- 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
- Beth Israel Lahey Health (Burlington, MA)
- …staff, pharmacy staff, and third party payers for issues regarding prior authorization approvals, ambulatory infusion reimbursement and Patient Assistance ... 2. Collects and reviews all data needed for pharmacy and medical prior authorization approvals. Provides formulary assistance for clinic administered or… more
- Fairview Health Services (Minneapolis, MN)
- …intake staff in the areas of insurance verification, benefit investigation, and prior authorization for home infusion therapies. This role ensures intake ... tools. Design and deliver training programs focused on benefit investigation and prior authorization workflows. Create micro learning video using AI tools… more
- Trinity Health (Fort Wayne, IN)
- …patients and providers as it pertains to the patient's pharmacy benefits. Determines if prior authorization is needed for the claim to be paid. Gathers ... requests. Collaborates with Clinical Staff to ensure appropriateness of the prior authorization documentation and ensures completeness of the prior… more
- US Tech Solutions (GA)
- …from distractions. You will provide processing and communication of specialty medication prior authorization (PA) requests reviewed by the Specialty Medical ... Prior Authorization department. Reporting to the Pharmacy Operations Manager, you...customer service, admissions and pharmacy operations departments to communicate prior authorization status. You will also oversee… more
- Henry Ford Health System (MI)
- …with high risk of denial or with high charges are verified for accuracy prior to claim submission + Managing authorization related denied claims to ensure ... Central Authorization : Supervisor is responsible for functions related to...work load to ensure referrals and authorizations are secured prior to patient arrival + Monitoring and adjusting workflow… more
- Henry Ford Health System (Troy, MI)
- …with high risk of denial or with high charges are verified for accuracy prior to claim submission Managing authorization related denied claims to ensure the ... working relationships with departments to resolve patient inquiries. Central Authorization : Supervisor is responsible for functions related to timely procurement… more
- UPMC (Pittsburgh, PA)
- …to pharmacy prior authorizations. Manage the first line clinical review of prior authorization requests on behalf of physicians and UPMC Health Plan members. ... and the clinical staff + Subject matter expert on formulary exceptions and prior authorization requirements/time frames according to line of business. + Perform… more
- Trinity Health (Syracuse, NY)
- …This role focuses on monitoring expirations of referrals, verifying insurance updates prior to procedure, and supporting authorization and denial processes. ... appropriate health care setting. Ideally, has a background in referrals, denials, and/or authorization processes. Working knowledge of ICD-9-CM, CPT & E & M coding… more
- Point32Health (Canton, MA)
- …responsible for reviewing, processing and managing the daily caseload of pharmacy prior authorization (PA) requests for coverage determinations (CD), and ... The Clinical Pharmacist consults as required with THP Medical Directors (MD) on prior authorization that fails to meet drug prior authorization (PA)… more
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