- Option Care Health (Sacramento, CA)
- …insurance verification information and payer contracts and/or self-pay guidelines.Obtains initial authorization prior to admitting the patient for all services ... authorization requirements.Obtains reauthorization as necessary, reviews physician orders from pharmacy to determine if authorization is required on changes… more
- Option Care Health (Denver, CO)
- …external facing responsibilities. Basic Qualifications Knowledge of insurances (Benefit Verifications/ Prior Authorization ), in specialized pharmacy therapies ... hiring, developing, and retaining a diverse workforce. Job Description Summary:The Specialist , Pharma Support Services serves as the designated representative on… more
- Jazz Pharmaceuticals (New York, NY)
- …targeted objectives and meet established MBO's and goals. Provider and account interface, prior authorization and coding education, as well as case management ... to support patient access needs.Educate and ensure providers understand payer prior authorization requirements, appeals process, clinical criteria, and… more
- Seattle Children's (Seattle, WA)
- Responsibilities: The Prior Authorization (PA) Specialist is responsible for all aspects of the prior authorization process while continuously ... year Seattle Children's Outpatient Pharmacy experience. + Specialty Pharmacy and/or Centralized Prior Authorization Services knowledge. Min to Max Hourly… more
- University of Michigan (Ann Arbor, MI)
- Prior Authorization Specialist Apply Now **Summary** Processes referrals and prior authorizations using established insurance company guidelines. Obtains ... action employer. **Job Detail** **Job Opening ID** 246886 **Working Title** Prior Authorization Specialist **Job Title** Patient Services… more
- BrightSpring Health Services (Englewood, CO)
- …patients nationwide through our growing network of branches and healthcare professionals. The Prior Authorization Specialist role will be responsible for ... of prior authorizations. This role requires working knowledge of pharmacy benefits and prior authorization process. NOTE: Work Schedule: Monday - Friday… more
- Sharp HealthCare (San Diego, CA)
- …patients, medical providers, insurance companies and pharmacies requesting prior authorizations.Collaborate with ancillary and operational departments to research ... patient's insurance eligibility, benefits and requirements.Request, track and obtain pre- authorization from insurance carriers within time allotted for medical and… more
- University of Colorado (Aurora, CO)
- …agency (https://www.jobelephant.com/) As a key member of the Revenue Cycle Team, the Prior Authorization and Payer Reimbursement Specialist (PAPR) at the ... info, etc., as necessary. + Work closely with the Pharmacy Revenue Cycle Specialist to coordinate and...a key member of the Revenue Cycle Team, the Prior Authorization and Payer Reimbursement Specialist… more
- Trinity Health (Fort Wayne, IN)
- …and provides information to patients and providers as it pertains to the patient's pharmacy benefits. Determines if prior authorization is needed for the ... documentation and ensures completeness of the prior authorization questionnaires. Collaborates with Integrated Specialty Pharmacy Staff located… more
- CareOregon (Portland, OR)
- …process. + Follow policy & procedures to facilitate a resolution for prior authorization , formulary exception and coverage determinations requests. Notify ... Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. Job Title Pharmacy Benefit Specialist II Exemption Status Non-Exempt...members, providers or providers staff of prior authorization and formulary exception decisions. +… more
- Stanford Health Care (Palo Alto, CA)
- …functions of this role: * Position will support the initiation of medication prior - authorization . * Help to start co-pay assistance forms and assistant patient ... to confirm qualification for tier exceptions. Patient Admin Specialist II, Medication Authorization Support - Outpatient Neuroscience **A Brief Overview** The… more
- Henry Ford Health System (West Bloomfield, MI)
- …Specialist is responsible for handling drug claim adjudication issues, prescription prior authorization , and pharmacy benefit inquiries from ... in the resolution of pharmacy benefit coverage issues and coordinating prior authorization and exception processes. PRINCIPLE DUTIES AND RESPONSIBILITIES: +… more
- Henry Ford Health System (Bingham Farms, MI)
- …place referral for patient follow-up in specialty clinics/departments, and facilitate prior authorization with appropriate pharmacy partners across ... GENERAL SUMMARY: The Pharmacy Specialist provides oversight and leadership...primary care or managed care is strongly desired. . Prior experience and knowledge or integrated health systems .… more
- Baptist Memorial (Memphis, TN)
- Summary Authorization Denial Specialist ensures that chemotherapy (specialty group) and other infusions/radiation therapy/radiology/ surgical services meet ... education + Employee referral program Job Summary: Position: 18063 - Specialist - Authorization Denial Facility: BMHCC Corporate Office Department: HS Revenue… more
- Henry Ford Health System (Rochester Hills, MI)
- …Specialist is responsible for handling drug claim adjudication issues, prescription prior authorization , and pharmacy benefit inquiries from ... in the resolution of pharmacy benefit coverage issues and coordinating prior authorization and exception processes. PRINCIPLE DUTIES AND RESPONSIBILITIES: +… more
- Marshfield Clinic (Marshfield, WI)
- …to support the most exciting missions in the world!** **Job Title:** SHP Clinical Pharmacy Specialist - Temporary Position from Mid-May to Mid-August (Remote or ... 5:00 pm (United States of America) **Job Description:** **JOB SUMMARY** The Clinical Pharmacy Specialist works with physicians, staff, and committees to optimize… more
- COFMC (Ada, OK)
- …claims to appropriate carrier for all commercial, federal, and state insurance plans. Submit prior authorization requests, follow up on submitted prior ... DEPARTMENT: Pharmacy NATURE OF POSITION: The Pharmacy Billing Specialist is responsible for performing tasks related to the management of third-party billing… more
- Option Care Health (Sacramento, CA)
- …insurance verification information and payer contracts and/or self-pay guidelines. Obtains initial authorization prior to admitting the patient for all services ... authorization requirements. Obtains reauthorization as necessary, reviews physician orders from pharmacy to determine if authorization is required on changes… more
- Intermountain Health (Murray, UT)
- …and complaint or problem resolution. Provides additional support for the prior authorization of medications. Provides support to multiple departments ... **Job Description:** The Pharmacy Government Specialist II is responsible for the day-to-day operations of Medicare Part D, providing superior customer service… more
- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: The Authorization Specialist works with providers, patients, ancillary departments, pharmacy and insurance carriers to ensure that all ... orders and insurance claim submission. Experience with healthcare insurance prior authorization /coding and performing insurance carrier/managed care review… more
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