- Option Care Health (Lansing, MI)
- …facing responsibilities. **Basic Qualifications** + Knowledge of insurances (Benefit Verifications/ Prior Authorization ), in specialized pharmacy therapies ... Summary:** The Specialist, Pharma Support Services serves as the designated representative on their assigned program(s) to ensure delivery of the referral… more
- Avera (Sioux Falls, SD)
- …information as needed from the medical record to answer clinical questions during authorization process. Communicate with care team and pharmacy staff to ensure ... applications for drug assistance. Provide accurate cost estimate details to patients prior to appointments. + Discuss benefits and other financial concerns with… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …pulls and synthesizes data across multiple domains, including utilization management, prior authorization , claims, denials, and appeals. Their work goes ... Pharmacy , ensuring data is pulled using the most representative methods. They also support high-risk regulatory reporting, where...clinical. * High school diploma (or equivalency) and legal authorization to work in the US Preferred Skills and… more
- North Shore Community Health (Gloucester, MA)
- …furthest extent possible when needed within the scope of nursing practice, including prior authorization forms . Provides health education to individuals and ... services. + Behavioral health care. + Care management. + Pharmacy services. + Substance abuse disorder treatment. + Nurse...employer. Our goal is to have a diverse workforce representative of all people, at all job levels, in… more
- TEKsystems (Morrisville, NC)
- …volume call center, Customer service call center, Insurance, Medicare, Medical terminology, Pharmacy , Medicaid, Prior authorization Additional Skills & ... unparalleled customer service while serving as a brand advocate and program representative ; understands the importance of achieving quality outcomes and committed to… more
- Immigration and Customs Enforcement (Miami, FL)
- …accordance with the Prompt Payment Act. Identifies and addresses discrepancies prior to validation. Collaborates with the headquarters contracting officer ... representative (COR) to ensure compliance with Federal Acquisition Regulations...records management, clinical services, nursing services, mental health services, pharmacy services, dental services, medical records, and administration; quality… more
- Luke Staffing (GU)
- …TRICARE benefit for approval. + Ensures Line of Duty paperwork is on file prior to authorization . + Verify eligibility of beneficiaries using Defense Eligibility ... appropriateness, covered benefit, and authorized surgery/medical procedures, laboratory, radiology, pharmacy , and general hospital procedures and regulations to analyze… more
- Adelante (Phoenix, AZ)
- …will work with patients to develop self-management goals, provide insurance, referral, and prior authorization support, and may also conduct patient outreach to ... and discharges, obtain medical records and assist patients with pharmacy /medication questions. EXPECTATIONS Every Adelante Healthcare employee will strive to… more
- Penn Medicine (Philadelphia, PA)
- …patients seeking care at UPHS, communicating with the patient and/or third party representative to ensure that all portions of the intake process are completed per ... as well as policies surrounding insurance verification, referral and authorization , and point-of-service payment after communication with financial officers within… more