- Caris Life Sciences (Irving, TX)
- …of experience in revenue cycle management with a focus on benefit verification, prior authorization , or pre-billing activities or with accessioning within a lab ... upfront portion of the billing process, including benefit investigations, prior authorizations, financial clearance, and payer-specific requirements. This leader… more
- Actalent (Austin, TX)
- …intake and processing of prior authorizations. Responsibilities include entering prior authorization requests into our system and coordinating with review ... to include review-related tasks.. Responsibilities + Accurately create and process prior authorization requests in the system. + Collaborate with… more
- Prime Therapeutics (Austin, TX)
- …Technician Sr - Remote **Job Description** Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone ... staff, medical management staff and/or pharmacists. Researches, resolves and documents prior authorization outcomes in pharmacy system. + Communicates selected… more
- TEKsystems (Houston, TX)
- …correct eligibility information, perform benefit investigations, copay assistance and check prior authorization and/or appeal status. Care managers may also ... and a commitment to lifelong learning and improvement. Skills insurance verification, prior authorization , medical insurance, Call center Top Skills Details… more
- Molina Healthcare (Dallas, TX)
- …family include those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and ... **KNOWLEDGE/SKILLS/ABILITIES** + Performs initial receipt and review of non-formulary or prior authorization requests against plan approved criteria. Requests… more
- CenterWell (Austin, TX)
- …requests for services, gathering necessary information, and communicating with relevant parties. + ** Prior Authorization Support:** Assisting with the prior ... service telephone experience desired + Experience with Utilization Review and/or Prior Authorization , preferably within a managed care organization **Additional… more
- Cardinal Health (Austin, TX)
- …is to provide a detailed outline of clearance criteria as well as prior authorization and advocacy identification for procedures and medications scheduled to ... for benefit investigation as well as clinical clearance for prior authorization and medical necessity + Extensive patient education/counseling to determine… more
- Molina Healthcare (Houston, TX)
- …a compact licensure. The ideal candidate will have experience with UM and prior authorization , within both Physical Health and Behavioral Health. Candidates with ... benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina… more
- Elevance Health (Grand Prairie, TX)
- …such as DUR, DIS and formulary management. + Assists in developing and configuring prior authorization decision trees in the workflow tool + Participates in ... quality assurance of prior authorization decision trees within the workflow tool + Provides clinical consulting services to internal partners + Assists in… more
- US Tech Solutions (San Antonio, TX)
- …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