• Medication Prior Authorization

    St. Luke's University Health Network (Allentown, PA)
    …serve, regardless of a patient's ability to pay for health care. The Medication Prior Authorization Specialist is responsible for the coordination of insurance ... process to resolution. JOB DUTIES AND RESPONSIBILITIES: + Monitors prior authorization work queues WQ(s) and promptly obtains and/or reviews patient insurance… more
    St. Luke's University Health Network (04/17/25)
    - Save Job - Related Jobs - Block Source
  • Prior Authorization Rep II

    University of Utah Health (Salt Lake City, UT)
    …verification, obtaining benefit information, calculating patient estimates and obtaining prior authorization before services are rendered. This position ... what each individual payer requires to authorize the visit. + Secures prior authorization for high dollar services such as scheduled day surgeries, planned… more
    University of Utah Health (03/28/25)
    - Save Job - Related Jobs - Block Source
  • Prior Authorization Specialist…

    Montrose Memorial Hospital (Montrose, CO)
    …meeting the highest standards of healthcare. About The Career: + The Hospital Prior Authorization Specialist is an advocate for the patient's medical needs ... through payer to patient for timely health care diagnostics and treatments. The Prior Authorization Specialist supports the provider and patient's plan of care… more
    Montrose Memorial Hospital (03/10/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Representative II…

    Elevance Health (San Antonio, TX)
    …the consumer's treatment journey. **Title:** Utilization Management Representative II - Prior Authorization **Location:** Onsite at 4751 Hamilton Wolf Rd, ... Make an extraordinary impact.** The Utilization Management Representative II - Prior Authorization is responsible for managing incoming calls, including… more
    Elevance Health (04/16/25)
    - Save Job - Related Jobs - Block Source
  • Prior Authorization Pharmacist

    US Tech Solutions (May, OK)
    **Job Description:** + Responsible for reviewing and completing criteria based on prior authorization as per policy and procedure. **Responsibilities:** + This ... skills. + Will be responsible for: Reviewing and completing criteria based on prior authorization as per policy and procedure. **Experience:** + Prior more
    US Tech Solutions (02/19/25)
    - Save Job - Related Jobs - Block Source
  • Prior Authorization Coordinator

    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
    SUNY Upstate Medical University (02/07/25)
    - Save Job - Related Jobs - Block Source
  • Prior Authorization Representative I

    University of Utah Health (Salt Lake City, UT)
    …verification, obtaining benefit information, calculating patient estimates, and obtaining prior authorization before services are rendered. This position ... paper trail. + May work to resolve claims denials related to the prior authorization . **Knowledge / Skills / Abilities** + Basic knowledge of accounting, word… more
    University of Utah Health (04/30/25)
    - Save Job - Related Jobs - Block Source
  • Prior Authorization Specialist

    Aston Carter (Salem, OR)
    Prior Authorization Specialist M-F Day Shift! Bi-Lingual in Spanish or Russian offers additional pay! MUST HAVE + Skills as a patient coordinator. + Two years of ... prior authorization or medical billing experience preferred. + Experience in detail-oriented positions. + Basic computer skills and EMR data entry experience. +… more
    Aston Carter (04/29/25)
    - Save Job - Related Jobs - Block Source
  • Prior Authorization Specialist

    Kelsey-Seybold Clinic (Pearland, TX)
    **Responsibilities** Under the supervision of the Business Services Supervisor, the Prior Authorization Specialist (PAS) is responsible for processing incoming ... requests by contacting the Health plans verbally or electronically to obtain prior authorization for services provided and directed by a Kelsey provider. The PAS… more
    Kelsey-Seybold Clinic (04/18/25)
    - Save Job - Related Jobs - Block Source
  • Prior Authorization Specialist

    US Tech Solutions (RI)
    **Job Title: Prior Authorization Specialist** **Location: Fully remote** **Duration: 12 months contract** **Job Description:** + Prior Authorization ... and courteous phone assistance to all callers through the criteria based prior authorization process. + Maintains complete, timely and accurate documentation… more
    US Tech Solutions (02/06/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Review Nurse - Prior

    Centene Corporation (Sacramento, CA)
    …shift Pacific Standard Hours with rotating weekends.** **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service ... teams, to assess medical necessity of care of member + Escalates prior authorization requests to Medical Directors as appropriate to determine appropriateness of… more
    Centene Corporation (04/20/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Specialist (Home-Based)…

    Sanford Health (SD)
    …relating to the implementation, ongoing evaluation, and improvements to UM and/or prior authorization processes with applicable. Completes activities relating to ... regulations and internal policies that effect resource utilization and potentially, prior authorization . Assists the department in monitoring the utilization… more
    Sanford Health (04/30/25)
    - Save Job - Related Jobs - Block Source
  • Prior Authorization Coordinator

    UCLA Health (Los Angeles, CA)
    …routine, pre-service, and retro authorization requests, as well as process prior authorization requests with accuracy and timeliness. This will involve the ... use of various business applications to perform analysis, obtain information, and enter prior authorization data necessary for claims adjudication. You will use… more
    UCLA Health (04/22/25)
    - Save Job - Related Jobs - Block Source
  • Associate Director, Medical Prior

    GRAIL (Durham, NC)
    …please visit grail.com . The Associate Director will proficiently lead the Prior Authorization , Billing Data Entry, and Billing Operations teams, ensuring ... oversee daily activities of the billing staff, managing all aspects of prior authorization billing, pre-certification, and eligibility functions. The Associate… more
    GRAIL (04/17/25)
    - Save Job - Related Jobs - Block Source
  • Prior Authorization Specialist

    US Tech Solutions (May, OK)
    …and courteous phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of ... assigned by the leadership team. Work closely with providers to process prior authorization (PA) and drug benefit exception requests for multiple clients or… more
    US Tech Solutions (04/18/25)
    - Save Job - Related Jobs - Block Source
  • Licensed Practical Nurse - Prior

    US Tech Solutions (May, OK)
    …pharmacists, other clinical colleagues, healthcare professionals and members. + Follow all prior authorization procedures to guarantee an accurate process on ... each prior authorization . + Train and mentor representatives on the PA team. + Complete other PA assignments as delegated by the PA leadership team.… more
    US Tech Solutions (02/15/25)
    - Save Job - Related Jobs - Block Source
  • Prior Authorization - Ambulatory…

    Trinity Health (Muskegon, MI)
    …Type:** Full time **Shift:** Day Shift **Description:** **Job Posting Title:** ** Prior Authorization - Ambulatory Pharmacy Technician 40 Hours** **Pharmacy ... **Position Summary:** The Pharmacy Technician will primarily support a centralized prior authorization clinic in Muskegon, MI. Pharmacy technician support… more
    Trinity Health (04/18/25)
    - Save Job - Related Jobs - Block Source
  • Prior Authorization Licensed…

    US Tech Solutions (May, OK)
    …other clinical colleagues, healthcare professionals and members. + * Follow all prior authorization procedures to guarantee an accurate process on each ... prior authorization . + * Train and mentor representatives on the PA team. + * Complete other PA assignments as delegated by the PA leadership team.… more
    US Tech Solutions (04/18/25)
    - Save Job - Related Jobs - Block Source
  • Care Review Clinician, Prior

    Molina Healthcare (Columbus, OH)
    …benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina ... its members. + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests additional… more
    Molina Healthcare (04/05/25)
    - Save Job - Related Jobs - Block Source
  • Care Review Clinician, Prior

    Molina Healthcare (Las Cruces, NM)
    …benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina ... its members. + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests additional… more
    Molina Healthcare (04/30/25)
    - Save Job - Related Jobs - Block Source