• Pre - Authorization

    CaroMont Health (Gastonia, NC)
    Job Summary: The Pre - Authorization Specialist is a member of the Utilization Review Department who is responsible for verifying eligibility, obtaining ... necessary authorizations for care, via phone, fax, or payer websites. The Pre - Authorization Specialist provides detailed and timely communication to both… more
    CaroMont Health (06/04/25)
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  • Pre -Service Authorization

    Trinity Health (South Bend, IN)
    …Full time **Shift:** Day Shift **Description:** **JOB SUMMARY** Obtains accurate authorization and billing information to effectively authorize/ pre -certify all ... payer authorizations, referrals) and will contact the physician/office and Case Management/ Utilization Review colleagues as necessary. Ensures all authorization more
    Trinity Health (05/23/25)
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  • Pre -Arrival Authorization

    UNC Health Care (Goldsboro, NC)
    **Description** Summary: The Pre - Arrival Authorization Specialist I will serve patients/customers and physician offices by obtaining authorizations from ... and retro authorizations. 6. Escalate matters/scheduled accounts that require attention to Pre -Arrival Team Lead/Manager. 7. Notify Utilization Review & Case… more
    UNC Health Care (04/01/25)
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  • Financial Clearance Authorization

    Catholic Health Services (Melville, NY)
    …was named Long Island's Top Workplace! Job Details The Financial Clearance Authorization Specialist is a highly skilled and productive individual responsible ... Clearance department of the Catholic Health (CH). The Financial Clearance Authorization Specialist will update patient insurance coverage, send notification… more
    Catholic Health Services (05/07/25)
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  • Full-time Utilization Review…

    St Joseph's Addiction Treatment & Recovery Centers (Saranac Lake, NY)
    …Centers Location: Inpatient Facility - Saranac Lake, NY Position: Full-time Utilization Review Specialist Shift/schedule: Monday-Friday, 8:00am-4:30pm Pay Range: ... and insurance companies to support the admission process and ensure continued authorization for treatment across multiple program types. The position requires a… more
    St Joseph's Addiction Treatment & Recovery Centers (05/29/25)
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  • Cell Therapy Clinical Authorization

    Dana-Farber Cancer Institute (Brookline, MA)
    The Cell Therapy Clinical Authorization Specialist is responsible for the comprehensive coordination and management of all prior authorization activities ... + 1 year clinical and/or related experience required. + Case Management, Utilization Review, Oncology, Cellular Therapy and/or Prior Authorization experience is… more
    Dana-Farber Cancer Institute (05/30/25)
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  • Medical Authorization Specialist

    Methodist Health System (Dallas, TX)
    …nurses, insurance utilization management staff, and patients to initiate pre - authorization and resolve issues that arise during the prior authorizations ... (United States of America) **Job Description :** Your Job: The Medical Authorization Specialist professional responsible for verification of medical coverage,… more
    Methodist Health System (05/25/25)
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  • Registered Nurse (RN) | Utilization

    Avera (Sioux Falls, SD)
    …Appeals Specialist to ensure tracking and trending of all Utilization Review related denials/appeals are appropriately documented. + Assists with the collection ... collaborates with clinicians and financial team members including the Pre -anesthesia Department, Surgery Scheduling, Clinical Departments, physicians, payers, Patient… more
    Avera (06/02/25)
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  • Preauthorization Specialist

    Access Dubuque (Dubuque, IA)
    …-certification process with physicians, PHO sites or insurance companies and obtains pre -cert/ authorization numbers and adds them to the electronic health record ... Preauthorization Specialist **UnityPoint Health Finley Hospital** 1 Positions ID:...in all appropriate computer systems * Notify and inform Utilization Review staff of authorization information to… more
    Access Dubuque (05/15/25)
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  • Insurance Specialist Main Campus

    Trinity Health (Syracuse, NY)
    …the clinical utilization reviews with the facilities Per Diem- Insurance Specialist to assist with authorizations for Substance abuse and Mental Health Service ... **Employment Type:** Full time **Shift:** Day Shift **Description:** **Insurance Specialist - St. Josephs Health Syracuse NY** **Position Summary:** The Insurance … more
    Trinity Health (06/03/25)
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  • Materials Management Specialist

