- US Tech Solutions (San Antonio, TX)
- …professional phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation ... professional phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation… more
- Abbott (Plano, TX)
- …Blue Shield) + **Efficiently** **submits** **and manages precertification and prior authorization requests** + **Understands payer-specific requirements and ... and assisting Abbott patients with the pre-certification, pre-determination and authorization process necessary as a prerequisite to perform various procedures… more
- Elevance Health (Grand Prairie, TX)
- …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
- Elevance Health (Grand Prairie, TX)
- …Management Representative I** is responsible for coordinating cases for precertification and prior authorization review. **How will you make an impact:** + ... eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization , and post service requests. + Refers cases… more
- CenterWell (Austin, TX)
- …service telephone experience desired + Experience with Utilization Review and/or Prior Authorization , preferably within a managed care organization **Additional ... UM teams, ensuring timely and accurate processing of referral and authorization inquiries in accordance with organizational policies and regulatory guidelines. The… more
- J&J Family of Companies (El Paso, TX)
- …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 (TX)
- …processes involved with the review of non-formulary drugs or other drugs requiring prior authorization . + Supervises pharmacy daily unit operations to ensure ... unrestricted in state of practice. + Health care delivery and pharmacy prior authorization experience + Knowledge of or experience with decision analysis and… more
- Adecco US, Inc. (Lubbock, TX)
- …computer, reviewing prior authorizations and receiving phone calls from prior authorization pharmacy technicians and/or healthcare providers to gather, ... clarify clinical questions, interpret guideline criteria, and provide decisions on prior authorization requests. . Collaborate with pharmacy technicians and/or… more
- ASM Global (Houston, TX)
- …north dock at NRG Stadium and NRG Center. + Ensuring all shipments received have prior authorization and verifying with the tenant any shipmentswithout prior ... below are representative of the knowledge, skill, and/or ability required. + Prior facility, operations, or administrative experience preferred but not required. +… more
- Molina Healthcare (Fort Worth, TX)
- …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