Pharmacy Prior Authorization Specialist
CVS Health
CVS Health is seeking a Pharmacy Technician for Prior Authorization, handling requests by phone, fax, or electronically. You will use medication guidelines to support reviews and maintain accurate documentation. You must have a national certification and state license, with 1–5+ years of prior authorization processing experience. The role features full-time hours, remote work options, and a comprehensive benefits package. #J-18808-Ljbffr
- WellDyne is seeking a Prior Authorization Tech II to initiate clinical PA requests by phone or email, create and fax cases, and document all... ...via telephone with prescriber staff and work closely with pharmacies, providers, and members to resolve issues. In this role you...Suggested
- ...through intelligent data management, pharmacy optimization, and value-driven... .... Job Overview: The Intake Specialist is responsible for managing incoming... ...all required elements are obtained prior to benefits investigation and authorization Conduct welcome calls to...SuggestedWork at officeRemote work
$75 per hour
...General Catalyst , Peter Thiel , Adam D'Angelo , Larry Summers , and Jack Dorsey . Position: Pharmacy Prior Authorization & Specialty-Medication Access Specialist Type: Contract Compensation: $75/hour Location: Remote Role Responsibilities...SuggestedRemote jobContract workSummer work$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 review,...SuggestedHourly payPart timeFor contractorsWork at officeRemote workFlexible hours- ...Prism Vision Group is seeking a Revenue Cycle Specialist located at Spokane Eye Clinic, Spokane, WA. This role involves handling billing and collecting from assigned payors, ensuring compliance with regulations and customer service excellence. Candidates should possess...Suggested
- ...InfuCare Rx is seeking a Revenue Cycle Specialist to manage the pharmacy/infusion reimbursement process. You will file claims, appeal when needed, and interact with insurers and patients to secure payment. Ideal candidates have at least 2 years of infusion billing experience...
$21.38 - $44.4 per hour
...: $21.38-$44.40/hr (Dependent on Experience) The Revenue Cycle Specialist is responsible for billing and collecting from their assigned payor... ...School Diploma or General Education Degree (GED) with 3 years prior hands‑on experience in a fast‑paced medical billing environment...- ...About the Role We're hiring an experienced Prior Authorization Specialist to help build the future of authorization automation for home health and hospice. Prior authorization is one of the largest operational bottlenecks for agencies. Our platform automatically...
$101.18k - $120.46k
...Business Title(s): Senior Shared Services Specialist Employment Type: Full-Time FLSA Status:... ...and within broad limits and authority,partner with adjuster, auto/property owner... ...for this or any other position without prior authorization from Human Resources will...Full timeWork experience placementLocal area- ...Boston Medical Center is seeking a part-time Prior Authorization Specialist to work remotely. The role involves screening prior authorization requests and coordinating with various stakeholders for financial clearance in the healthcare system. Responsibilities include...Part timeRemote work
- ...with 10% travel nationwide Position Summary The PAHub & Prior Authorization Specialist serves as a trusted consultant to customers and internal... ...utilization management, PBM, health plan operations, specialty pharmacy, or healthcare technology. Hands-on experience with PAHub...Local areaRemote work
- ...operations and improve financial performance. Prior authorizations are a critical component of that... ...We are seeking a Prior Authorization Specialist (Contract) to support high-volume... ...commonly used in pain management Navigate pharmacy benefit portals and step-therapy...Contract work
- Job Description The Surgical Room Specialist I functions within the policies and procedures of UVMMC and Peri-Operative Services. This... ...with OR RNs, OR Technicians, Surgeons, Anesthesia Providers, Pharmacy, Operating Room Staff and Biomedical Engineering. They will help...
$19.5 per hour
Job Details Health Care Administrative Support Referrals Specialist I- Hybrid- Bilingual English/Spanish Bronx,NY Posted:8/17/202... ...reception calls and providing referral action steps. Seeks prior authorization from patient insurance carriers. Responds in a timely manner...Hourly payFull timeWork at officeWork from homeMonday to Friday- Overview Large Cardiology Practice located in Kew Gardens, Queens, is seeking a Prior Authorization Specialist that meets the following requirements: Benefits Competitive salary Health insurance Opportunity for advancement Paid time off Profit sharing Health benefits and...
