- St. Luke's University Health Network (Allentown, PA)
- …communities we serve, regardless of a patient's ability to pay for health care. The Medication Prior Authorization Specialist is responsible for the ... Escalates complex prior authorization issues to Supervisor, Medication Prior Authorization for assistance/guidance. + Maintains working knowledge of… more
- St. Luke's University Health Network (Allentown, PA)
- …serve, regardless of a patient's ability to pay for health care. The Network Prior Authorization and Referral Specialist is responsible for the coordination ... Provides insurance company with clinical information necessary to secure prior - authorization or referral + Works in alignment... ordered is the same as what is being prior authorized + Validate medication ordered is… 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 ... Responsibilities + Initiate, process, and oversee the clinical review of prior authorization requests for medication and supply, ensuring compliance with… more
- Sharp HealthCare (San Diego, CA)
- …pharmacy insurance eligibility.Effectively utilize the EMR, as well as online authorization sites for medication programs, ie CoverMyMeds.Demonstrate and apply ... from patients, medical providers, insurance companies and pharmacies requesting prior authorizations.Collaborate with ancillary and operational departments to research… more
- Beth Israel Lahey Health (Burlington, MA)
- …staff, pharmacy staff, and third party payers for issues regarding prior authorization approvals, ambulatory infusion reimbursement and Patient Assistance ... making a difference in people's lives.** Job Summary: The Medication Access Specialist will fulfill all of...and reviews all data needed for pharmacy and medical prior authorization approvals. Provides formulary assistance for… more
- AdventHealth (Hinsdale, IL)
- …**The role** **you'll** **contribute:** The Pre-Access Infusion Benefits and Authorization Specialist , under general supervision, maintains performance standards ... other injection/infusion treatment orders and determines insurance benefits and authorization requirements. Reviews clinical data such as patient pathology reports,… 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 information ... orders and insurance claim submission. Experience with healthcare insurance prior authorization /coding and performing insurance carrier/managed care review… more
- DMC Primary Care (Derry, NH)
- …to process refill requests per protocol/guidelines + Calculate when refills are due prior to sending to provider for authorization + Authorize drug refill ... our patient's needs. We are seeking a personable, motivated, and professional Refill Specialist to join our multi-disciplinary healthcare team. This is a full time… more
- University of Rochester (Rochester, NY)
- …clinics. Duties will include collaboration with clinical staff to acquire prior authorization for relevant providers, benefit investigation, enrollment of ... be able to establish strong collaborative working relationships. **SPECIFIC RESPONSIBILITIES:** Prior Authorization Management 1. Highly knowledgeable of the… more
- University of Rochester (Rochester, NY)
- POSITION SUMMARY: Serves as the patient referral and prior authorization specialist , with oversight of data and compliance to enterprise standards and ... referral and prior authorization guidelines. Communicates regularly with patients,...required for testing and services ordered by referred to specialist includes, preparing and providing multiple, complex details to… more
- Carle (Urbana, IL)
- …status of renewals to patients and/or physician offices. + Participates in prior - authorization processes pertaining to medications. + Receives and enters to ... Certified Medical Assistant - CMA Medication Renewal Center + Department: Med Renewal Center...groups upon request. + Successfully completes PCC scheduling center specialist training/education and maintains adequate proficiency with call intake… more
- Swedish Health Services (Seattle, WA)
- **Description** The Prior Authorization Specialist facilitates processing of medication prior authorizations for clinic patients in accordance with ... In a related field. + 2 years Experience in an area such as prior authorizations, medical audits, appeals or delegation. + 1 year Epic software experience. **Why… more
- Health First (Rockledge, FL)
- …determinations for the clinical reviewer; which includes, all Formulary Exception, Prior Authorization and Administrative Authorization requests for ... transitions of care and disease management. *Primary Accountabilities * 1. Apply proper authorization requirements to all prior authorization requests. 2.… more
- Trinity Health (Fort Wayne, IN)
- …patients and providers as it pertains to the patient's pharmacy benefits. Determines if prior authorization is needed for the claim to be paid. Gathers ... requests. Collaborates with Clinical Staff to ensure appropriateness of the prior authorization documentation and ensures completeness of the prior… more
- AdventHealth (Durand, WI)
- …**length of authorization , total number of visits, and/or units of medication ** Obtains PCP referrals when applicable** Alerts physician offices to issues with ... **Consumer Access Specialist - AdventHealth Durand** **All the benefits and...customer service by contacting patients to inform them of authorization delays 48** **hours prior to their… 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 the system. ... care team. PRINCIPLE DUTIES AND RESPONSIBILITIES: For Ambulatory Clinical Pharmacy Specialist : . Provides comprehensive medication and disease state management… more
- MD Anderson Cancer Center (Houston, TX)
- …to comply with institutional standards, initiatives, and guidelines (ABN's, prior authorization requirements, reimbursement optimization, formulary management, ... to optimize the pharmacotherapeutic aspects of patient care. * Manages the medication therapy of individual patients (in collaboration with the healthcare team);… more
- Henry Ford Health System (West Bloomfield, MI)
- … is responsible for handling drug claim adjudication issues, prescription prior authorization , and pharmacy benefit inquiries from members/patients, physicians, ... expert in the resolution of pharmacy benefit coverage issues and coordinating prior authorization and exception processes. PRINCIPLE DUTIES AND RESPONSIBILITIES:… more
- Marshfield Clinic (Marshfield, WI)
- …Specific Responsibilities: + Interpret clinical guideline criteria to make clinical prior authorization and appeal determinations in accordance with medical ... the most exciting missions in the world!** **Job Title:** SHP Clinical Pharmacy Specialist - Temporary Position from Mid-May to Mid-August (Remote or Hybrid Option)… more
- HCA Healthcare (San Antonio, TX)
- … medication regimens and providing appropriate interventions. The Clinical Specialist shall also assist in mentoring pharmacy staff and precepting ... you have the career opportunities as a(an) Clinical Pharmacist Specialist BMT Onc you want with your current employer?...improvements identified + You will provide accurate and timely medication information to healthcare staff and patients + You… more