Healthcare Utilization & Authorization Specialist
Santa Barbara Cottage Hospital
Allegheny Health Network is seeking a Utilization Review Support position to manage insurance verification, authorizations, payer communications, and follow-up. This role supports utilization review nurses to ensure proper documentation and payment authorization for transfers and admissions. Responsibilities include documenting payer communications, adhering to timelines, and identifying trends to reduce denials. Strong communication, attention to detail, and HIPAA compliance are essential. #J-18808-Ljbffr Santa Barbara Cottage Hospital
$80 per hour
...OpportunityWe are sharing a specialised part-time consulting opportunity for United States-based healthcare professionals experienced in prior authorization, utilization management, clinical review, medical necessity criteria, payer authorization workflows, documentation...SuggestedHourly payPart timeFor contractorsWork at officeRemote workFlexible hours$20 - $30 per hour
A behavioral healthcare organization is seeking a Utilization Review Specialist to conduct clinical auditing and negotiate authorizations. The ideal candidate has a Bachelor's degree in Social Work or Nursing and 1-2 years of healthcare experience. Responsibilities include...Suggested- ...nationwide Position Summary The PAHub & Prior Authorization Specialist serves as a trusted consultant to... ...& Optimization Assess customer utilization of PAHub and identify opportunities for... ...5+ years of experience in healthcare operations, prior authorization, utilization...SuggestedLocal areaRemote work
$50k
...Employer Industry: Behavioral Healthcare Management Why consider this job opportunity Starting pay up to $50... ...What to Expect (Job Responsibilities) Complete pre-authorizations, concurrent reviews, and internal utilization review assessments Consult with the...SuggestedRemote work- Centene Corp. in New York is seeking an Authorization Support Specialist to assist the prior authorization request process and document information... ...determinations. This role helps ensure accuracy in the utilization management workflow and supports clinicians in...SuggestedRemote job
$39.4 - $53 per hour
...healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should... ...Time and every other weekend We are seeking Virtual Utilization Review Specialists to join our team. Essential job function include:...Temporary workWork at officeLocal areaRemote workMonday to FridayWeekend work- ...growing healthtech company transforming how healthcare organizations deliver care through AI-... ...improve financial performance. Prior authorizations are a critical component of that... ...We are seeking a Prior Authorization Specialist (Contract) to support high-volume authorizations...Contract workRemote work
- A healthcare services provider is seeking a Prior Authorization Specialist I to ensure the efficient triaging of prior authorizations. This role involves answering calls, contacting providers for necessary information, and documenting patient details. Ideal candidates...Remote workShift work
$76k - $199.6k
...maintain customer engagement by successfully utilizing existing and ever-changing digital... ...and/or Account Management Relevant Healthcare/Scientific roles (e.g., RN, Pharmacist,... ...and/or eligibility. Candidates must be authorized to be employed in the U.S. by any employer...Permanent employmentFull timeH1bLocal areaRemote workVisa sponsorshipWork visaRelocation package$86.7k - $173.3k
...Sr Regional Oncology Specialist Abbott is a global healthcare leader that helps people live more fully at... ...implement a plan to maximize the utilization of Abbott's Cancer Diagnostics' products... ...or without accommodation. ~ Authorization to work in the United States...Night shift$15 per hour
...data collaboration platform trusted for healthcare. Guided by our mission to make the... ...right to privacy by ensuring that only authorized individuals have access to the patient’... ...Basic computer proficiency. Comfortable utilizing phones, fax machine, printers, and other...Hourly payFull timeWork experience placementWork at officeMonday to Friday- ...data collaboration platform trusted for healthcare. Guided by our mission to make the... ...right to privacy by ensuring that only authorized individuals have access to the patient’... ...Basic computer proficiency. Comfortable utilizing phones, fax machine, printers, and other...Full timeWork experience placementWork at office
- ...companies to support treatment plans, authorization reviews, denial prevention, and discharge... ...support concurrent and retrospective utilization reviews Identify quality concerns,... ...or Case Management experience within a healthcare system or insurance organization required...
