel and Macess. + Review documents received by fax… 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 company + Answer incoming phone calls and direct appropriately to team members + Conveys professional image by adhering to the established dress code.… more
- Guthrie (Corning, NY)
- …safe and timely dispensing of the medication for the patient as needed. Medication Prior Authorization * *Collect necessary documentation and submit it to the ... Cancellation notifications * *Electronic Refill Requests * *System generated Medication Authorization Request * *Staff Messages * *Provider In basket - when… 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