- University of Rochester (Rochester, NY)
- …considerations._ **Responsibilities:** GENERAL PURPOSE: Serves as the patient referral and prior authorization specialist, with oversight of data and compliance to ... enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non-clinical staff, identifying… more
- SUNY Upstate Medical University (Syracuse, NY)
- …medical necessity of medication use based on established criteria. Obtain prior authorization from intermediaries and payers, including managed care companies, ... activities that maximize revenue capture for high-cost medications. Conduct prospective prior authorization services to expedite clinic workflow and enhance patient… more
- Aston Carter (Salem, OR)
- Prior Authorization Specialist M-F Day Shift! Bi-Lingual in Spanish or Russian offers additional pay! MUST HAVE + Skills as a patient coordinator. + Two years of ... prior authorization or medical billing experience preferred. + Experience...skills. + Possessing a positive attitude. Job Description The Prior Authorization Specialist plays a crucial role in ensuring… more
- Elevance Health (San Antonio, TX)
- …the consumer's treatment journey. **Title:** Utilization Management Representative II - Prior Authorization **Location:** Onsite at 4751 Hamilton Wolf Rd, STE 101, ... Make an extraordinary impact.** The Utilization Management Representative II - Prior Authorization is responsible for managing incoming calls, including triage,… more
- US Tech Solutions (RI)
- **Job Title: Prior Authorization Specialist** **Location: Fully remote** **Duration: 12 months contract** **Job Description:** + Prior Authorization Specialist ... phone assistance to all callers through the criteria based prior authorization process. + Maintains complete, timely and accurate...but not limited to: outbound calls, reviewing and processing Prior Auth's received via fax and ePA, monitoring and… more
- Actalent (Ridgeland, MS)
- Job Title: Prior Authorization NurseJob Description The Prior Authorization Nurse plays a crucial role in analyzing authorization requests to determine the ... the quality and cost-effectiveness of medical care. Responsibilities + Analyze prior authorization requests to determine medical necessity and appropriate level of… more
- 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
- University of Rochester (Rochester, NY)
- …Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 910335 Ortho Prior Authorization Work Shift: Range: UR URCB 205 H Compensation Range: $20.31 - ... internal equity considerations._ **Responsibilities:** Oversees and provides direction to Prior Authorization and Referral Coordinator Associates and Specialists. Trains… more
- Montrose Memorial Hospital (Montrose, CO)
- …meeting the highest standards of healthcare. About The Career: + The Hospital Prior Authorization Specialist is an advocate for the patient's medical needs and ... through payer to patient for timely health care diagnostics and treatments. The Prior Authorization Specialist supports the provider and patient's plan of care as… 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