Medicare Prior Authorization Specialist
Virtual Vocations Inc
To support Medicare coverage determination operations, the full-time Medicare Prior Authorization Specialist will manage incoming documentation, create case reviews using multiple software systems, and maintain accurate records while working remotely with rotating weekend shifts. Key responsibilities Review and route incoming fax documents to appropriate work queues Create and maintain Medicare prior authorization case reviews while ensuring documentation accuracy Meet government-mandated turnaround times and productivity standards Required qualifications High School Diploma or equivalent Minimum of 1 year of medical insurance and prior authorization experience Data entry experience of at least 1 year Ability to work in a fast-paced production environment Experience using multiple software applications simultaneously
- ...Management – Stone Oak in San Antonio, Texas is seeking a detail-oriented Medication Prior Authorization Specialist to manage prior authorizations across commercial insurance, Medicare, Medicaid, workers' compensation, and personal injury cases. This full-time, onsite role...SuggestedFull time
- ...Actalent is seeking a Remote Pharmacy Technician to support Medicare and Medicaid patients by processing and reviewing prior authorizations in a fully remote environment. You will handle intake, apply criteria, and determine whether medications should be approved, denied...SuggestedRemote work
- ...Actalent is seeking a Remote Pharmacy Technician to support Medicare and Medicaid patients by processing prior authorizations in a fully remote role. You will intake requests, perform technical reviews, and determine coverage based on established criteria, SOPs, and medical...SuggestedContract workRemote work
$21.17 per hour
...is seeking a dedicated Patient Visit Specialist to support visit closure activities, ensuring... ...payor requirements, and securing prior authorizations, certifications, and referrals as... ...580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care)...SuggestedTemporary workWork at officeLocal areaImmediate startWeekday work$20 per hour
...Role Snapshot The Intake Specialist manages inbound and outbound communications for Health... ...routing of cases. This role supports prior authorizations, claims processing including writing... ...customer support for beneficiaries of the Medicare program and manage benefits for...SuggestedHourly payFor contractorsWork at officeLocal areaImmediate startRemote work2 days per week- All Seniors Foundation in Los Angeles, CA, is seeking an Insurance Authorization Specialist to obtain prior authorizations from Medi-Cal, Medicare Advantage plans, and commercial payers so seniors receive needed care without billing surprises. You will work upstream of...Full time
$20 - $22 per hour
...Medicare/Medicaid Claims Specialist 3-5+ years of experience understanding Medicare/Medicaid requirements Pay Range: $20$22/hr Role Responsibilities... ...'s Local Coverage Determinations (LCDs), National Coverage Determinations (NCDs), and prior authorization Partners PersonnelLocal area- ...week) – Onsite Compensation: Competitive wage based on experience Benefits: Eligible for benefits Now Hiring – Prior Authorization Specialist: About the Position Cherry County Hospital is seeking a dedicated and detail-oriented Prior Authorization...Full timeTemporary workWork at officeImmediate startFlexible hours
$16.73 per hour
...pharmacy experience Patient access experience Insurance verification experience Benefits investigation experience Prior authorization experience Financial assistance program experience Healthcare call center experience Pharmacy industry experience...Full time- ...experienced healthcare professional with a sharp eye for detail and a strong background in prior authorizations? We are seeking a highly organized, detail-oriented Prior Authorization Specialist to join our national Utilization Management team. In this role, you will serve...Full timeLive inRemote workWork from homeMonday to Friday
$60k
...Prior Authorization Specialist – CPhT | Montvale, NJ HealthCare Support is seeking a Prior Authorization Specialist - CPhT to join a growing Pharmacy Benefit Management (PBM) organization in Montvale. This is a great opportunity for a Certified Pharmacy Technician...Full timeTemporary workWork at officeLocal areaImmediate startMonday to Friday$19 per hour
...Immediate need for a talented Intake Specialist. This is a 06+months contract opportunity... ...specific providers requiring education on prior approval or pre-certification process Screen inquiries to determine if authorization is required Verify member benefits and...Full timeContract workLocal areaImmediate start- ...America)Job Summary:When ProMedica patients prepare for orthopaedic surgeries and injections, the Pre-Certification Specialist performs prior authorization and certification for the services with payers. You will have a general understanding of coding for surgeries and...Full timeWork at officeFlexible hours
$19.41 - $28.14 per hour
