Senior Pharmacy PA & Appeals Specialist (Remote)
ISHE
- Remote job
UnitedHealth Group seeks a Senior Pharmacy PA/Appeals Technician to support PA and appeals processes. You will handle inquiries from providers, members, and internal partners, processing PA requests and documenting actions to ensure regulatory compliance. The role emphasizes accuracy, timely processing, and escalation to pharmacists when needed, with telecommuting flexibility to states listed in the ad. #J-18808-Ljbffr ISHE
- UnitedHealth Group seeks a Senior Pharmacy PA/Appeals Technician to support prior authorization and appeals across formulary and non-formulary meds. You will review requests, verify information, and route questions to pharmacists while maintaining compliance and SLAs....Remote jobSenior
- Optum is seeking a Senior Pharmacy PA/Appeals Technician to support prior authorization and appeals for formulary and non-formulary medications. You will receive, research, document, and process PA requests across phone, fax, and electronic systems, ensuring accuracy and...Remote jobSenior
- UnitedHealth Group is seeking a Senior Pharmacy PA/Appeals Technician to support prior authorization and appeals processes. You will receive, research, document, and process requests through multiple channels, ensuring data accuracy and compliance. The role offers telecommuting...Remote jobSenior
- UnitedHealth Group is hiring a Senior Pharmacy PA/Appeals Technician for a remote, nationwide position. The role involves supporting prior authorization and appeals, reviewing requests, and maintaining thorough documentation across multiple systems. Required licensure...Remote jobSeniorWork at officeFlexible hours
$18 - $32 per hour
Realistic Job Preview Video Remote in Alabama, Arizona, Arkansas, Colorado, Delaware... ...by connecting people with the care, pharmacy benefits, data and resources they... ...Caring. Connecting. Growing together. Senior Pharmacy PA/Appeals Technician The essential functions of...Remote workSeniorHourly payMinimum wageFull timeTemporary workWork experience placementLocal areaFlexible hoursShift work$85k - $100k
...long-term care, home infusion, specialty pharmacies, senior living, and other group living... ...Finishers. Who we’re looking for: The Senior Specialist, Member Experience Team Lead serves as... ...Purchase Plan (ESPP) Location: Onsite/Remote/Hybrid – as directed by your manager....Remote workSeniorContract workTemporary workFlexible hours- ...UnitedHealthcare offers a remote-friendly physician assistant role across the United States, focusing on review and adjudication of appeals and grievances. You will collaborate with medical... ...benefit design. The position requires PA licensure, NCCPA certification, and 5+...Remote workWeekday work
- ...in-bound calls from providers, pharmacies, members, etc providing... ...process prior authorization (PA) and drug benefit exception requests... ...to Coverage Determinations and Appeals Learning Advocates and management... ...status and results (seniors, pharmacists, appeals, etc)....Remote work
- Judi Health in New York, NY seeks a subject-matter expert in prior authorization and appeals to oversee operations across multiple lines of business. This role manages a team of appeals pharmacists and staff, ensuring compliance and high quality of care. The position requires...SeniorFlexible hours
$107k - $127k
...Job Description Job Description Senior Managed Care Pharmacist – Formulary / Pharmacy and Therapeutics Strategy (PA Licensed) Role Type: Full-Time, Regular Employee... ...business hours) Work Arrangement: 100% Remote / Work from Home Location: Pennsylvania...Remote workSeniorPermanent employmentFull timeContract workWork from homeMonday to FridayShift work$104.5k - $114.4k
...forward. The Strategic Sourcing Specialist will support all aspects of application... ...Sourcing methodology. The Senior Strategic Sourcing Specialist will... ...internal considerations.Location:Remote -Charlotte, NC, Dallas, TX, Harrisburg, PA, Houston, TXIf this job description...Remote workSeniorFull timeFor contractorsWork at officeLocal area$225k - $300k
...certified Pediatric Nurse Practitioner (PNP) or PA or MD or DO OR General Pediatrician OR... ...pediatric care with both in-person and remote services, giving our team members... ...and procedures Facilitate referrals to specialists and medical facilities as necessary Collaborate...Remote workDaily paidFull timePart timeRelocation packageMonday to FridayFlexible hoursShift work$18.65 - $19.9 per hour
...site at Tower - Phoenixville Hospital in Phoenixville, PA**** The Senior Patient Access Specialist is responsible for performing admitting duties for... ...in Healthcare 2024 Monster Top Workplace for Remote Work 2024 Great Place to Work certified 2023-2024...Remote workSeniorWork at officeLocal area$31.25 - $33.65 per hour
...Appeals Specialist Remote GeneDx delivers personalized and actionable health insights to inform diagnosis, direct treatment, and improve drug discovery. The company is uniquely positioned to accelerate the use of genomic and large-scale clinical information to enable...Remote workWork at officeWork from homeHome office- ...Sr. Specialist Customer Account - Giant Eagle Foods you love. Brands you trust. And a career that empowers you to grow. At Nestl USA,... ...fast-paced and evolving marketplace. Position Overview: The Senior Customer Account Specialist supports customer and category...Remote jobSeniorWork experience placementImmediate start
