- St. Luke's University Health Network (Allentown, PA)
- …serve, regardless of a patient's ability to pay for health care. The Medication Prior Authorization Specialist is responsible for the coordination of insurance ... process to resolution. JOB DUTIES AND RESPONSIBILITIES: + Monitors prior authorization work queues WQ(s) and promptly obtains and/or reviews patient insurance… more
- University of Utah Health (Salt Lake City, UT)
- …verification, obtaining benefit information, calculating patient estimates and obtaining prior authorization before services are rendered. This position ... what each individual payer requires to authorize the visit. + Secures prior authorization for high dollar services such as scheduled day surgeries, planned… more
- Actalent (Ridgeland, MS)
- Job Title: Prior Authorization NurseJob Description The Prior Authorization Nurse plays a crucial role in analyzing authorization requests to ... the quality and cost-effectiveness of medical care. Responsibilities + Analyze prior authorization requests to determine medical necessity and appropriate… more
- CVS Health (Indianapolis, IN)
- …conducts criteria based & clinical review of medical data collected to perform prior authorization as per policy and procedure. The Pharmacist/Clinician will ... therapy knowledge through self-education. Responsibilities: 1.) Evaluate and review all prior authorization requests and render coverage determinations based on… 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 ... through payer to patient for timely health care diagnostics and treatments. The Prior Authorization Specialist supports the provider and patient's plan of care… 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, ... Make an extraordinary impact.** The Utilization Management Representative II - Prior Authorization is responsible for managing incoming calls, including… more
- US Tech Solutions (May, OK)
- **Job Description:** + Responsible for reviewing and completing criteria based on prior authorization as per policy and procedure. **Responsibilities:** + This ... skills. + Will be responsible for: Reviewing and completing criteria based on prior authorization as per policy and procedure. **Experience:** + Prior … more
- SUNY Upstate Medical University (Syracuse, NY)
- …and medical necessity of medication use based on established criteria. Obtain prior authorization from intermediaries and payers, including managed care ... of activities that maximize revenue capture for high-cost medications. Conduct prospective prior authorization services to expedite clinic workflow and enhance… more
- Centene Corporation (Tallahassee, FL)
- …FROM HOME SUPPORTING MEDICARE UTILIZATION FOR OUTPATIENT, DME, HOME HEALTH AND MEDICAL PRIOR AUTHORIZATION APPROVALS.** **THE WORK SCHEDULE WILL BE MONDAY - ... SATURDAY OR SUNDAY WITH A WEEK DAY OFF.** **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service and… more
- University of Utah Health (Salt Lake City, UT)
- …verification, obtaining benefit information, calculating patient estimates, and obtaining prior authorization before services are rendered. This position ... paper trail. + May work to resolve claims denials related to the prior authorization . **Knowledge / Skills / Abilities** + Basic knowledge of accounting, word… more
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