- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: The Authorization Office Manager will be responsible for the day-to-day insurance authorization oversight of both outpatient and inpatient ... in insurance and reimbursement requirements inclusive of coding and treatment authorization and making recommendations to optimize compliance. Management of … more
- Trinity Health (Syracuse, NY)
- …referrals, verifying insurance updates prior to procedure, and supporting authorization and denial processes. **EDUCATION, TRAINING, EXPERIENCE, CERTIFICATION AND ... 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
- CVS Health (Phoenix, AZ)
- …all with heart, each and every day. **Position Summary** The **Associate Manager , Clinical Health Services (Prior Authorization )** is responsible for oversight ... RN licensure in state of Arizona. + Demonstrated proficiency in Microsoft Office products (Word, Excel, PowerPoint, Outlook). + Must reside in Arizona. +… more
- University of Connecticut (UConn) (Storrs, CT)
- …the Storrs campus, is seeking a Medical Referral Coordinator and Insurance Authorization Specialist to coordinate and provide assistance in carrying out the accurate ... and timely pre- authorization / authorization of insurance coverage and benefits for...scans. Provides administrative support for the insurance and billing office . This position reports to the Student Health and… more
- LA Care Health Plan (Los Angeles, CA)
- Authorization Technician II (12 Month Assignment) Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... the safety net required to achieve that purpose. Job Summary The Authorization Technician II supports the Utilization Management (UM) Specialist by handling all… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …denials cannot be overturned. + Appropriately escalates complex cases to Drug Authorization Supervisor or Manager of Prior Authorizations. + Monitors email ... Working in a fast-paced, high volume, dynamic environment, the Clinical Authorization Specialist will bring clinical expertise to the prior authorization and… more
- Methodist Health System (Dallas, TX)
- …**Work Shift :** **Job Description :** Your Job: The Medical Authorization Specialist professional responsible for verification of medical coverage, along with ... notification, prior authorization , and/or pre-determination of healthcare benefits for proposed medical...for clinic operating policies. * Strong proficiency using Microsoft Office products * Strong oral and written communication skills… more
- University of Rochester (Rochester, NY)
- …ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non-clinical ... Serves as liaison, appointment coordinator, and patient advocate between the referring office , specialists, and patient to assist in the coordination of scheduled… more
- US Tech Solutions (May, OK)
- …criteria for a determination in a specialty/skilled clinical setting ie, specialty medical office or Pharmacy Benefits Manager (PBM) **Skills:** + MUST HAVE ... that conducts clinical reviews of medical data collected to perform prior authorization for medications. + The clinical pharmacist will apply clinical knowledge to… more
- Elevance Health (Nashville, TN)
- …lens, to deliver member-centered, lasting pharmacy care. **Title** : Prior Authorization Clinical Pharmacist **Virtual:** This role enables associates to work ... may be considered if candidates reside within a commuting distance from an office . **_Please note that per our policy on hybrid/virtual work, candidates not within… more