- US Tech Solutions (May, OK)
- …based role that conducts clinical reviews of medical data collected to perform prior authorization for commercial and specialty medications. + The clinical ... denied prior authorizations. **Responsibilities:** + Evaluate and review all prior authorization requests and render coverage determinations based on… more
- Hartford HealthCare (Farmington, CT)
- …across the system. *_Position Summary:_* Under the direction of the Manager, Prior Authorization Services, HHC Cancer Institute, performs all clerical duties ... applicable. **_Position Responsibilities:_** **Key Areas of Responsibility** Monitors and reviews the prior authorization work queue daily to verify accuracy of… more
- University of Rochester (Rochester, NY)
- …internal equity considerations._ **Responsibilities:** 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,… 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 Rochester (Rochester, NY)
- …data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical ... follow up. Adheres to approved protocols for working referrals and prior authorizations. **ESSENTIAL FUNCTIONS** + Responsible for managing department referrals.… 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
Recent Jobs
-
Physical Therapist - Outpatient Float Pool
- ProMedica Health System (Toledo, OH)
-
Medical Laboratory Scientist I/Medical Lab Technician Auto Lab at HUP, PRN 1st Shift
- Penn Medicine (Philadelphia, PA)
-
Maintenance Tech-3rd shift
- Dairy Farmers of America (Winston Salem, NC)
-
*RT - New Work/Life Opportunity - Cardiac Cath Lab - Baptist/Clearview/Jeff Hwy campuses - $30k Sign On BONUS Available
- Ochsner Health (New Orleans, LA)