Prior Authorization Specialist: Claims & Reimbursement Expert
JobRx, Inc.
Polaris Pharmacy Services is seeking a Prior Authorization Specialist to manage rejected pharmacy claims, optimize payer reimbursement, and ensure timely billing. The role requires attention to detail, strong data entry, and proficiency with Word, Excel, and Outlook. You will work in a fast-paced environment, collaborate with healthcare providers, and support training and reporting obligations while adhering to HIPAA and company policies. #J-18808-Ljbffr JobRx, Inc.
- ...Prior Authorization SpecialistSignio Specialty Pharmacy - Rockaway... ...seamless, compassionate, and expert support.Founded in 2015... ...Prior Authorization Specialist is responsible for... ...portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to...ReimbursementClaimsHourly payFull timePart timeShift workWeekend work
- Polaris Pharmacy Services seeks an experienced Prior Authorization Specialist to manage rejected pharmacy claims, ensuring maximum payer reimbursement and timely billing. You will interact with providers and plans, resolve issues, and maintain compliance while delivering...ReimbursementClaims
- ...Revenue Cycle Specialist On-site position only! InfuCare Rx is a leading home infusion... ...multiple facets of the pharmacy/infusion reimbursement process as you interact with insurance... ...with a track record of filing claims, billing, appeals, reviews, customer service...ReimbursementClaimsWork experience placementWork at office
- ...preparing patients and equipment, and ensuring patient safety in a high-pressure cath lab. This position offers competitive pay, comprehensive benefits, licensure reimbursement, and 24/7 recruiter support through Fusion Medical Staffing. #J-18808-Ljbffr Fusion Medical StaffingReimbursement
$100k - $300k
...disabilities residing in Northern NJ. The IL Specialist will work both in DAWN’s physical... ...license, a clean driving record, legally be authorized to drive in the state of NJ and proof... ...at the end of each workday. Mileage reimbursement is provided for use of personal vehicles...ReimbursementFull timeWork at officeMonday to Friday$96k - $129k
Underwriting Specialist, Accident and Health Join us as an Underwriting Specialist to make... ....The role will work closely with Sales, Claims and Operations, Finance, Legal, Risk and... ...underwriting guidelines, directives, and delegated authority limits.Review portfolio analytics and...ClaimsFull timeWork at office- ...entry-level role. What does a Medical Billing and Coding Specialist do? A medical billing and coding specialist processes and codes healthcare claims to ensure accurate billing and insurance reimbursement, supporting the financial operations of healthcare facilities...ReimbursementClaims
$200k - $320k
...clients regarding the Anti-Kickback Statute, Stark Law, False Claims Act, fee-splitting restrictions, and corporate practice of medicine... .... Counsel clients on provider enrollment, credentialing, reimbursement, billing compliance, overpayments, audits, recoupments, and payor...ReimbursementClaims- ...Senior Therapeutic Specialist, Oncology Gilead's mission is to discover, develop and deliver therapies that will improve the lives of... ...implementing regulations, the Federal Anti-Kickback Statute, the False Claims Act, PhRMA, Corporate Code of Business Conduct and the Office...ClaimsWork at officeWorldwide
$60k - $80k
...have you on our team. Benefits: Simple IRA License reimbursement Bonus based on performance Competitive salary... ...customers with policy changes and inquiries. Process insurance claims and follow up with customers on claim status. Coordinate with...ReimbursementClaimsFull timePart timeFor contractorsWork at officeLocal areaFlexible hours- ...regulations. You will work in a field-based capacity, handling partial and total losses, documenting activity, and supporting catastrophe claims as needed. A Bachelor's degree and 5-7 years of auto claims appraisal experience are required, with ICAR or #J-18808-Ljbffr...Claims
$45k - $50k
...people find work. We currently have an opening for an Employment Specialist for our family of offices in Northern NJ. As an... .... Offered: Medical Benefits, 401K with matching, Mileage Reimbursement, Cell Phone Reimbursement, Free Gym Membership Job Type:...ReimbursementFull timeWork at officeLocal areaMonday to FridayFlexible hours- ...Delivery Specialist Paul Miller Land Rover - PARSIPPANY, NJ 07054 Overview Salary Range $18.00 Base+Commission/month Description... ...~ Company-Funded Life Insurance ~ Health & Wellness Reimbursement Program ~401K & Roth Investing (with Employer Match!) ~ FSA...ReimbursementTemporary work
- What You’ll Do: The Revenue Cycle Specialist—Full Cycle Management is responsible for the... ...requires attention to detail and flexibility. Claims Processing: Review all patient... ...denials. Manage claim denials related to authorization, medical record. Patient Billing & Collections...ClaimsWork at office
$50k - $55k
...Claims Associate, PD The Claims Associate, PD is responsible for managing Auto Property... ...and settle claims within individual authority limits and seek supervisor approval for... ...and wellness program and fitness reimbursements ~ Various Paid Family leave options including...ReimbursementClaimsWork at office$30 - $36 per hour
