- Merck & Co. (North Wales, PA)
- …execution of observational or non-interventional research studies (including Post Authorization studies), in compliance with Good Pharmacoepidemiology Practice (GPP) ... studiesExecution, and close out of primary data collection, chart review , database, and molecular epidemiology studies in addition to...of twelve (12) months of service in current position prior to applying for open positions.If you have been… more
- Kepro (AL)
- …to being a vital partner for health solutions in the public sector. Acentra seeks a Prior Authorization Reviewer to join our growing team. Job Summary: The ... Prior Authorization Reviewer : + Reviews...AM to 4:00 PM Central. ** ** This is a Remote position within the state of Alabama, where the selected candidate… more
- Kepro (Harrisburg, PA)
- …in an acute or med-surgical environment + Minimum of one year UR and/or Prior Authorization or related experience + Medical record abstracting skills + Knowledge ... solutions in the public sector. Acentra seeks a Clinical Reviewer Immediate Advocacy ( Remote ) to join our...to join our growing team. Job Summary: The Clinical Reviewer utilizes clinical expertise for the review … more
- Kepro (AL)
- …member! Job Summary: In this PRN position, the physical therapist will perform prior authorization reviews for the Alabama Utilization Management contract. The ... public sector. Acentra is looking for a Physical Therapist Reviewer ( Remote ) join our growing team. Are...Physical Therapist will utilize clinical expertise for the review of medical records against appropriate criteria in conjunction… more
- Kepro (Charleston, WV)
- …in the State of West Virginia. + Minimum of 2 year of experience in Utilization Review (UR), Prior Authorization , or related fields. + Minimum of at least ... in West Virginia for an exciting opportunity. As an RN Utilization Management Reviewer , you will be actively involved in pre- authorization reviews to determine… more
- US Tech Solutions (Canton, MA)
- Remote position but will be required to go on...Coordinates the review process for services requiring prior authorization by . This includes matching the ... necessary for coverage determinations and prepares cases for Medical Director Review , including the procurement of Plan Benefit Documents and Medical Necessity… more
- University of Michigan (Ann Arbor, MI)
- …+ Ability to meet and exceed departmental quality, production, and prior authorization standards. + Ability to review and resolve denials pertaining to ... Prior Authorization Specialist Apply Now **Summary**...and employees. + Ability to effectively work in a remote environment and connect via multiple communication channels (phone,… more
- CVS Health (Austin, TX)
- …plan/employer-agreed criteria within the designated service level agreements. - Evaluate and review all prior authorization requests and render coverage ... Specialty and Non-Specialty Pharmacy programs administered within the Commercial Prior Authorization and Case Review ...employee discount at all CVS stores. This is a remote role open to candidates within the United States.… more
- CVS Health (Austin, TX)
- …plan/employer-agreed criteria within the designated service level agreements. - Evaluate and review all prior authorization requests and render coverage ... Specialty and Non-Specialty Pharmacy programs administered within the Commercial Prior Authorization and Case Review ...employee discount at all CVS stores. This is a remote role open to candidates within the United States.… more
- Valor Health (Emmett, ID)
- PRIOR AUTHORIZATION SPECIALIST WFH Flexible * Emmett, ID (http://maps.google.com/maps?q=OFF-SITE+Emmett+ID+USA) Apply Description Position Title: Prior ... Office Supervisor's Title: HIM/Business Office Manager IHA# Position Summary: The Prior Authorization Specialist is responsible for obtaining pre-certifications… more
- Fairview Health Services (St. Paul, MN)
- …computer systems, including Microsoft Office 365 **Preferred** **Experience** + Referrals and/or prior authorization experience + Epic experience + Knowledge of ... **Overview** This is a remote position under Revenue Cycle Management that is responsible for obtaining all medical necessity approvals for a patient's service… more
- TEKsystems (Dallas, TX)
- …experience in Medical field can only apply! Description: Position Purpose: Supports the prior authorization request to ensure all authorization requests are ... Supports authorization requests for services in accordance with the insurance prior authorization list Responsibilities: Supports and performs data entry to… more
- Corewell Health (Kentwood, MI)
- …or equivalent + 1 year of relevant experience in related field Preferred + Prior Authorization experience + Epic experience + Payor portal experience + Basic ... by way of obtaining accurate and timely authorizations. Crucial to obtaining an authorization is the ability to read and understand basic insurance information as… 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 ... data entry, data management, and reporting. **Experience:** + * Review criteria-based prior authorizations following policy and... prior authorization . + * Train and mentor… more
- Centene Corporation (Getzville, NY)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** Supports the prior authorization request to ensure all authorization requests ... requests for services in accordance with the insurance prior authorization list + Supports and performs...accordance with policies and guidelines + Contributes to the authorization review process by documenting necessary medical… more
- CVS Health (Baton Rouge, LA)
- …+ 5+ years of clinical experience + 1+ year(s) of utilization management, concurrent review and/or prior authorization experience + 5+ years of equipment ... care more personal, convenient and affordable. Position Summary Fully remote role in Louisiana.Requires Monday-Friday: 8:00am-5:00pm CST shift. Weekend/holiday… more
- Sutter Health (Salt Lake City, UT)
- …Candidates from Arizona, Arkansas, Idaho, Tennessee and Utah will be eligible. Remote position - Hours will be 8-5 Pacific Standard Time. Provides medical ... administration support to providers by obtaining referral or prior authorizations for patients to see specialty providers. Completes referrals and/or authorizations… more
- University of Michigan (Ann Arbor, MI)
- Customer Service Representative Senior/Intermediate - Authorization Apply Now **How to Apply** A cover letter is required for consideration for this position and ... **Summary** This position is primarily responsible for processing and obtaining prior authorizations for all Medicare, Medicaid and Third-Party payer equipment… more
- Molina Healthcare (CA)
- …financial responsibility for Molina Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed. + Processes ... **JOB TITLE: CARE REVIEW CLINICIAN INPATIENT REVIEW : REGISTERED...to work some weekends and holidays. This is a remote position and you may work from home. Please… more
- St. Luke's University Health Network (Allentown, PA)
- …patient class obtained prior to discharge, communicate back to PEC for re- authorization , as needed + Is a resource to the Coding department, SLPG practices, ... patient's ability to pay for health care. The Surgical Review Specialist prospectively reviews, validates, and audits procedure code...patient class is obtained for IP only Medicare cases prior to date of service + Ensure all IP… more