    Entergy (Beaumont, TX)
    **Job Title:** Materials Management Specialist **Work Place Flexibility:** Onsite **Legal Entity:** Entergy Texas, Inc.-GTX **Please note:** Authorization to ... Command implement in Transmission. The primary difference in the material management specialist roles is the additional level of expertise in the operating… more
    Entergy (05/30/25)
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  • Procurement Specialist

    Entergy (Russellville, AR)
    **Job Title:** Procurement Specialist **Work Place Flexibility:** Hybrid **Legal Entity:** Entergy Services, LLC **Please note:** Authorization to work in the ... for this posting. This position may be filled as a Site Procurement Specialist I, II, III, or Senior, depending on qualifications.** **JOB SUMMARY/PURPOSE:** The… more
    Entergy (06/04/25)
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  • Ops-UM Training Specialist

    Integra Partners (Troy, MI)
    …experience with Utilization Management within the healthcare industry, including pre - authorization and utilization reviews, along with medical claims ... our Operations Training & Development team as an Operations UM Training Specialist , specializing in Utilization Management (UM) processes. The ideal candidate… more
    Integra Partners (06/03/25)
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  • Healthcare Specialist

    Actalent (Redlands, CA)
    …progression of goals, utilizing complex/routine criteria. Essential Skills + Proficiency in utilization review and prior authorization . + Experience in care ... Job Title: Healthcare SpecialistJob Description Join our Utilization Management team as an LVN Case Manager,...last names, with all new referrals added after clinical authorization . Case volume varies daily, ranging from 30 to… more
    Actalent (05/31/25)
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  • Patient Access Specialist - Specialty…

    Sanford Health (Fargo, ND)
    …pharmacy team staff and clinic staff. **Job Summary** The Patient Access Specialist reviews and validates insurance eligibility, prior authorization and/or ... of medication, procedures, etc.; determines if insurance meets prior authorization criteria. Collects necessary documentation and communicates with third party… more
    Sanford Health (05/20/25)
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  • Senior Category Management Specialist

    Entergy (The Woodlands, TX)
    **Job Title:** Senior Category Management Specialist **Work Place Flexibility:** Hybrid **Legal Entity:** Entergy Services, LLC **Please note:** Authorization to ... this posting.** **Job Summary/Purpose** The Senior Staff Category Management Specialist utilizes extensive supply chain, category management, strategic sourcing, and… more
    Entergy (05/13/25)
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  • IT Specialist (Network) (Title 32)

    Air National Guard Units (Fort Smith, AR)
    …TITLE 32 EXCEPTED SERVICE POSITION. This National Guard position is for a IT SPECIALIST (NETWORK) (Title 32), Position Description Number D2181P01 and is part of the ... and software and develops base wide network operating procedures. Analyzes LAN utilization statistics through data collection and performance measures to ensure the… more
    Air National Guard Units (05/21/25)
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  • Patient Access Specialist 1

    Trinity Health (Howell, MI)
    …as appropriate. Under limited supervision; determines need for and obtains authorization for treatment /procedures and assignment of benefits required. Provides ... financial assistance. Secures and documents payment arrangements. Obtains medical authorization or referral forms, if appropriate. Audit authorizations for accuracy… more
    Trinity Health (05/07/25)
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  • PCP/Endo Business Specialist - Cleveland

    Boehringer Ingelheim (Chattanooga, TN)
    **Description** The PCP/Endo Business Specialist is responsible for developing and implementing a plan for maximizing net sales of BIPI and co-promoted diabetes ... and with BIPI guidelines, policies, and directives. The PCP/Endo Business Specialist will conduct their business with key targeted healthcare providers and… more
    Boehringer Ingelheim (05/29/25)
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  • PCP/Endo Business Specialist

    Boehringer Ingelheim (Springfield, IL)
    …includes Springfield, Quincy, Alton IL, and Edwardsville IL** The PCP/Endo Business Specialist is responsible for developing and implementing a plan for maximizing ... and with BIPI guidelines, policies, and directives. The PCP/Endo Business Specialist will conduct their business with key targeted healthcare providers and… more
    Boehringer Ingelheim (05/21/25)
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