- Elevance Health (Atlanta, GA)
- …eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization , and post service requests. + Obtains intake ... ** Utilization Management Representative II** **Virtual:** This role enables...to screen basic and complex requests for precertification and/or prior authorization . + Verifies benefits and/or eligibility… more
- Elevance Health (Columbus, GA)
- …Management Representative I** will be responsible for coordinating cases for precertification and prior authorization review. **How you will make an impact:** + ... ** Utilization Management Representative I** **Virtual:** This role enables...provides authorization for inpatient admission, outpatient precertification, prior authorization , and post service requests. +… more
- Elevance Health (Columbus, GA)
- …eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization , and post service requests. + Obtains intake ... ** Utilization Management Representative II** **Virtual:** This role enables...to screen basic and complex requests for precertification and/or prior authorization . + Verifies benefits and/or eligibility… more
- Molina Healthcare (GA)
- …benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina ... + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. +...Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization… more
- US Tech Solutions (GA)
- …leadership team. **Experience:** + 1-3 years of related work experience. **Skills:** + Prior Authorization + Utilization Reeview **Education:** + High School ... from distractions. You will provide processing and communication of specialty medication prior authorization (PA) requests reviewed by the Specialty Medical … more
- Humana (Atlanta, GA)
- …health outcomes of our members. + _Outcomes_ : Characterize the impactable drivers of prior authorization and look at appeals rate with denials and overturns. ... Utilization Management of medical review by physician or nurse , with a focus on our 5+ million Medicare..._Access_ _:_ Ensure Humana members have fair and consistent authorization review and ability to appeal and have justification… more
- Molina Healthcare (Atlanta, GA)
- …benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina ... + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. +...Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization… more