• Medication Prior Authorization

    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
    St. Luke's University Health Network (04/17/25)
    - Related Jobs
  • Prior Authorization Rep II

    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
    University of Utah Health (03/28/25)
    - Related Jobs
  • Clinical Review Nurse - Prior

    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
    Actalent (05/01/25)
    - Related Jobs
  • Clinical Pharmacist - Prior

    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
    CVS Health (05/02/25)
    - Related Jobs
  • Prior Authorization Specialist…

    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
    Montrose Memorial Hospital (03/10/25)
    - Related Jobs
  • Utilization Management Representative II…

    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
    Elevance Health (04/16/25)
    - Related Jobs
  • Prior Authorization Pharmacist

    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
    US Tech Solutions (02/19/25)
    - Related Jobs
  • Prior Authorization Coordinator

    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
    SUNY Upstate Medical University (02/07/25)
    - Related Jobs
  • Clinical Review Nurse- Prior

    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
    Centene Corporation (05/03/25)
    - Related Jobs
  • Prior Authorization Representative I

    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
    University of Utah Health (04/30/25)
    - Related Jobs