...industries in which we operate. As a Workplace Health & Safety Specialist (WHSS), you'll be at the forefront of transforming workplace... ...Line, Flexible Spending Accounts, Adoption and Surrogacy Reimbursement coverage), 401(k) matching, paid time off, and parental leave...ReimbursementHourly payFlexible hoursShift workNight shiftWeekend work$18 - $31 per hour
...d) executing revenue cycle claim scrubbing and missing slip completion... ...identity and coverage prior to services being rendered... ...patient safety and financial reimbursement. • Adhere to HIPAA... ...insurance verification, and prior authorization requirements. • Train other...ReimbursementClaimsWork at office- ...Patient Support Specialist Duration: 6 months contract, Full-Time Shifts 8:30am-5pm... ...providing program information, eligibility, reimbursement support, and general assurances and... ...Respond to inbound phone calls and claims (as well as outbound calls) to/from patients...ReimbursementClaimsFull timeContract workShift work
$100.4k - $197.9k
...health plan benefit changes, network changes, or other detailed claims analytics Use strategic thinking to shape the direction of... ...systems, or health care reform analysis 1 year of experience with reimbursement mechanisms or payment models 1 year of experience developing...ReimbursementClaimsWork at officeLocal areaVisa sponsorship$191k - $225k
...programming languages (e.g., R, SAS)· Experience working with registry/claims data, including assessing the suitability and quality of such... ...disability coverage, basic life insurance, wellness benefits, reimbursement for certain tuition expenses, sick time of 1 hour per 30 hours...ReimbursementClaimsFull timeTemporary workLocal areaFlexible hours- ...join our team. This is a hands-on leadership role for someone who understands the restoration industry, knows how to manage insurance claims, and can take a job from emergency response through completion while delivering an outstanding customer experience....ClaimsFor subcontractor
$75k - $142.5k
...Customer Service Specialist The Customer Service Specialist is responsible for supporting domestic top-tier domestic customers including... ...suspect you have received a fraudulent offer or communication claiming to be from AbbVie, please do not respond, open any attachments...ClaimsTemporary workWork at officeLocal areaImmediate startRemote workMonday to Friday$17 - $25 per hour
...policies and procedures by properly handling claims and returns, zoning the area, arranging... ...business to work in other areas. Be an Expert: Prepares food according to item... ...Leave Pay, adoption and surrogacy expense reimbursement, and more. Live Better U is a company paid...ReimbursementClaimsHourly payMinimum wageFull timeTemporary workPart timeImmediate startFlexible hours$54.7k - $80.1k
...center services (inbound and outbound) and claims processing operations. They are part of... ...program information, eligibility, reimbursement support, and general assurances and ease... ...Quality and Training as subject matter experts to improve processes, procedures, and training...ReimbursementClaimsWork at officeLocal areaImmediate startFlexible hoursShift work- A reputable claims adjusting firm in New Jersey is urgently seeking Licensed Claims Adjusters to meet the rising demand due to storm-related events across the country. This role allows you to help individuals and businesses recover from disasters while enjoying flexibility...ClaimsFlexible hours
$200k - $320k
...on complex regulatory, transactional, reimbursement, compliance, and enforcement matters. The... ...‑Kickback Statute, Stark Law, False Claims Act, fee‑splitting restrictions, and corporate... ...to perform background checks with your authorization. Jobot will consider qualified...ReimbursementClaimsLocal area$15.26 - $21.5 per hour
...sum of its parts. The Patient Support Specialist, under the direction of the Supervisor,... ...program information, eligibility, reimbursement support, and general assurances and ease... ...Responds to inbound phone calls and claims (as well as outbound calls) to/from patients...ReimbursementClaimsFull timeRemote work$54k - $68.4k
...requires an incumbent to analyze healthcare reimbursement contracts and load contract terms... ...Validate and test contract configurations for claims pricing accuracy. Maintain fee... ...proficiency. Must be an intermediate to expert user of Excel Possesses solid analytical...ReimbursementClaimsFull timeContract workWork experience placementWork at officeLocal areaVisa sponsorshipFlexible hours- Langan provides expert land development engineering and environmental consulting services... ...Job Summary Langan is seeking a Hazmat Specialist to join its collaborative team in... ...professional license bonuses; and educational reimbursement. Langan offers employee resource groups...ReimbursementHourly payFull timeTemporary workPart timeFor contractorsWork experience placementWork at officeLocal areaWorldwideFlexible hours
$141.2k - $278.3k
...operational data (e.g., product-level sales, claims data, rebate and chargeback data,... ...around revenue quality, pricing realization, reimbursement exposure, and operational performance.... ...may be available Preferred: Prior experience at a large or mid-size consulting...ReimbursementClaimsContract workLocal areaVisa sponsorship
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