- 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
- Arnot Health (Elmira, NY)
- …Assists in tracking/trending by payer for denial reason items such as prior authorization , untimely filing, coordination of benefits, services type issues, ... on Bonus for qualified Case Managers! MAIN FUNCTION: The Case Management (denial/ prior auth) will review and appeal as appropriate for concurrent and retrospective… 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
- CDPHP (Latham, 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
- Planned Parenthood of Greater New York (Schenectady, NY)
- …Visits: (15%) . Complete pre-registration tasks for procedure visits, including initiating prior authorization processes. . Review payer information and verify ... role o Previous experience working with electronic health record. o Prior experience in patient scheduling, insurance verification, or healthcare administrative… more
- YAI (Manhattan, NY)
- …associated documentation (eg, prescription fax forms). Update EHR accordingly. + Obtain Prior Authorization for non-covered medications or feeding supplies for ... are checked, and computers are logged on and working prior to patient visit. If any issues report to...made, prioritized correctly and have the necessary supporting documents prior to the first visit. + Document all Hospital/… more
- Bassett Healthcare (Cooperstown, NY)
- …supervisor or manager + Maintains 100% attendance to all divisional or staff meetings unless prior authorization of the Manager or Director What we need from you ... the facility. Refuses to admit persons who cannot show either proper authorization or cause for being admitted. Provides information and directions. Explains rules… more
- Bassett Healthcare (Cooperstown, NY)
- …supervisor or manager + Maintains 100% attendance to all divisional or staff meetings unless prior authorization of the Manager or Director What we need from you ... the facility. Refuses to admit persons who cannot show either proper authorization or cause for being admitted. Provides information and directions. Explains rules… more
- Highmark Health (Buffalo, NY)
- …**Job Description :** **JOB SUMMARY** This job is responsible for completing all Prior Authorization outbound call tasks and/or inbound triage case creations. In ... and/or provider of the approval and/or denial of the requested authorization . **ESSENTIAL RESPONSIBILITIES** + Obtain call task from Utilization Management platform,… more
- Molina Healthcare (Syracuse, NY)
- …pharmacy/health plan providers, Molina staff and others as needed. * Performs prior authorization reviews of high-cost medications and deferred authorization ... requests as needed. * Researches, develops, and implements drug utilization and disease state management strategies and intervention techniques to deliver high quality, cost effective health care. * Assists in coordination of care for pharmacy-related issues… more
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