- Actalent (Rancho Cordova, CA)
- Job Title: Prior Authorization Nurse Job Description The Prior Authorization Nurse will triage and review cases as necessary, handling prior ... Responsibilities + Triage and review cases as needed. + Work on prior authorization cases following medical policy. + Utilize resources effectively to manage… more
- UCLA Health (Los Angeles, CA)
- …This position is responsible for reviewing and evaluating clinical documentation related to prior authorization requests for medical services. The UM Review ... efficient utilization of resources. Key Responsibilities: + Conducts clinical reviews of prior authorization requests to evaluate medical necessity and benefit… more
- US Tech Solutions (May, OK)
- …other clinical colleagues, healthcare professionals and members. + * Follow all prior authorization procedures to guarantee an accurate process on each ... policy and procedure. + * Provide on-call after hours nurse availability for urgent PA requests. + * Provide... prior authorization . + * Train and mentor... prior authorization . + * Train and mentor representatives on the… more
- Centene Corporation (New York, NY)
- …have an active New York State nursing license.** **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service and ... interdepartmental teams, to assess medical necessity of care of member + Escalates prior authorization requests to Medical Directors as appropriate to determine… more
- US Tech Solutions (May, OK)
- …pharmacists, other clinical colleagues, healthcare professionals and members. + Follow all prior authorization procedures to guarantee an accurate process on ... following policy and procedure. + Provide on-call after hours nurse availability for urgent PA requests. + Provide internal...each prior authorization . + Train and mentor representatives… more
- US Tech Solutions (LA)
- **Position Summary:** As a Prior Authorization Nurse , you work outside the walls of a hospital setting in a specialty area of the nursing field providing ... utilization management prior authorization reviews. Build strong direct relationships...indicated by staffing and business needs. **Duties:** + **Registered Nurse with current license in LA state of employment.… more
- AssistRx (Orlando, FL)
- …support programs. + Familiarity with PSP workflows: hub services, copay programs, prior authorization , benefits investigations, nurse support. + Strong ... treatment. Our suite of solutions-including iAssist(R), Hub Lite (TM) , Prior Authorization , Benefits Verification, Copay Support, specialty pharmacy… more
- Hartford HealthCare (Farmington, CT)
- …on billing and authorization processes.* * *Assists with training of new prior authorization staff and other duties as assigned.* *At Hartford HealthCare, we ... based on eligibility.* *Job Summary: Under the direction of the Prebilling and Authorization Manager, the Authorization Specialist performs all duties related to… more
- Aspirus Ironwood Hospital (Wausau, WI)
- …WI is seeking an AUTHORIZATION SPECIALIST to join our team! The Authorization Specialist is critical to ensure accurate prior and ongoing authorizations. ... and communication with the patients, clinical team including physicians, nurse practitioners, patient navigator, pharmacy staff, and patient financial services… 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. ... Technician (or eligible), Registered Record Administrator (or eligible) or Licensed Practical Nurse (LPN) with a minimum of 5 years' experience in an appropriate… more