Clinical Authorization & Appeals Specialist
Remote Jobs
Dana-Farber Cancer Institute in Boston seeks a Clinical Authorization Specialist to manage prior authorizations for molecular pathology and high-cost drugs. You will advocate for patients, discuss cases with physicians and payers, and guide appeals when denials occur. The role requires 1 year of relevant experience, strong payer knowledge, and ability to handle sensitive information in a fast-paced environment. #J-18808-Ljbffr Remote Jobs
Vacancy posted 5 days ago
Similar jobs that could be interesting for youBased on the Clinical Authorization & Appeals Specialist in New York, NY vacancy
$50k
...mission is to bring 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,...SuggestedContract workWork experience placementRemote workMed Review Inc
New York, NY1 day ago- ...Health seeks an experienced subject matter expert in prior authorization and appeals, ensuring compliance with federal and state standards... ...management. You will perform PA and appeal reviews, discuss clinical decisions with providers, and collaborate with Medicare to...Suggested
- 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
- Healthfirst seeks a Manager of Clinical Appeals & Grievances to lead a fast-paced team and coordinate with organizational leaders to optimize processes and drive performance. The role oversees internal and external production and ensures high quality and compliance across...Suggested
- ...About the Role We're hiring an experienced Prior Authorization Specialist to help build the future of authorization automation for home health... ...fast-moving startup Nice to Have RN, LPN, or clinical background Experience with Careport, Forcura, Ensocare,...Suggested
Claim Health
New York, NY5 days ago $86k
...accrediting body and national authority for the Baby-Friendly... ...POSITION SUMMARY: Possesses strong clinical foundation with respect to differential... ...assignment Writes clinical appeal letters and supports denial... ...Clinical Documentation Specialist (CCDS) AHIMA Certified Coding...Full timeShift work$55k - $60k
...and a competitive benefits program. Job Summary The Authorizations Specialist ensures timely payer approvals by managing authorizations,... ...including network exceptions and single case agreements Review clinical documentation to determine medical necessity Process...Full timeContract workRemote workKoya Medical, Inc.
New York, NY1 day ago$39.4 - $51.47 per hour
...of overall quality and completeness of clinical documentation in patient record through... ...preferred. Certified Clinical Documentation Specialist (CCDS) or Certified Documentation... ...set to YES, then this position has the authority (delegated) to hire, terminate, discipline...Full timeTemporary workPart timeFlexible hours- ...Flagler Health Is Building The Clinical Operating System For Modern Musculoskeletal Care... ...improve financial performance. Prior authorizations are a critical component of that success... .... We are seeking a Prior Authorization Specialist (Contract) to support high-volume authorizations...Contract work
$24.76 - $33.17 per hour
...Authorization-Referrals Specialist II The 61st Street Service Corporation, provides administrative and clinical support staff for ColumbiaDoctors. This position will support ColumbiaDoctors, one of the largest multi-specialty practices in the Northeast. ColumbiaDoctors...Hourly payFull timeWork at officeLocal area- JOB SUMMARY The basic function of the Authorization Specialist is to verify benefits/eligibility and obtain authorizations when necessary for visits... ...Specialist will serve as a liaison between the clinical team, provider, outside facilities and the patient. SCHEDULE...Temporary workWork at officeMonday to Friday
- 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,...
- We here at Licensed Behavior Analyst Professional Services, PLLC are on the hunt for a meticulous and proactive Authorizations Specialist to keep our clinical services moving without interruption. Your work directly enables our therapists and BCBAs to serve children and...Hourly pay
- ...individuals with Autism Spectrum Disorder. Our authorization team plays a crucial role in ensuring... ...We are seeking an Authorization Specialist to support insurance authorization and... ...authorization status and renewals Coordinate with clinical, billing, and administrative teams...
- Santa Barbara Cottage Hospital is seeking a Remote Authorization Specialist to manage insurance authorizations for PHP and IOP programs, ensuring... ...by handling pre-certifications, concurrent reviews, and appeals across payer plans. In this remote role you will verify benefits...Remote job
- MedImpact Healthcare Systems, Inc. is hiring for a Prior Authorization Operations role to process PA requests, validate information, and ensure timely, accurate determinations following clinical guidelines and client requirements. The position emphasizes collaboration with...