$18.92 - $23.46 per hour
...“Best Place to Work Modern Healthcare” - Join a team where people... ...Summary: The Payment Posting Specialist will work in a team-based environment... ...knowledge and skill in utilizing the MS Office suite of... ...hires only individuals who are authorized to work in the United States...Full timeTemporary workLocal areaImmediate startFlexible hours- JOB SUMMARY The basic function of the Authorization Specialist is to verify benefits/eligibility and obtain authorizations when necessary for... .... Reviews clinical documents with Nurse Reviewers and/or Utilization Managers at various insurance companies and third-party administrators...Temporary workWork at officeMonday to Friday
- ...operational work that keeps healthcare organizations running — the... ...and covered, securing authorizations, moving claims through to payment... ...Prior Authorizations & Utilization Support: initiating, submitting... ...Manager Revenue Cycle Specialist / RCM Analyst Medical Billing...Work at office
$20k
...referred by BCI providers to non-Bassett specialists, clinics and treatment centers. The... ...and chart documentation Obtains prior authorization for treatment/ therapy plans, and medications... ...travel required Total Rewards Bassett Healthcare Network’s commitment to our employees...Full timeLocal areaRelocation packageMonday to Friday- ...About Amperos Amperos is healthcare's first AI-native denial management and revenue recovery... ...for a Senior Accounts Receivable Specialist to join our client onboarding team — a... ...resolution across multiple categories: authorization, medical necessity, timely filing, COB,...Permanent employmentFull timeWork at officeImmediate startFlexible hours
- ...Associate Vice President, Space Planning & Utilization About the Company Acclaimed clinical research & medical care center Industry... ...Databases Specialties medicine education healthcare science and biomedical research Business Classifications...
$120k - $125k
...here. Medtronic is a global leader in healthcare technology with a Mission to alleviate... ...outcomes. Join Medtronic as an EP Mapping Specialist and be at the forefront of transforming... ...may be specific to each role.U.S. Work Authorization & Sponsorship At Medtronic, we are...Full timeWork experience placementH1bWork at officeLocal areaImmediate startRemote workWorldwideFlexible hoursNight shift$135k - $140k
...here. Medtronic is a global leader in healthcare technology with a Mission to alleviate... ...infectious disease and radiation Clinical Specialists are required to be within their... ...to confirm the identity and employment authorization of all newly hired employees. For further...Full timeWork experience placementH1bWork at officeLocal areaImmediate startRemote workWorldwideFlexible hoursNight shift$120k - $125k
...here. Medtronic is a global leader in healthcare technology with a Mission to alleviate... ...outcomes. Join Medtronic as an EP Mapping Specialist and be at the forefront of transforming... ...may be specific to each role.U.S. Work Authorization & Sponsorship At Medtronic, we are...Full timeWork experience placementH1bWork at officeLocal areaImmediate startRemote workWorldwideFlexible hoursNight shift$60 per hour
...in the field. The Per Diem Diagnostic Specialist performs radiologic procedures, assists... ...equipment and organization of x-ray films. Utilizes PACS system to process films,... ...innovation as we work together to transform healthcare. We encourage all team members to actively...Hourly payDaily paidTraineeshipLocal area- ...Humana Healthy Horizons in Kentucky seeks a Utilization Management Behavioral Health Professional 2 to support coordination, documentation, and communication of medical services and benefit determinations. The role requires interpreting criteria and policies with independent...
- A healthcare provider is seeking a Billing & Revenue Cycle Specialist based in Georgia for part-time remote work. This role involves ensuring accurate billing, managing service authorizations, and conducting daily eligibility checks. The successful candidate will need to...Part timeRemote work
$10k
...Program Evaluation Specialist ONLY PERMANENT EMPLOYEES IN THE TITLE AND THOSE THAT ARE... ...develop presentations and materials by utilizing entry and exit interviews, surveys and... ...population health strategist and policy authority for NYC, with a rich history of public...Permanent employmentFull timeWork at officeWork from home2 days per week- ...About the Role We're hiring an experienced Prior Authorization Specialist to help build the future of authorization automation for home... ...post-acute care. Build the future. Join an early-stage healthcare AI company where your knowledge directly shapes the product...
- ...FHE Health is seeking an experienced UR Specialist to manage clinical authorizations with insurers, ensuring timely communication and adherence to payer guidelines. You will support patient access by securing initial and continued authorizations and collaborating with...Remote work
$50k
...accuracy, accountability, and clinical excellence to healthcare. As such, we are a leading authority in payment integrity solutions including DRG... ...Cost Outlier and Readmission reviews. The Appeals Specialist I is responsible for performing triage, review, analysis...Contract workWork experience placementRemote work- ...Health provides the highest quality healthcare services to residents of Bronx, Brooklyn... ...includes over 27,000 primary care providers, specialists and participating clinics. For more... ...CMA worker is unavailable. Utilize the personal lived experience with mental...Work at officeLocal areaTrial period
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