Remote Senior Pharmacy PA & Appeals Specialist
UnitedHealth Group
- Remote job
UnitedHealth Group's Optum unit seeks a Senior Pharmacy PA/Appeals Technician to support prior authorization and appeals, handling inquiries from members, providers, and pharmacies. This role emphasizes accuracy, regulatory compliance, and timely processing across multiple channels, with telecommuting options for licensed technicians in listed states. You will collaborate with pharmacists and clinicians, document actions clearly, and help improve health outcomes in a fast-paced, metric-driven #J-18808-Ljbffr UnitedHealth Group
- UnitedHealth Group in the United States is seeking a Senior Pharmacy PA/Appeals Technician to support prior authorization and appeals, handling requests through phone, fax, and electronic systems. The role requires meticulous review of member, provider, medication, diagnosis...Remote jobSeniorFlexible hours
$18 - $32 per hour
...Remote in Vermont or Maine Optum is a global organization that delivers care... ...by connecting people with the care, pharmacy benefits, data and resources they need... .... The essential functions of a Senior Pharmacy PA/Appeals Technician include supporting the prior...Remote workSeniorHourly payMinimum wageFull timeTemporary workWork experience placementLocal areaMonday to FridayShift workAfternoon shift- ...Senior Pharmacy PA/Appeals Technician Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy...Remote jobSeniorTemporary workFlexible hoursShift work
$18 - $32 per hour
...Senior Pharmacy PA/Appeals Technician Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy...Remote jobSeniorHourly payDaily paidMinimum wagePrice workFull timeTemporary workWork experience placementWork at officeLocal areaFlexible hoursShift work- Medica, a nonprofit health plan serving communities across multiple states, seeks a remote Appeals & Grievances Specialist III to manage complex member complaints, grievances, and appeals with regulatory alignment. You will work with cross-functional teams to ensure timely...Remote jobSenior
$124.09k - $150.37k
...of those who do it. Job Posting Title: Senior Therapeutic Area Specialist, Cardiovascular Community – Philadelphia East, PA Therapeutic Area (TA): Cardiovascular... ...level deemed acceptable by the Company. #li-remote We hire for skills and capabilities, not...Remote workSeniorHourly payFull timeSummer workPrivate practiceLive inWork at officeLocal areaFlexible hours- NYX Health Group is seeking an experienced Infusion Prior Authorization Specialist based in the United States for a remote, full-time role within our Cancer Infusion Team. EPIC proficiency and 4+ years of prior authorizations are required. You will complete insurance verifications...Remote jobSeniorFull time
- ...Pharmacy Technician Assists in most aspects of drug distribution that do not require the... ...License through Ohio Board of Pharmacy PA: Pharmacy Technician or Pharmacy... ...through West Virginia Board of Pharmacy Remote Workers Only: Must additionally hold Pharmacy...Remote workSeniorTraineeshipLocal areaShift workNight shift
- ...is actively screening for multiple remote Pharmacists to join a leading pharmacy benefits optimizer based out of Birmingham... ...reviews prior authorization and appeals, collaborates with prescribers and... ...compliance while improving the PA program. Responsibilities include evaluating...Remote work
- ...expertise that ensure outstanding results for our clients. About this Role Senior Cost Specialist Location: Pittsburgh PA. Join our growing Pittsburgh team! This position will be remote initially as we complete our new office then transition to an in-office...Remote workSeniorWeekly payFull timeWork at officeLocal area
- ...Physician Management (IPM) offers a remote Accounts Receivable Specialist role with a required 3-month in-office... ...distance to King of Prussia, PA. The AR specialist will manage unpaid... ...underpaid claims, research denials, file appeals, and ensure timely collections...Remote jobWork at office
$19 - $20 per hour
...- At Amber Specialty Pharmacy, our commitment to patient... ...Management Specialist Department: Operations... ...Responsible for preparing appeal summaries and prior authorizations... ...appropriateness of all PA requests and provider... ..., meetings, and remote events Constantly operates...Remote workHourly payFull timeWork experience placementWork at officeLocal areaMonday to Friday- ...for meetings and events, the full-time Senior Purchasing Specialist will manage creative program... ...procurement, and negotiation, while working remotely. Key responsibilities Coordinate large... ...team members and suppliers Develop appealing programs that maximize client budgets...Remote workSeniorFull timeWork at office
- ...Prior Authorization Specialist Location: Fully remote Duration: 12 months... ...calls from providers, pharmacies, members, etc... ...prior authorization (PA) and drug benefit exception... ...Determinations and Appeals Learning Advocates... ...status and results (seniors, pharmacists, appeals...Remote workContract work
