- St. Peters Health (Helena, MT)
- …but are not limited to: + Applying medical knowledge and experience for prior authorization requests; + Performing detailed medical reviews of prior ... The primary function of the Prior Authorization Specialist position is to provide premier customer service to the patient, physician and office staff by… more
- Select Medical (West Orange, NJ)
- …Rehabilitation - West Orange** A Select Medical Hospital West Orange, NJ ** Prior Authorization Specialist/ Payor Relations Specialist ( RN , LPN )** ... and independent judgment, the Payor Relations Specialist manages the pre-certification and prior authorization of referrals scheduled for admission to the Acute… more
- US Tech Solutions (May, OK)
- …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 + Establishes and maintains communication among, health… more
- Methodist Health System (Dallas, TX)
- …responsible for verification of medical coverage, along with notification, prior authorization , and/or pre-determination of healthcare benefits for proposed ... initiate pre- authorization and resolve issues that arise during the prior authorizations process. Supports and promotes the vision, mission, and strategic plans… more
- Mille Lacs Health System (Onamia, MN)
- …companies within the electronic medical record. + Document all prior authorization information including approval dates, billing units, procedure codes, ... expired. + Work closely with HI Clerk who performs clerical prior authorization functions. + Secure patients' demographics and medical information by using… more
- Beth Israel Lahey Health (Westwood, MA)
- …Assistance programs. 2. Collects and reviews all data needed for pharmacy and medical prior authorization approvals. Provides formulary assistance for clinic ... of Pharmacy 3-5 years related work experience required in specialty pharmacy and medical prior authorization experience or a minimum of 4 years of pharmacy… more
- US Tech Solutions (GA)
- …medication prior authorization (PA) requests reviewed by the Specialty Medical Prior Authorization department. Reporting to the Pharmacy Operations ... staff and customer service, admissions and pharmacy operations departments to communicate prior authorization status. You will also oversee fax processing and… more
- Kelly Services (Rochester, NY)
- …Authorization Technician performs initial-level processing and review of prior authorization requests for both pharmacy and medical specialty drug reviews ... authorization process. **Essential Responsibilities/Accountabilities** + Conduct initial medication prior - authorization , exception, and medical necessity… more
- Centene Corporation (New York, NY)
- …license.** **8:30am-5pm, Monday-Friday Eastern Standard hours.** **Position Purpose:** Analyzes all prior authorization requests to determine medical ... to assess medical necessity of care of member + Escalates prior authorization requests to Medical Directors as appropriate to determine appropriateness… more
- Banner Health (AZ)
- …customers of the Health Plan including members, providers, contracted pharmacies, case managers, medical prior authorization staff, and the customer care ... POSITION SUMMARY This position supports the Pharmacy Department in processing pharmacy prior authorization (PA) requests in an accurate and timely manner.… more