• Prior Authorization

    St. Luke's University Health Network (Orwigsburg, PA)
    …serve, regardless of a patient's ability to pay for health care. The Network Prior Authorization and Referral Specialist is responsible for the coordination ... information. + Provides insurance company with clinical information necessary to secure prior - authorization or referral . + Works in alignment with Central… more
    St. Luke's University Health Network (08/19/25)
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  • Authorization Specialist

    UPMC (Wexford, PA)
    …and core values of UPMC in the performance of duties. Responsibilities: + Prior authorization responsibilities: + 1. Reviews and interprets medical record ... 18+ UPMC system and insurance payor or contracted provider web sites to perform prior authorization , edit, and denial services + .4. Utilize authorization more
    UPMC (08/29/25)
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  • Authorization Specialist, Digestive Health…

    UPMC (Pittsburgh, PA)
    …18+ UPMC system and insurance payor or contracted provider web sites to perform prior authorization , edit, and denial services. + Utilize authorization ... resources along with any other applicable reference material to obtain accurate prior authorization . + Resolves basic authorization edits to ensure timely… more
    UPMC (08/26/25)
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  • Referral Tracking Coordinator-Star…

    St. Luke's University Health Network (Bethlehem, PA)
    …Acquire and submit all necessary clinical information to insurance company needed to obtain prior authorization in a timely fashion + Obtains knowledge of any ... we serve, regardless of a patient's ability to pay for health care. The Referral Scheduling Specialist is a liaison between the providers and the patients. They are… more
    St. Luke's University Health Network (08/08/25)
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  • Director, Product Management

    PSKW LLC dba ConnectiveRx LLC (Pittsburgh, PA)
    …Agentforce. Knowledge Deep understanding of patient services, including benefits verification, prior authorization , affordability, case management , and ... candidate brings deep experience in Hub services (covering benefits verification, prior authorization , affordability, and access/adherence) and a proven track… more
    PSKW LLC dba ConnectiveRx LLC (09/10/25)
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  • Sr. Director, Program Management

    PSKW LLC dba ConnectiveRx LLC (Pittsburgh, PA)
    …practices in specialty pharmaceutical reimbursement operations, including benefit verification, prior authorization and managed care restrictions, and ... USD $119,600.00 - USD $180,100.00 /Yr. Submit a Referral (https://careers-connectiverx.icims.com/jobs/3174/sr.-director%2c-program- management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-1834382591) Share on News Feed… more
    PSKW LLC dba ConnectiveRx LLC (08/29/25)
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  • Construction Manager

    Qualus (Doylestown, PA)
    …**POWER your future with Qualus** as a Construction Manager in our Program Management organization. This individual will direct the construction management of ... state and local agencies before, during and after construction as required. + Prior to commencement of construction, coordinates with customer(s) at the jobsite to… more
    Qualus (08/18/25)
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  • Insurance Pre-Cert Coord at Infusion Services…

    Penn Medicine (Philadelphia, PA)
    …will ensure access to integrated health care; achieve clinically appropriate authorization to assure optimal reimbursement for the hospital for services provided. ... for pre-cert, patient payments, coverage limitation and determine necessary action prior to patient arrival. Assess information for appropriateness of setting and… more
    Penn Medicine (08/07/25)
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  • Preregistration Specialist

    Penn Medicine (West Chester, PA)
    authorization and referrals for services being performed, documenting the prior authorization / referral information in EPIC. Reviews all high-tech ... up with patients and/or referring sources for all "pended" or "denied" authorization requests. Confirms that the required precert/ authorization information is… more
    Penn Medicine (09/06/25)
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  • Clinical Service Specialist - Full Time

    Penn Medicine (Gap, PA)
    …Verifies patient, guarantor, coverage and hospital account information. Performs required referral authorization processes and enters orders for applicable ... tests. + Understands insurance company coverage and referral authorization requirements of payors. Performs electronic...all pertinent information to document imaging or heath information management team with in the established time frames. +… more
    Penn Medicine (09/04/25)
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