- US Tech Solutions (May, OK)
- …+ Responsible for reviewing and completing criteria based on prior authorization as per policy and procedure. **Responsibilities:** + This individual must have ... excellent interpersonal skills. + Will be responsible for: Reviewing and completing criteria based on prior authorization as per policy and procedure. **Experience:** + Prior authorization experience required. + Previous pharmacy experience in retail or… more
- US Tech Solutions (May, OK)
- …This position is responsible for reviewing and completing criteria based prior authorizations as per policy and procedure. **Responsibilities:** + Conducted coverage ... determinations and prior authorizations for prescription drugs, evaluating them against established workers compensation criteria, guidelines, and relevant literature. + Reviewed worker's compensation claims data for clinical appropriateness, cost efficiency,… more
- US Tech Solutions (May, OK)
- …+ It is an operation based role that conducts clinical reviews of medical data collected to perform prior authorization for specialty medications. The clinical ... pharmacist will apply clinical knowledge to plan approved criteria for prospective and concurrent reviews of cases. **Responsibilities:** + Collaborates with the CRU Technician to process referrals, including answering clinical questions, collecting… more
- US Tech Solutions (May, OK)
- …+ This position is responsible for reviewing and completing criteria based on prior authorization as per policy and procedure. **Responsibilities:** + Reviewing and ... completing criteria based on prior authorization as per policy and procedure. **Experience:** + Previous pharmacy experience in PBM (Pharmacy Benefits Management) required. + Since the job duties consist of reviewing and completing criteria based on prior… more
- US Tech Solutions (May, OK)
- …+ The AR Representative is charged with maximizing cash flow by making outbound calls on patient accounts. + This role is essential to ensuring patient financial ... services are handled properly. The Accounts Receivable Specialist position is responsible for helping patients understand their pharmaceutical charges and assist in resolving any resident questions or concerns. **Responsibilities:** + Reconcile daily cash… more
- US Tech Solutions (May, OK)
- …As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy benefits. Responsible for ensuring ... cases are accurately set up for our members, review clinical information for decisioning the request, performing outreach to providers for more information when needed, and ensuring accurate decisions that comply with compendia and Medicare guidance and… more
- US Tech Solutions (May, OK)
- …The Tech I is the initial point of contact for Prior Authorization requests from members, providers, and a diverse customer base. The Tech I will make the ... determination if a complex request should be transferred to a pharmacist for assistance. Additionally, the Tech I is responsible for maintaining complete, timely, and accurate documentation of all approvals and denials. **Responsibilities:** + This position… more
- US Tech Solutions (May, OK)
- …This is a remote position and requires the ability to effectively support a work from home environment. Must have the ability to work in a HIPAA compliant work area ... away from distractions, and must have their own secure private internet services of at least 25mbps download/3mbps upload in order to ensure sufficient speed to adequately perform work duties. Must provide a screenshot of internet speeds with resume and… more
- US Tech Solutions (May, OK)
- …The Tech I Prior Auth takes in-bound calls from providers, pharmacies, members, etc providing professional and courteous phone assistance to all callers through the ... criteria based prior authorization process. Maintains complete, timely and accurate documentation of reviews. Transfers all clinical questions, escalations and judgement calls to the pharmacist team. The Tech I will also assist with other duties as needed to… more
- US Tech Solutions (May, OK)
- …The clinical pharmacist is an operation based role that conducts clinical reviews of medical data collected to perform prior authorization for specialty medications. ... The clinical pharmacist will apply clinical knowledge to plan approved criteria for prospective and concurrent reviews of cases. authorizations. **Responsibilities:** 1. Collaborates with the CRU Technician to process referrals, including answering clinical… more
- US Tech Solutions (May, OK)
- …This position involves receiving in-coming calls from members, providers, etc., and providing professional phone assistance through the criteria-based prior ... authorization process. The role requires maintaining complete, timely, and accurate documentation of all approvals and denials, and transferring all clinical questions and judgment calls to the pharmacist. **Duties:** + At least 1 year experience as a pharmacy… more
- Elara Caring (Buffalo, OK)
- …Pay: $11.50 Join our Elara Caring family and become a superhero of care! We're on a mission to keep people in their homes safely, one client at a time. Why Choose ... Elara Caring? + We've got an awesome team environment where everyone supports each other. + Daily Pay Available! Work today, get paid tomorrow. + Need a flexible schedule? We've got you covered. + Paid travel time between assignments Yes, please! + Paid… more
- US Tech Solutions (May, OK)
- …This position interprets relevant clinical criteria through review of medical records, annotates via Adobe PDF and populates a data collection tool to support ... compliance with HEDIS and CMS performance measures. Ensures accurate and complete documentation of required information to meet risk management, regulatory, and accreditation requirements. The candidate must be proficient with databases and with conducting… more
- US Tech Solutions (May, OK)
- …. Participates in the development and ongoing implementation of QM Work Plan activities. . Improve quality products and services, by using measurement and analysis to ... process, evaluate and make recommendations to meet QM objectives Responsibilities: . Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations. . Considers all documented system information as… more
- Paychex (May, OK)
- …+ Leads a team of Advocates that own the client relationships in the Small (10-99) and Mid-size client (100-199) segments. Manages a team of Advocates that will grow ... revenue per client and will be responsible for that group's success in this metric. Guides a team of Advocates the achieve revenue and retention targets by providing exceptional service and retaining existing clients. + Responsible for and uses tools available… more
- Paychex (May, OK)
- …+ Manages annual 5500 process. + Develops and establishes communications and reports regarding plan design changes for internal and external stakeholders to ensure ... messages are clear, accurate and consistent. + Identifies compliance issues affecting the PEO H&B product offering and provides management with recommended solutions. + Evaluates and reviews integration of PEO insurance products and services with agency… more
- Paychex (May, OK)
- …+ Acts as a contact for the client during the implementation process to resolve issues, answer questions and ensure expectations and deadlines are met. + Manages ... client employees benefit onboarding process, including conducting the employee orientation meeting. + Creates and manages an implementation timeline, sets expectations and defines responsibilities with concise communication, including all tasks to be completed… more
- US Tech Solutions (May, OK)
- …+ The Tech I Prior Auth takes in-bound calls from providers, pharmacies, members, etc providing professional and courteous phone assistance to all callers through the ... criteria based prior authorization process. Maintains complete, timely and accurate documentation of reviews. Transfers all clinical questions, escalations and judgement calls to the pharmacist team. **Responsibilities:** + The Tech I will also assist with… more
- US Tech Solutions (May, OK)
- …+ Prior Authorization Specialist takes in-bound calls from providers, pharmacies, members, etc providing professional and courteous phone assistance to all callers ... through the criteria based prior authorization process. + Maintains complete, timely and accurate documentation of reviews. + Transfers all clinical questions, escalations and judgement calls to the pharmacist team. + The Rep I, Clinical Services will also… more
- Love's Travel Stops & Country Stores (Buffalo, OK)
- **Req ID:** 444278 **Address:** Hwy 64 & Brule Buffalo, OK, 73834 **Benefits:** _* Fuel Your Growth with Love's - company funded tuition assistance program * Paid ... Time Off * Flexible Scheduling * 401(k) - 100% Match up to 5% * Medical/Dental/Vision Insurance after 30 days * Competitive Pay * Career Development * Hiring Immediately_ **Welcome to Love's!** At Love's, our cashiers work in a fast-paced environment and… more