- Endeavor Health (Warrenville, IL)
- …RN licensure Current CPR for Healthcare Providers Office RN and BSN preferred Prior work experience in an Orthopedic setting, highly preferred Self-starter, able ... triage, patient education and Continuous Glucose Monitor placement, testing, insurance pre- authorization and referrals, occasional rooming of patients, RN visits -… more
- Adecco US, Inc. (San Diego, CA)
- Adecco Healthcare & Life Sciences is hiring Pharmacists in California! This role is work from home and all equipment is provided. Please note you must reside ... Friday, 8am to 8pm CST (Must be open to work these hours and be flexible) **Responsibilities of the...multiple databases/platforms, and applications. Competent use of computers/technology. **Why work for Adecco?** . Weekly Pay . 401(k) Plan… more
- CVS Health (HI)
- …This position provides processing and communication of Specialty and Non-Specialty medication prior authorization referrals reviewed by the Case Review Unit. ... in customer service or call center environment - Must be able to work from home , this is a 100% work from home position - Have wired high speed internet… more
- CVS Health (AZ)
- …do it all with heart, each and every day. Position Summary - Processes prior authorization requests received by phone, fax, or electronically and utilizes ... resources, existing criteria, and medication guidelines to perform clinical research to support prior authorization reviews. - Proactively completes prior … more
- St. Luke's University Health Network (Allentown, PA)
- …orders placed by PG PCP and Specialty service lines. + Utilizes specific Epic Work Queues designed for Prior Authorization and Insurance Referral workflows ... be considered as a detailed description of all the work requirements that may be inherent in the position....medical necessity of genetic testing/infusion services in addition to prior authorization to ensure revenue for services.… more
- 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
- Centene Corporation (Austin, TX)
- …Central with occasional weekends and holidays required. **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service ... flexibility. Applicants for this position have the flexibility to work remotely from their home anywhere in...assess medical necessity of care of member + Escalates prior authorization requests to Medical Directors as… more
- University of Rochester (Rochester, NY)
- …data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical ... Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 910146 OBGYN Billing Work Shift: UR - Day (United States of America) Range: UR URCD 204 H… more
- Adecco US, Inc. (Cumberland, RI)
- Job Title: Pharmacy Technician I - Prior Authorization (Remote) Location: Fully Remote (US) Pay Rate: $19.99 - $ 21.13/hour Training: + 5 weeks, Monday-Friday, ... for PST time zone candidates Position Overview: The Pharmacy Technician I ( Prior Authorization ) handles inbound calls from providers, pharmacies, and members,… 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 ... position and requires the ability to effectively support a work from home environment. Must have the...each prior authorization . + Train and mentor representatives… 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 ... position and requires the ability to effectively support a work from home environment. Must have the... prior authorization . + * Train and mentor... prior authorization . + * Train and mentor representatives on the… more
- University of Rochester (Rochester, NY)
- …Management, Utilization Management, Social Work , Patient Accounts, Medical Records, Home Care Coordinators, Prior Authorization Teams, Contracting and ... Scheduled Weekly Hours: 40 Department: 500183 Health Insurance Counseling Work Shift: UR - Day (United States of America)...western New York, Rochester is our namesake and our home . One of the world's leading research universities, Rochester… 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 ... the Authorization Specialist performs all duties related to insurance verifications and prior authorizations for Home Health and Hospice services in a timely… more
- UPMC (Pittsburgh, PA)
- …expertise, research initiatives, and strong administrative support. **Responsibilities:** + Prior authorization responsibilities1. Reviews and interprets medical ... Monday through Friday 8am to 4:30pm (1 day work from home ). The primary responsibilities of...insurance payor or contracted provider web sites to perform prior authorization , edit, and denial services.4. Utilize… more
- Catholic Health Services (Melville, NY)
- …whether authorization is required and utilize payer-specific requirements to secure authorization . + Submit prior authorization requests to payers on ... employees, six acute care hospitals, three nursing homes, a home health service, hospice and a network of physician...of the hospital or physician. + Ensure the required prior authorization clinical documents are complete and… more
- UHS (Vestal, NY)
- …for therapy services, acting as a patient advocate when necessary to resolve authorization issues or disputes + Work closely with the Therapy Denials ... Terminology + Basic knowledge of insurance approval process related to outpatient therapies + Prior experience in clerical work Why You'll Love Working at UHS At… more
- Catholic Health Services (Roslyn, NY)
- …has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a network of physician practices across the island. ... the way we treat and serve our communities. We work collaboratively to provide compassionate care and utilize evidence...Top Workplace! Job Details We are seeking an experienced Authorization Specialist to join our cardiology office, where your… more
- BayCare Health System (Clearwater, FL)
- …Healthcare Business Office and /or Managed Care experience + Highly Preferred - Infusion prior authorization + Highly Preferred - Oncology prior ... will work the hours listed above)** **Responsibilities:** The Central Authorization Specialist II is responsible for verifying health insurance information and… more
- Billings Clinic (Bozeman, MT)
- …Starting Wage DOE: $17.15 - 21.44 Responsible for the completion of pre-certification, prior authorization and notification for third party and government payers ... outpatient examination and procedures requiring preauthorization. May provide back-up pre-certification/ prior authorization resources for other departments as… more
- Henry Ford Health System (MI)
- …with high risk of denial or with high charges are verified for accuracy prior to claim submission + Managing authorization related denied claims to ensure ... Central Authorization : Supervisor is responsible for functions related to...impacted staff on payor regulations/ requirements, + Coordinating staff work load to ensure referrals and authorizations are secured… more
