- University of Rochester (Rochester, NY)
- …data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and ... follow up. Adheres to approved protocols for working referrals and prior authorizations. **ESSENTIAL FUNCTIONS** + Responsible for managing department referrals.… more
- US Tech Solutions (May, OK)
- …role that conducts clinical reviews of medical data collected to perform prior authorization for specialty medications. The clinical pharmacist will apply clinical ... from physicians or members regarding their pending, approved, or denied prior authorizations. **Responsibilities:** + Ensure accuracy of case setup and clinical… more
- Cardinal Health (Providence, RI)
- …for all requested procedures, tests, drugs, etc. The Coordinator, Benefits Eligibility and Prior Authorization may be asked to perform other duties if necessary and ... patient responsibility such as deductible, out of pocket, copay and coinsurance prior to services rendered. + Communicate with patients, front end staff, physicians… more
- Insight Global (Robinson, PA)
- Job Description Insight Global is seeking a Prior Authorization Specialist to help make specialty medications more accessible and affordable. This is an onsite role ... patients. The majority of each day will consist of completing prior authorizations for specialty medications and helping process claims. Key Responsibilities… more
- US Tech Solutions (May, OK)
- …courteous phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of reviews. ... but not limited to outbound calls, reviewing and processing Prior Auth's received via fax and ePA, monitoring and...without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a… more
- US Tech Solutions (May, OK)
- …data entry, data management, and reporting. **Experience:** + * Review criteria-based prior authorizations following policy and procedure. + * Provide on-call after ... other clinical colleagues, healthcare professionals and members. + * Follow all prior authorization procedures to guarantee an accurate process on each prior… more
- Avera (Pierre, SD)
- …Work where you matter.** **A Brief Overview** Responsible for obtaining prior authorization from insurers for medical tests, procedures, surgeries and specialty ... by the provider. Has understanding of tests, procedures and preparation required prior to testing. Sees that all necessary paperwork and documentation is complete… more
- US Tech Solutions (May, OK)
- …with resume and provide license number. **Responsibilities:** + Review criteria-based prior authorizations following policy and procedure. + Provide on-call after ... pharmacists, other clinical colleagues, healthcare professionals and members. + Follow all prior authorization procedures to guarantee an accurate process on each … more
- Fallon Health (Worcester, MA)
- **Overview** **This is 3 months temporary contract position for a Prior Authorization RN.** **About us:** Fallon Health is a company that cares. We prioritize our ... members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation,… more
- Fallon Health (Worcester, MA)
- …members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, ... and inpatient, utilization management operations, including but not limited to prior authorization, concurrent review and discharge planning. + Ensures that members… more