- University of Rochester (Rochester, NY)
- …considerations._ **Responsibilities:** GENERAL PURPOSE Serves as the patient referral and prior authorization representative, with oversight of data and ... compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non-clinical… more
- Fallon Health (Worcester, MA)
- …of purpose** : Under the direction of the Manager of Prior Authorization , communicates with contracted and non-contracted facilities/agencies/providers to ... collect pertinent prior authorization request data and disseminates information to the Authorization Coordinators. Additionally, supports the … more
- University of Michigan (Ann Arbor, MI)
- …payor requirements are met and authorizations are obtained timely and appropriately prior to service. The Authorization Specialist will provide subject matter ... Outpatient Authorization Specialist Apply Now **How to Apply** A...communication protocols. + Prioritize and procure all required authorizations prior to service reducing appointment cancelations and reschedules due… more
- Prime Healthcare (Chicago, IL)
- …West Talcott Ave, Chicago, IL 60631 Responsibilities The Infusion Insurance and Prior Authorization Representative assists with referrals by determining and ... are required. Preferred qualification: 1. Previous experience in pharmacy, infusion, or prior authorization process is preferred. Pay Transparency Saint Francis… more
- Eastern Connecticut Health Network (Manchester, CT)
- …are prevented. + Verifies insurance policy benefit information and obtains Authorization /Precertification prior to the patient's visit, scheduled surgery, ... POSITION SUMMARY: This position reports to the Manager, Central Authorization Center and works directly with FCC, ASC scheduling...Insurance eligibility and benefits and documenting in ADT system. ( prior to date of service and or upon admission).… more
- US Tech Solutions (RI)
- …and courteous phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of ... **Job Summary:** + The Tech I Prior Auth. takes in-bound calls from providers, pharmacies,...but not limited to: outbound calls, reviewing and processing Prior Auth's received via fax and ePA, monitoring and… more
- US Tech Solutions (May, OK)
- …conducts criteria based & clinical review of medical data collected to perform prior authorization as per policy and procedure. + The Pharmacist/Clinician will ... urgent PA request as needed. **Responsibilities:** + Evaluate and review all prior authorization requests and render coverage determinations based on clinical… more
- Elevance Health (Richmond, VA)
- …for the interpretation and data entry of moderately complex prescriptions, prior authorization processing, and troubleshooting adjudication issues. **How you ... will make an impact:** + Assists in developing and configuring prior authorization decision trees in the workflow tool + Participates in quality assurance… more
- Robert Half Office Team (Blue Ash, OH)
- …join our client's team in Blue Ash, Ohio. This role involves managing prior authorization processes, ensuring patients receive timely approvals for prescription ... requests, including physician recommendations and patient records. * Submit prior authorization requests to insurance providers and diligently follow… more
- WellSpan Health (Lewisburg, PA)
- …least two hours prior to testing or infusion. - Contacts patients the evening prior to their procedure if authorization is not obtained to give them the ... requirements and restrictions. **Duties and Responsibilities** **Essential Functions:** + AUTHORIZATION DUTIES: - Performs online and telephone authorization … more