- Insight Global (Montgomery, AL)
- …initiatives within the managed care space. This role requires expertise in prior authorization processes, TPA liability, and Medicaid-related MMIs. The ideal ... Business Analyst in managed care or healthcare environments. Strong understanding of prior authorization , TPA liability, and Medicaid processes. Ability to… more
- J&J Family of Companies (Santa Clara, CA)
- …- authorization requirements. + Provide one-on-one and group training on prior authorization , claim submission, appeals, and payment processes. + Identify, ... triage, and resolve access barriers in collaboration with internal reimbursement support teams. + Identify key issues and trends with commercial and government payers; determine and implement appropriate solutions. + Conduct webinars for new and existing… more
- Centene Corporation (New York, NY)
- …Provider. + Provides first level RN review for all outpatient and ancillary prior authorization requests for medical appropriateness and medical necessity using ... level clinical review for all outpatient and ancillary services requiring authorization . Utilizes decision-making and critical-thinking skills in the review and… more
- Sanofi Group (Fort Lauderdale, FL)
- …the field subject matter expert relating to patient support, access, reimbursement, prior authorization , appeal, financial assistance, and other business related ... ABM as appropriate + Support field in education of office personnel on prior authorization and appeals processes, reimbursement support through Dupixent MyWay,… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …The UM Coordinator is responsible for coordinating all aspects of the prior authorization process, including member eligibility and benefit verification, ... members of the organization. Primary Responsibilities + Research and confirm authorization requirements and communicate to member, providers, and facility staff. +… more
- TEKsystems (Washington, DC)
- …with the Collections Policy Manual. Requirements: + 2+ years experience in Prior Authorization , Precertification, or Charge Entry + Associates Degree required ... an extensive client base, TEKsystems is searching for experienced Medical Authorization and Precertification Specialists in the DC, Maryland, and Northern Virginia… more
- Molina Healthcare (Fort Worth, TX)
- …stay for requested treatments and/or procedures. * Conducts reviews to determine prior authorization /financial responsibility for Molina and its members. * ... 2 years experience in a hospital acute care, inpatient review, prior authorization , and/or managed care setting, or equivalent combination of relevant education… more
- AssistRx (Orlando, FL)
- …the patient journey. Our portfolio-including iAssist(R), Hub Lite (TM) , Prior Authorization , Benefits Verification, and connected specialty pharmacy ... the pharmaceutical pipeline via ClinicalTrials.gov, EvaluatePharma, TrialScope, or similar. + Prior experience supporting Sales or Commercial teams in life sciences.… more
- Albany Medical Center (Albany, NY)
- …report to the front check in desk. * Coordinate patients' referrals and prior authorization for additional diagnostic testing or procedures. * Schedule surgical ... Department. + Compile booking sheets, all surgical consents, pre-op orders, prior authorization and pre-admission forms. + Preparing patient disability… more
- AssistRx (Overland Park, KS)
- …and details on how to expedite patient access + Document and initiate prior authorization process and claims appeals + Report any reimbursement trends ... and navigating complex reimbursement issues. This position also provides support for Prior Authorizations (PA) for an assigned caseload and helps navigate the… more