- ...Point32Health, Inc. is seeking an Appeals and Grievance Coordinator to manage day-to-day tasks within the A&G department. You will process mail, assign cases, and support analysts while ensuring compliance with regulatory timelines. The role requires 1-2 years of relevant...Remote workWork from home
$90k - $105k
...Functional Area: Sales Working Model: Remote Days of Work: Wednesday, Tuesday,... ...Other key product areas include nutrition, pharmacy admixture and compounding, ostomy and wound... ...Medical is headquartered in Bethlehem, Pa., and is part of the B. Braun Group of Companies...Remote workFor contractorsSeasonal workWork at officeRelocationShift work- ...Insurance Company is seeking a seasoned Title Curative Specialist to assess title issues, determine remedies, and... ...strong client communication. The position is full-time and remote, based from Plymouth Meeting, PA, with a focus on meeting deadlines and maintaining high...Remote jobSeniorFull time
- ...Medical Branch (UTMB Health) is seeking a Sr. Patient Account Specialist in Galveston, TX. Hybrid remote work is available with a Monday-Friday schedule; the role focuses on billing third-party payers and appealing denied claims. The position requires experience in patient...Remote workSeniorMonday to Friday
$60k - $70k
Sasser, Inc. in Hatboro, PA, is seeking a Senior Accounts Receivable Specialist to manage collections for Express 4x4 Truck Rental and related AR ledgers. The... ...Ledger team. Hybrid schedule: four days onsite, one day remote weekly. Base salary range is $60,000-$70,000 USD...Remote workSenior- ...seeking an experienced LVN/LPN for a fully remote Prior Authorization and Appeals role in the United States. The position supports a high-volume pharmacy benefits team with meticulous... ...an active LVN/LPN license and 2+ years PA experience in PBM, MDO, or clinical settings...Remote jobShift workWeekday work
$100k - $125k
...straight answer from a person who can actually help. Location: Remote (U.S.) Employment Type: Full-time Department: Marketing... .... Manage restrictions, special ad category requirements and appeals proactively; a disabled ad account is a company-level event at...Remote workSeniorFull timeHome officeFlexible hours- ...Phothera is seeking a Denials & Appeals Specialist to own the appeals process for denied and underpaid claims, focusing on medical necessity... ...maximize reimbursement and patient access. While the role is fully remote, candidates based in or near Beachwood, OH are strongly...Remote work
$65k - $97.5k
...Parts Center - Troy Commerce Center Blvd Location Shift: 1st Workstyle: Remote Eligible up to 20% Career Level: 4 Job Grade: Exempt-2 Job Purpose The Purchasing Specialist (EX2) position within Recycling & Spec Control supports the overall mission and...Remote workSeniorFull timeTemporary workWork experience placementWork at officeRelocation packageShift work- ...Healthfirst seeks a Grievance Specialist to join the Appeals & Grievances team. This is a 100% remote, non-clinical role focused on resolving member grievances across Medicare, Medicaid, CHPlus, SHP, QHP, EP, and CompleteCare. The Specialist will independently manage...Remote work
$28 - $35 per hour
...Location: Remote (U.S.) Preferred Location: Candidates based in or near Beachwood, OH are strongly preferred. Reports To:... ...Madison Industries, on a direct hire opportunity for a Denials & Appeals Specialist. This is a remote revenue cycle role focused on...Remote workHourly payWork at officeLocal area- ...Senior Electric Transmission Specialist Do you want to build an impactful career to change the world for the better?... ...position will support our Philadelphia, PA, and the flexibility to work a hybrid schedule or fully remote from your home-office in Newport, KY is available...Remote workSeniorContract workWork at officeHome office
$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- ...Managing appeals cases, the full-time Appeals Specialist II will review documentation, communicate resolutions, and coordinate with departments to ensure compliance in a remote work environment. Key responsibilities Manage appeals cases and document all actions taken...Remote workFull time
$80k - $129k
...Job Title Senior Specialist, External Quality Operations Requisition JR000016029 Senior Specialist... ..., NJ Additional Locations Malvern, PA Job Description Summary The Senior... ...Conditions: This position works in a remote, office type environment. Limited travel...Remote workSeniorFull timeWork at office$29.7 - $31.8 per hour
...between $29.70 - $31.80 based on experience The Acute Coding Appeals Specialist integrates medical coding principles and objectivity in the... ...and improve patient and client experiences. ~ This is a remote position; however, candidates must be willing and able to travel...Remote workTemporary workWork at officeLocal area
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