- Cambia Health Solutions, Inc (Tacoma, WA)
- …all activities associated with requests for Provider Billing Disputes and Appeals . Includes analysis, preparation, evaluation of prior determinations, ... Appeals Specialist IRemote within WA, ID, OR, and...subscriber or provider contracts, company documents, government mandates, other appeals regulatory requirements and internal policies and procedures. Provides… more
- Jazz Pharmaceuticals (New York, NY)
- …to support patient access needs.Educate and ensure providers understand payer prior authorization requirements, appeals process, clinical criteria, and ... objectives and meet established MBO's and goals. Provider and account interface, prior authorization and coding education, as well as case management all will… more
- A-Line Staffing Solutions (Dallas, TX)
- … Appeals clinical pharmacists and management team as needed Prior Authorization Representative Requirements 2+ years experience working in customer service/call ... A-Line Staffing is now hiring Prior Authorization Representative. The Prior Authorization Representative would be working for a Fortune 500 company and has… more
- A-Line Staffing Solutions (Atlanta, GA)
- Job Title: Prior Authorization and Benefits Specialist Pay: $17.50 an hr | Bi-weekly Job Type: Remote Shift Options: Hours: Mon-Fri 7AM-8:30PM CST. Training hours: ... Mon-Fri 8AM-4:30PM CST for 4 weeks. Prior Authorization and Benefits Specialist Overview: The Commercial PA Representative I will work closely with providers to… more
- Accounting Now (Tampa, FL)
- …advanced-level work related to clinical and coding denial management and appeals follow-up. The individual is responsible for conducting a comprehensive review ... to compile appropriate documentation and medical records to submit appeals or corrected claims in a timely manner. This...corrected claims in a timely manner. This position applies prior knowledge of denials to assess and ensure services/items… more
- A-Line Staffing Solutions (Cleveland, OH)
- …Management, Registered Nurse, MCO, RN, Nurse, Managed Care, Medical Claims, Appeals , Mail Order Medications, Insurance Verification, Pharmacy, Prior ... Management, Registered Nurse, MCO, RN, Nurse, Managed Care, Medical Claims, Appeals , Mail Order Medications, Insurance Verification, Pharmacy, Prior … more
- Abbtech Professional Resources (Washington, DC)
- …of criminal litigation, including pretrial discovery, motions, hearings, trials, and appeals . * Reviews and analyzes documents, transcripts, files, and other ... through 8:00 PM, Eastern; the proposed schedule must receive prior approval. During their core hours shift, all staff...is needed, overtime shall only be performed with the prior approval of the COR and in accordance with… more
- A-Line Staffing Solutions (Pittsburgh, PA)
- …Staffing is looking for qualified Benefit Verification Representatives or Prior Authorization Representatives for our Pittsburgh location Benefit Verification ... The Benefit Verification Representative II will work closely with providers to process prior authorization (PA), and drug benefit exception requests on behalf of the… more
- Cambia Health Solutions, Inc (Boise, ID)
- …and obtaining appropriate documentation for pharmacy medical exception requests, prior authorization requests, reconsiderations, and appeals . Prepares ... reconsideration requests for Clinical Pharmacy Consultant review by obtaining and organizing appropriate documentation, including, but not limited to medical chart notes/reports and medication profiles. Communicates (orally and by written documentation)… more
- Compass Health Network (Raymore, MO)
- …interest you, if running a Medication Clinic and acting as a case manager appeals to you! Our Compass Health Network Nursing Staff use the Compass "Champion" ... maintain accurate logs on all medications received and dispensed Assist with Prior Authorizations Maintain injection list, ordering and delivery, verify orders are… more
- Compass Health Network (Sullivan, IL)
- …interest you, if running a Medication Clinic and acting as a case manager appeals to you! Our Compass Health Network Nursing Staff use the Compass "Champion" ... maintain accurate logs on all medications received and dispensed Assist with Prior Authorizations Maintain injection list, ordering and delivery, verify orders are… more
- Compass Health Network (Sullivan, MO)
- …interest you, if running a Medication Clinic and acting as a case manager appeals to you! Our Compass Health Network Nursing Staff use the Compass "Champion" ... maintain accurate logs on all medications received and dispensedAssist with Prior AuthorizationsMaintain injection list, ordering and delivery, verify orders are… more
- ConsultNet (Scottsdale, AZ)
- …in resolving tax-related disputes and participate in negotiations, settlements, and appeals , if required. Oversee Year End Payroll Processes with vendor Required ... Skills: Prior supervisory and management experience. Advanced knowledge of Microsoft Office applications. Ability to study, analyze and interpret complex information… more
- CVS Health (Tallahassee, FL)
- …make health care more personal, convenient and affordable. Position Summary- Cdr I Prior Auth & Appeals will be responsible for performing non-clinical ... activities and functions in accordance with policies and procedures, under the supervision of the Clinical Supervisor. Responsible for reviewing and maintaining compliance with ERISA, CMS, Medicaid, and client specific requirements. Works as part of the team… more
- TEKsystems (Woodland Hills, CA)
- …data entry, calls to providers offices, and claims research. Skills: Grievances, Appeals , Claims, Prior Authorizations Customer service, Data entry. Workplace: ... Hiring For Grievance and Appeals Coordinator TekSystems is currently hiring for Grievance and Appeals Coordinator for one of top healthcare company in CA.… more
- Elevance Health (Cincinnati, OH)
- …and Experiences:** + Prior experience working coverage determination or prior experience with appeals preferred. + Experience creating reports preferred. ... **Grievance/ Appeals Analyst Lead** **Must be located within 50...working in a local office once per quarter** The **Grievance/ Appeals Analyst Lead** is responsible for leading and coaching… more
- Elevance Health (Altamonte Springs, FL)
- …up is performed. + Collaborates with other departments to assist in obtaining prior authorizations/ appeals . + Document insurance company interactions and all ... **Build the Possibilities. Make an Extraordinary Impact.** The **Pharmacy** ** Prior ** **Authorization Representative** is responsible for the administration of … more
- Elevance Health (Denver, CO)
- …up is performed. + Collaborates with other departments to assist in obtaining prior authorizations/ appeals . + Document insurance company interactions and all ... PM The **Authorization Representative II** is responsible for the administration of prior authorizations requests for patients whose health plan requires drug … more
- CVS Health (Phoenix, AZ)
- …health care more personal, convenient and affordable. Position Summary The Senior Technician Prior Auth & Appeals will work a rotating call schedule throughout ... Services Representative I, II, and III with complex non-clinical or Prior Authorization questions or calls. Responsibilitiesinclude assisting supervisors with day to… more
- Commonwealth of Pennsylvania (PA)
- Appeals Referee Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4477399) Apply Appeals Referee Salary $74,191.00 - $112,666.00 Annually ... Industry, Unemployment Compensation Board of Review is seeking an Appeals Referee for our Harrisburg office. In this position,...answer the supplemental questions. All documents MUST be uploaded prior to the submission of your application. + Your… more
