- University of Utah (Salt Lake City, UT)
- Details **Open Date** 01/08/2026 **Requisition Number** PRN43980B **Job Title** Prior Authorization Representative I **Working Title** Prior Authorization Rep I ... 01/22/2026 **Job Summary** We are looking for an experienced Prior Authorization Representative to join our team. As the... Authorization Representative to join our team. As the ** Prior Authorization Representative I** , you will be responsible… more
- CVS Health (Phoenix, AZ)
- …it all with heart, each and every day. **Position Summary** - Processes prior authorization requests received by phone, fax, or electronically and utilizes various ... criteria, and medication guidelines to perform clinical research to support prior authorization reviews. - Proactively completes prior authorization approvals… more
- US Tech Solutions (May, OK)
- …role that conducts clinical reviews of medical data collected to perform prior authorization for commercial and specialty medications. + The clinical pharmacist will ... calls from physician or members regarding their pending, approved, or denied prior authorizations. **Responsibilities:** + Evaluate and review all prior … more
- Hartford HealthCare (Farmington, CT)
- …the system. *_Position Summary:_* Under the direction of the Manager, Prior Authorization Services, HHC Cancer Institute, performs all clerical duties required ... to obtain insurance prior authorizations for chemotherapy and other services in a...Responsibilities:_** **Key Areas of Responsibility** Monitors and reviews the prior authorization work queue daily to verify accuracy of… more
- University of Rochester (Rochester, NY)
- …internal equity considerations._ **Responsibilities:** 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, families, clinical and non-clinical staff, identifying… more
- University of Washington (Seattle, WA)
- …Pharmacy Department** has an outstanding opportunity for a **Pharmacy Technician 2 - Prior Authorization Center** . **WORK SCHEDULE** * Per Diem * Day Shifts ... * Perform specialized, technical pharmacy tasks related to the management of prior authorization for patients served by the UWMC ambulatory clinics * Act… more
- 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 works with ... clinic managers, and financial advocates to resolve issues that arise during the prior authorizations process. This position is not responsible for providing care to… more
- Cardinal Health (Dover, DE)
- …research and problem/dispute resolution. **_Job Summary_** The Senior Coordinator, Prior Authorization is responsible for obtaining, documenting, and tracking payer ... prescribed supply categories (eg, ostomy, urological, wound care). This role submits prior authorization requests through payer portals or via fax, and conducts… more
- US Tech Solutions (May, OK)
- …Description:** + Responsible for reviewing and completing criteria based on prior authorization as per policy and procedure. **Responsibilities:** + This individual ... skills. + Will be responsible for: Reviewing and completing criteria based on prior authorization as per policy and procedure. **Experience:** + Prior … more
- US Tech Solutions (Canton, MA)
- …processing and managing the daily caseload of pharmacy and medical prior authorization (PA) requests for coverage determinations and exceptions. The Clinical ... timeframes. The Clinical Pharmacist consults as required with Medical Directors on prior authorization that fails to meet drug prior authorization (PA)… more
- Mille Lacs Health System (Onamia, MN)
- …MN, USA | Hourly | 20.61-30.92 per hour | Full Time Summary The Prior Authorization Specialist works under the direction of the Health Information Manager. This role ... end of the bullet point. + Receive and monitor prior authorization requests in accordance with MLHS standards. *...document all interactions in the EMR. * + Record prior authorization details including approval dates, billing units, procedure… more
- University of Utah (Salt Lake City, UT)
- …PRN43444B **Job Title** PS Coordinator, Scheduling **Working Title** Coordinator, Prior Authorization **Career Progression Track** C **Track Level** **FLSA Code** ... Utah School of Medicine has an immediate opening for a Scheduling and Prior Authorization Coordinator. This position works with a team of professionals responsible… more
- SUNY Upstate Medical University (Syracuse, NY)
- …medical necessity of medication use based on established criteria. Obtain prior authorization from intermediaries and payers, including managed care companies, ... activities that maximize revenue capture for high-cost medications. Conduct prospective prior authorization services to expedite clinic workflow and enhance patient… more
- US Tech Solutions (RI)
- **Job Title: Prior Authorization Specialist** **Location: Fully remote** **Duration: 12 months contract** **Job Description:** + Prior Authorization Specialist ... phone assistance to all callers through the criteria based prior authorization process. + Maintains complete, timely and accurate...but not limited to: outbound calls, reviewing and processing Prior Auth's received via fax and ePA, monitoring and… more
- University of Rochester (Rochester, NY)
- …data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and ... follow up. Adheres to approved protocols for working referrals and prior authorizations. **ESSENTIAL FUNCTIONS** + Responsible for managing department referrals.… more
- Polaris Pharmacy Services, LLC (Covina, CA)
- …need it most, we invite you to grow with us. JOB SUMMARY: The Prior Authorization Supervisor is responsible for managing and identifying a portfolio of rejected ... billing to eliminate financial risks to Polaris and their customers. The Prior Authorization Supervisor must be responsive and courteous when addressing our… more
- US Tech Solutions (May, OK)
- …role that conducts clinical reviews of medical data collected to perform prior authorization for specialty medications. The clinical pharmacist will apply clinical ... from physicians or members regarding their pending, approved, or denied prior authorizations. **Responsibilities:** + Ensure accuracy of case setup and clinical… more
- Actalent (Wharton, NJ)
- Job Title: Prior Authorization Specialist Job Description We are seeking a dedicated Medical Office Specialist to manage patient prior authorizations and ensure ... and maintaining accurate patient records. Responsibilities + Handle a high volume of prior authorizations for patients. + Utilize ModMed as the EMR for patient… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- Position Type Full Time Category Pharmaceutical Description PRIOR AUTHORIZATION SPECIALIST (REMOTE) WHO WE ARE At Polaris Pharmacy Services, we're more than a ... who need it most, we invite you to grow with us. OVERVIEW The Prior Authorization Specialist is responsible for managing and identifying a portfolio of rejected… more
- Avera (Pierre, SD)
- …Work where you matter.** **A Brief Overview** Responsible for obtaining prior authorization from insurers for medical tests, procedures, surgeries and specialty ... by the provider. Has understanding of tests, procedures and preparation required prior to testing. Sees that all necessary paperwork and documentation is complete… more
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