$21.16 - $38.37 per hour
...A healthcare provider is seeking a Medicare Appeals & Grievances Specialist to handle member appeals and grievances. This remote position requires strong experience in managed care, particularly with Medicare regulations. Ideal candidates will have excellent attention...Remote workHourly payWork at office$45k - $55k
...Kids connects leading pediatric specialists with families to providebest-... ...optimal work-life balance. Senior Authorizations Specialist... ...authorization denials or delays for appeal or peer-to-peer review.... ...priorities and meet deadlines in a remote work environment. General...Remote workSeniorWork at office- ...Baptistfirst in Alabama is seeking a Denials Management Specialist to handle disputes, validate payment issues, and generate appeals for denied claims. This role involves resolving complex accounts and requires in-depth knowledge of billing rules and payer contracts....Remote work
- A leading healthcare consulting firm is seeking a Grievance & Appeals Coordinator I for a contract role. Responsibilities include managing member appeals, ensuring compliance with CMS guidelines, and maintaining a high productivity benchmark. Candidates need a high school...Remote workContract work
- ...To support a growing remote team, the full-time Appeals and Grievance Specialist will manage and resolve complaints, grievances, and appeals from members and providers while ensuring compliance with applicable requirements. Key responsibilities Manage and resolve complaints...Remote workFull time
- ...Reimbursement Specialist UPMC Corporate Pharmacy is hiring a Reimbursement Specialist to join our team! This role will work Monday through Friday... ...rejections and investigates problems, resubmitting and/or appealing claims where appropriate. Periodically monitors...Remote workContract workMonday to Friday
$67.81k - $89k
...Senior Specialist, Process Improvement Hi, we're Oscar. We're hiring a Senior Specialist, Process... .... Work Location: This is a remote position, open to candidates who reside... ...data analysis into synthesized, visually appealing insights and conclusions Provide analytical...Remote workSeniorFull timeTemporary workWork experience placementWork at officeShift work$20 - $36 per hour
...Senior Enrollment Eligibility Specialist This position is National Remote. You'll enjoy the flexibility to telecommute from anywhere... ...connecting people with the care, pharmacy benefits, data and resources... ...and make determinations on appeal reviews ~ Proficiency with...Remote workSeniorHourly payMinimum wageFull timeWork experience placementLive inWork at officeLocal areaMonday to FridayFlexible hoursShift workWeekend work- ...Prior Authorization Specialist About Our Company: At Infinx, we are... ...physician groups, hospitals, pharmacies, and dental groups. We are in... ...Summary Description: This remote Prior Authorization Specialist... ...prior authorization issues and appeals ~ Medical Assistant...Remote workWork at officeFlexible hours
- UT Southwestern Medical Center is seeking a Technical Denials Management Specialist II in the Revenue Cycle Department to review, research, and resolve claim denials and appeals for various insurers, while identifying payment trends to maximize collections. This WFH role...Remote jobWork at officeWork from home
$22 - $26 per hour
...Pharmacy Prior Authorization Specialist This role will be responsible for activities relating to the proper initiation, clinical review, submission,... ...established protocols. Knowledgeable to perform all PA functions. High School Diploma or GED or licensed/registered...Remote workTemporary workLocal areaMonday to FridayFlexible hours- ...Member Appeals Specialist Primary responsibilities would include triaging incoming appeals/grievances, categorizing them appropriately,... ...focused on handling standard member appeals for pre-service pharmacy coverage for non-Medicare products, the turnaround times for...Remote workTraineeship
$22 - $26 per hour
...Patient Accounts Billing Specialist At STRIDE Community Health Center... ...servicesincluding primary care, dental, pharmacy, behavioral health, health... ...0PM Location: Hybrid: 2 days remote, 3 days onsite at our Oneida... ...Submit third party payor appeals and reconsideration requests...Remote workHourly payLocal areaRelocationMonday to FridayFlexible hours$85k - $105k
...Specialist II, Neurosurgery Company: AESCULAP INC.... ...Sales Working Model: Remote Days of Work: Wednesday... ...areas include nutrition, pharmacy admixture and... ...headquartered in Bethlehem, Pa., and is part of the B.... ...operations. May consult with senior management....Remote workSeasonal workWork at officeRelocationShift work$140k - $170k
...engineering firm headquartered in Wayne, PA with full-service offices in New York,... ...which are positioned for growth. The Senior Systems Specialist - Technology will have a telecommunications... ...work in office and qualify for one day remote work Follow us @balaconsultingengineers...Remote workSeniorFull timeContract workWork at office
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