- Judi Health is seeking a PA Systems Specialist to maintain and validate prior authorization criteria, decision trees, and templates within the PA system. You will translate clinical requirements into system logic, collaborate with pharmacists and cross-functional teams,...
$61.29k - $68.86k
...join our team as an Offshore Operational Specialist. In this role, the successful candidate... ...Responsibilities Financial Clearance, Authorization, Eligibility Verification & Patient... ...Financial Clearance activities, including prior authorization, eligibility verification...Work at officeRemote work- ...Services, PLLC are on the hunt for a meticulous and proactive Authorizations Specialist to keep our clinical services moving without interruption.... ...you secure matters Responsibilities Submit and track prior authorization requests to insurance companies daily Communicate...Hourly pay
- ...Behavioral Health Revenue Cycle Coordinator to help patients access care quickly by verifying insurance benefits, obtaining prior authorizations, and reconciling balances. You will identify and fix issues that cause denials and support patients with billing questions via...Remote job
- ...Representative responsible for managing Care Coordination services and Health Information Management tasks. The role includes prior authorizations, electronic filing, and ensuring compliance with protocols. Ideal candidates will have a High School Diploma, experience in...Remote jobWork from home
- JOB SUMMARY The basic function of the Authorization Specialist is to verify benefits/eligibility and obtain authorizations when necessary for visits... ...authorization is secured with the insurance company prior to scheduled service. Obtains authorization timely when the...Temporary workWork at officeMonday to Friday
- Agadia Health Systems, Inc. is seeking a PAHub & Prior Authorization Specialist to serve as a trusted consultant for customers and internal teams. You will bridge product functionality with customer operations, implementation, and training to maximize value and adoption...Remote job
$44.84k - $53.38k
About Us Navitus - Putting People First in Pharmacy - Navitus was founded as an alternative to traditional pharmacy benefit manager (... ...Navitus Health Solutions is seeking a Pharmacy Network Reporting Specialist to join our team! The Reporting Specialist, Pharmacy Network...Work experience placementRemote workFlexible hours$18.67 - $21.96 per hour
...Vermont, West Virginia, and Wyoming. Overview Lumicera Health Services is seeking a Prior Authorization Specialist I to join our team! Under direction from the Supervisor, Specialty Pharmacy Services, and pharmacists in the Specialty Pharmacy, the Prior Authorization...TraineeshipRemote workFlexible hoursShift work$14k
Influencer Partnerships Specialist (Contract) Remote | Part-Time Contract (20 hrs/week) | U.S., Canada, Mexico & Latin America About Springboard... ...) and Allied Health training (Certified Medical Assistant, Pharmacy Technician, Sterile Technician) — all focused on helping...Contract workPart timeRemote work$70k - $80k
Overview Accreditation Specialist - Specialty Pharmacy Job Summary: Facilitate accreditation related tasks and work closely with internal and external team members to ensure the pharmacies meet accreditation requirements. Assist as necessary to support accreditation compliance...Temporary workWork at officeWork from home- 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
$25 - $27 per hour
Harlem Cardiology on Madison Avenue in New York City seeks a skilled medical biller and insurance authorization specialist to obtain prior authorizations for procedures. Join a dedicated cardiology team delivering cardiovascular care to East Harlem residents; compensation...Hourly payFull time- ...facing experience is MUST. We are seeking a skilled Integration Specialist with strong Electronic Data Interchange (EDI) expertise and... ...processes including claims, eligibility, payments, and prior authorizations. Solid understanding of XML, JSON, SQL, REST, and SOAP-...
- ...North Carolina. The Field Reimbursement Specialist (FRS) serves as a subject‑matter... ...liaisons between providers, manufacturers, pharmacies, and payers to navigate reimbursement... ...in pharmacy benefit reimbursement, prior authorizations, appeals, and specialty pharmacies is...Work at officeLocal areaNight shift
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