- Raventra Health is seeking a Prior Authorization Specialist to coordinate requests for scheduled procedures, treatments, and services, working with payer portals, provider teams, and clinical documentation to secure timely approvals. You will submit and track authorizations...Remote job
- ...is seeking a detail-oriented Insurance Verification & Prior Authorization Specialist to secure outpatient services by verifying benefits,... ...authorizations. This role collaborates with physicians, nurses, clinic managers and financial advocates to resolve authorization issues...Remote job
$21.38 - $44.4 per hour
Overview This role is located at Spokane Eye Clinic, Spokane, WA, which is part of Prism... ...on Experience) The Revenue Cycle Specialist is responsible for billing and collecting... ...accounts and prepare charge corrections. Appeal carrier denials through review of coding...- WellDyne is seeking a Prior Authorization Tech II to initiate clinical PA requests by phone or email, create and fax cases, and document all activity with accuracy. You will also complete PA requests via telephone with prescriber staff and work closely with pharmacies,...
- Remote Jobs in the United States is seeking an Authorization Specialist to support the Clinical, Imaging, and Physical Therapy departments. You will verify insurance information, obtain authorizations for procedures, surgeries, imaging, and office visits, and actively...Work at officeRemote work
$105.07k - $131.33k
Job Description Support clinical safety aspects of MicroVention clinical studies. Job duties: Provide all required clinical safety support... ...management, regulatory submissions, questions from regulatory authorities, scientific analyses, and other scientific documentation....Remote job$22 per hour
...Overview The Prior Authorization Coordinator will facilitate the logging in and out of all prior authorization, appeal, reimbursement and grievance requests, and follow-up on requests... ...Essential Accountabilities Assist Clinical Review Pharmacist in making appropriate...Hourly payTemporary workIndependent Health
New York, NY5 days ago- A healthcare service provider is seeking an Appeals and Grievances Clinical Specialist to manage member complaints and clinical case resolutions. This is a 100% remote role requiring an RN, LPN, or Dental Hygienist license. Responsibilities include developing cases, researching...Remote work
Health First
New York, NY5 days ago - ...equivalent) and experience with healthcare provider strategy and operations are highly preferred5+ years of experience in a hospital/clinical setting, specifically within workforce management, staffing office operations, or clinical labor consultingDeep interest or...ApprenticeshipWork at officeEasy work
- ...Clinical AssistantThe Clinical Assistant provides clinical and administrative support to physicians and surgeons. This individual coordinates... ...as a Medical AssistantBCLS certification ? Required Issuing Authority: AHAAbout UsStrength through Unity and InclusionThe Mount...TraineeshipLocal areaShift work
Mount Sinai Health System
New York, NY2 days ago $26 - $34 per hour
...VNACJ Community Health Center is hiring a Clinical Assistant/ Senior Certified Medical Assistant! Strengthen Community Health. Shape... ...care testing, immunizations, and medication administration as authorized. Provides patient education and coordinates referrals, diagnostic...Work experience placementLocal areaVNA Health Group
New York, NY2 days ago$26.37 per hour
...Clinical Aide NYU is hiring for a Clinical Aide Position in Greenwich Village, New York City. Base pay starts at $26.37/hr. #TransparentPay... ...and no additional income. This does not represent any legal authority and is just an estimate used for approximation purposes....Hourly payWork at officeBANDANA
New York, NY5 days ago- Grow Therapy in the United States is seeking an Authorization Specialist II to ensure timely access to care by keeping authorization data accurate across our behavioral health claims. You will enter and validate packets, resolve issues, and audit throughput while partnering...Remote jobHourly pay
$80 per hour
...-based healthcare professionals experienced in prior authorization, utilization management, clinical review, medical necessity criteria, payer authorization... ...authorization status tracking, denial outcomes, appeal pathways, escalation processes, and turnaround time expectationsEvaluate...Hourly payPart timeFor contractorsWork at officeRemote workFlexible hours24-MAG LLC
New York, NY1 day ago
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