- Molina Healthcare (Rochester, NY)
- …Services (CMS) standards. * Provides coordination and processing of pharmacy prior authorization requests and/or appeals. * Explains point-of-sale claims ... not limited to: formulary information, copay amounts, pharmacy location services and prior authorization outcomes. * Assists members and providers with… 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
- University of Rochester (Rochester, NY)
- …+ Prior Authorizations and Referrals: + Acts as a back up to prior authorization and referral teams to obtain approval for testing and services ordered ... multiple, complex details to insurance or worker's compensation carrier to obtain prior authorizations for both standard and complex requests such as imaging,… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …authorization requests for eligible members. PRIMARY RESPONSIBILITIES: + Assists in the prior authorization of services and ongoing authorization requests ... the care plan of the member + Coordinates with providers regarding authorization activities + Coordinates communication between authorization clinical staff,… more
- Highmark Health (Albany, NY)
- …claims history, clearly defines the medical necessity of non-formulary and prior authorization medication exception requests. Interacts with pharmacy network ... requests for drug authorizations or denials. + Review of prior authorization criteria for drug products. +...practices through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. +… more
- Emerson (Albany, NY)
- …Participation in select professional meetings, trade shows, and conferences as a representative of Emerson **WHO YOU ARE:** You adjust communication content and ... annually within the United States and Canada + Legal authorization to work in the United States without the...work visas **Preferred Qualifications that Set You Apart:** + Prior experience and relationships w/ Hyper Scale customers (Oracle,… more
- Upstone Materials (Wells, NY)
- …factory regarding quality alignment and continuous improvement measures. Pre-Shipment Verification and Authorization + Prior to shipment of PSC sleepers, verify ... standards (EN, ASTM and others). Acts as the on-site representative of Colas Rail to verify quality control, monitor...approved logistics and packing procedure. + Provide formal written authorization ("GO for Shipment") only once all quality and… more
- Finger Lakes Health (Geneva, NY)
- …Range 19.21-22.31 Pay Range 19.21-22.31 Job Description The Patient Service Representative (PSR) is responsible for obtaining patient demographics, insurance and ... financial information, and applicable co-pays and deductibles for all scheduled patients prior to the date of service. Responsibilities include entry of the data… more
- SMX (Albany, NY)
- …external clients such as the Contracting Officer and the Contracting Officer Representative . They oversee and manage work assignments of other Financial Analyst(s) ... in Finance, Accounting and or Business. **Desired Skills:** * Prior experience with GSA AAS/FEDSIM contracts * Experience of...SMX does not sponsor a new applicant for employment authorization or immigration related support for this position (ie… more
- Pfizer (New York, NY)
- …portfolio pull-through. + Test and evaluate new customer data assets prior to operational rollout; document performance and integration recommendations. + **Insight ... ability to translate complex findings into clear recommendations **Preferred** + Prior experience in Hospital / Generic Injectables analytics or US hospital… more