- The Oncology Institute of Hope and Innovation (Cerritos, CA)
- …with third-party insurance, clinical staff, and patients to effectively process prior authorization requests for Chemotherapy (IV and Oral), Hydration, ... IV injections. Compile clinical documentation for prior authorizations (ex: progress notes, labs, diagnoses codes, previously tried therapies, doctor visits). This… more
- HealthCare Partners (Garden City, NY)
- …care. Interested in joining our successful Garden City Team? We are currently seeking a Prior Authorization Nurse ! JOB SUMMARY: The purpose of the prior ... and ensure the requests meet national standard and contractual requirements. The prior authorization nurse will promote the quality and cost effectiveness… more
- Accede Solutions, Inc. (Mclean, VA)
- The Prior Authorization (PA) Pharmacist would facilitate efforts in the review of clinical documentation and the Preferred Drug list (PDL) to determine proper ... medicine Peer to Peer discussions with medical providers to discuss Prior Authorization reviews. Consultations/Interventions: work with staff in contacting… more
- Palo Verde Cancer Specialists (Glendale, AZ)
- …requirements) , and "leading practices Requirements Minimum 1 year charge posting, prior authorization and AR follow up experience Understanding of payer ... reviewing, and transmitting claims using billing EMR Reconcile missing encounters Prior Auth Portion: Review EMR chart messaging and review schedules daily… more
- Teton Valley Health (Driggs, ID)
- …families and other health care organizations assuring a seamless disposition. Assures prior authorization from insurance carriers for services rendered in ... outpatient therapies. Maintains up to date knowledge of TVHC strategic objectives and assists in coordination of operational planning and related quality improvement tools. Maintains skills for effectively deploying these tools to the organization. Creates and… more
- Optum (Hillsboro, OR)
- …National Pharmacy Technician Certification 1+ years of Retail Pharmacy Technician experience Prior Authorization experience Bilingual in Spanish and English Pay ... is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity… more
- Corcept Therapeutics (Redwood City, CA)
- …and communicate the patient's plan benefit coverage including the need for prior authorization , appeal, tier exception, and/or formulary exclusions Support the ... facilitation of prior authorization and appeal processes by gathering necessary clinical documentation and information, with guidance from senior team members as… more
- The Judge Group Inc. (Orange, CA)
- …of which must be as a Clinical Nurse Reviewer. 1 year of utilization management/ prior authorization review experience required. Again, if you would be interested ... Judge Group is currently seeking a Case Manager LVN ( Prior Auth) for a fantastic client of our in...requests for Medical Director review, gathers pertinent medical information prior to submission to the Medical Director, follows up… more
- United Digestive (Atlanta, GA)
- …High School Diploma or GED required; 3-5 years of insurance verification, prior authorization , and precertification experience in a medical setting, ... include but are not limited to: Utilizes Greenway and Authorization Worklist to verify and thoroughly document benefits for...visits and manages referrals/authorizations a minimum of 3 days prior to date of service. Works with self-pay patients,… more
- Intermountain Healthcare (Boise, ID)
- …accounts to determine insurance coordination of benefits, may include pre-certification/ prior authorization . Assists patients in completing necessary ... forms to meet regulatory and billing needs prior to receiving clinical care. Scans necessary paperwork and educates patient on financial assistance. Proactively… more
- CVS Health (Phoenix, AZ)
- …and courteous phone assistance to all callers through the criteria based prior authorization process. Certified Pharmacy Technicians (CPhT) are preferred and ... path from Level I, Level II, and Level III positions within the Prior Authorization (PA) team is a structured path that encourages advocates to widen their… more
- EVERSANA (Mason, OH)
- …Payers by providing reimbursement support for activities related to benefit coverage, prior authorization , claim denials, appeals, triage to third party support ... benefits, including information about coverage and out-of-pocket costs. Assist with prior authorization and medical necessity processes, benefit verification and… more
- A-Line Staffing Solutions (Dallas, TX)
- Job Description Now Hiring: Remote Prior Authorization Pharmacist We're seeking experienced Prior Authorization Pharmacists (not retail) for a fully ... Time) Pay Rate: $53.00 per hour Key Responsibilities: Review and process prior authorization requests based on policy and procedure Ensure compliance with PBM… more
- ASIAN PACIFIC HEALTH CARE VENTURE (Los Angeles, CA)
- …follow-up appointments with their primary care provider. h. Fill out medication prior authorization requests with as much demographic and pertinent information ... Unit RN staff. p. Ensure charts and pertinent test results are available prior to clinicians' or Triage Unit RN staff's direct/telephone interaction with patient. q.… more
- Children's National Hospital (Washington, DC)
- …parents of the need for completed insurance referral form or pre- authorization prior to scheduled/unscheduled appointments. Discuss co-payment, deposits, payment ... payment schedule or method of payment. Verify insurance information is complete prior to procedure and collect and verify pre- authorization /referral information:… more
- Local Infusion (Plainview, NY)
- …Required Prior Experience in Infusion is Preferred Insurance Prior Authorization Experience Medical Terminology Experience Overall Medical Insurance ... will be primarily based in Plainview. The ideal candidate will have prior experience reading medical charts and working on insurance pre-authorizations. The Infusion… more
- Western Reserve (Cuyahoga Falls, OH)
- …scheduling and rescheduling procedures. Verifies eligibility and obtains or verifies prior authorization was obtained for service(s). Verifies patient's ... demographics and accurately inputs the information into the registration and/or scheduling application(s), including documenting the account thoroughly in order to maximize reimbursement and minimize denials/penalties from the payor(s). Verifies and… more
- PRISM Vision Group (Linwood, NJ)
- …parties of the appointment time, referral criteria, insurance verification, and prior authorization requirements. Train other patient services representatives ... and (if applicable) insurance card(s) and validate patient identity and coverage prior to services being rendered to ensure patient safety and financial… more
- Akumin (Clearwater, FL)
- …responsibility. May be responsible for verifying insurance coverage and obtain prior authorization . Patient Assistance: May perform preliminary screening of ... patients prior to procedures, which may include medical history. May...May schedule patient appointments and obtain insurance verification and/or authorization . May prepare medical records for physicians, patients and… more
- IQVIA, Inc. (Northborough, MA)
- …correct eligibility information, perform benefit investigations, copay assistance and check prior authorization and/or appeal status. Care Managers may also ... Contact insurance companies for benefit investigation and coverage eligibility Provide prior authorizations and appeals support Assist patients with the enrollment… more