Job Description: The Pre-Access Authorization Specialist I is responsible for accurately verifying and completing insurance eligibility, securing prior authorization and managing authorization related denials to ensure patient financial health. Essential Functions Confirms...Hourly payWork at officeRemote work- ...Description: Baptist Health is looking for a Revenue Cycle Specialist to join our team! This is a remote work position that requires... ...well as pre and post billing. Obtains pre-determinations, prior authorizations, and retro authorizations when required by payor. Responds...Remote work
- ...The Prior Authorization Specialist is responsible for obtaining and coordinating insurance authorizations and precertifications for medical services... .... Familiarity with commercial insurance plans, Medicare, Medicaid, HMOs, PPOs, and other managed-care plans preferred...Work at office
$20 per hour
...Training is 6 weeks, M-F CST. Two shift options: 11a-11p or 8a-4:30p CST, with pay at $20/hour. Responsibilities include inbound Prior Authorization support, documentation, and escalation to pharmacists. Additional duties may include outbound calls and processing Prior...Contract workRemote workShift work- ...Utilization Reviewer SpecialistThe Utilization Reviewer Specialist plays a vital role in ensuring patients have timely access to care by managing both front-end prior authorizations and in-house concurrent review authorizations. This position is part-time, 20-25 hours...Part timeWork at officeLocal areaFlexible hours
- ...University of Utah Health is seeking a detail-oriented Insurance Verification & Prior Authorization Specialist to secure outpatient services by verifying benefits, calculating patient estimates and obtaining prior authorizations. This role collaborates with physicians...Remote work
- ..., we invite you to join us at CRMC and be part of something bigger.A Day in the Life of a Medication Prior Auth SpecialistThe Medication Prior Authorization Specialist plays a crucial role in managing the approval process for patient medications, ensuring that all necessary...
$55k
...to come! As the Utilization Review Specialist, you will work in an office based setting... ...is responsible for all aspects of the authorization of treatment via insurance and managed... ...Responsibilities: Requesting and obtaining prior authorizations for treatment services...Extra incomeWork at office$22 - $26 per hour
...This role will be responsible for activities relating to the proper initiation, clinical review, submission, and follow up of prior authorizations. This role requires working knowledge of pharmacy benefits and prior authorization process. Shift: Monday-Friday 8:30am-5...Remote workMonday to FridayShift work- ...To support the financial clearance process, the part-time Per Diem Prior Authorization Specialist will screen prior authorization requests, coordinate specialized services, and ensure compliance with departmental guidelines while working remotely. Key responsibilities...Daily paidPart timeWork at officeRemote work
- ...GENERAL SUMMARY OF DUTIES: The Medication Access & Adherence Specialist plays a dual role in supporting timely medication access... ...health outcomes. This specialist is responsible for managing prior authorization (PA) processes while proactively engaging patients to...Work at officeRemote workWork from homeHome office
- ...Shreveport, LA Newly Created Position Full-Time, Day The Willis Knighton Department of Pharmacy is seeking a Pharmacy Prior Authorization Specialist to join our team. This individual will work directly with our Outpatient Infusion Units under the supervision of the Pharmacy...Full timeWork at officeShift work
- ...Representative for the Therapy Center in Sioux Center, IA. The role focuses on determining eligibility for payors and obtaining timely prior authorizations, while supporting scheduling and therapy center tasks. Key duties include communicating with physicians, patients and...Monday to Friday
$28.72 - $36.92 per hour
...opportunities are posted here as they become available.Authorization & Referrals Specialist III #Full Time #RemoteThe 61st Street Service Corporation... ...information, securing payer required referrals and authorization prior to the patient's visit, scheduled admission, or...Hourly payFull timeWork at officeLocal areaImmediate startRemote work$19.65 per hour
...necessary information to others as appropriate. Request any necessary documentation/information from outside providers to complete prior authorizations. Obtain prior authorization by calling patients insurance company, assisting patients with questions and offering assistance...Full timeTemporary workWork at officeFlexible hours- ...Otsuka’s evolved customer engagement model, a Neuroscience LTC Specialist will engage HCPs through a variety of in-person, virtual... ..., such as local market payor coverage, co-pay options, prior authorization requirements, formulary placement, and availability expectations...Work at officeLocal areaWorldwide
$29.32 - $36 per hour
...Schedule: Days (1st Shift)Work Authorization: Applicants must be... ...Appeals and Grievances (A&G) Specialist will receive, investigate, and... ...compliance with Centers for Medicare and Medicaid Services (CMS),... ...grievance workflows.Experience with prior authorization processes....Local areaWork visaShift workDay shift
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