Remote Pharmacy Prior Authorization Specialist - Appeals
Communicare Health Services
CommuniCare Health is seeking a Pharmacy Prior Authorization Specialist for a full-time remote role. This position involves managing the Prior Authorization workflow for facilities in states including Ohio and West Virginia. The successful candidate will submit prior authorizations, resolve discrepancies, and ensure compliance with federal and state regulations. Ideal for those with prior authorization or Long-Term Care pharmacy experience, offering comprehensive benefits including health insurance and a 401(k) match. #J-18808-Ljbffr
- ...performance through pharmacy. Our team of... ...add a Medication Specialist to our Specialty... ....ABOUT THE ROLE (Remote, work from home)THE... ...FOLLOWINGReviewing medication authorizations submitted by... ...related to prior authorization... ...with submitting appeals related to coverage...Remote workFull timeWork from home
- ...heartland. Facility: Remote SD (Central Time)... ...Facilitates the denial and appeal process through... ...of responsibility and authority. Communicates well downward... ...companies and pharmacies, according to regulations... ...medical necessity, or prior authorization process....Remote workFull timePart timeImmediate startWork from homeShift workDay shift
$19 - $20 per hour
...any) At Amber Specialty Pharmacy, our commitment to... ...Job Title: Dedicated Authorization Management Specialist Department: Operations... ...Responsible for preparing prior authorizations and appeals, correspondence with... ...conferences, meetings, and remote events Constantly...Remote workHourly payWork experience placementWork at officeLocal areaMonday to Friday- ...challenges in health system pharmacy—designing pharmacy... ...THE POSITION (Remote)The Medication Access Specialist plays a vital role... ...medication authorizations, conducting benefits... ...programs. They gather prior authorization details... ...support coverage denial appeals, and communicate...Remote workFull timeWork at office
- ...takes in-bound calls from providers, pharmacies, members, etc providing professional and... ...callers through the criteria based prior authorization process. Maintains complete, timely and... ...issues to Coverage Determinations and Appeals Learning Advocates and management team...Remote work
$23 per hour
...Pharmacy Prior Authorization Specialist – CareMed Specialty Pharmacy Louisville, KY | Full-Time | Starting at... ...for candidates local to the area. Remote work possible after initial on‑site... ...Manage prior authorization requests and appeals with insurance carriers....Remote workFull timeTemporary workLocal areaRelocation package- ...positions are classified as hybrid, onsite or remote. While the majority of our employees... ...to requests for member and provider appeals, grievances, reconsiderations and... ...focus in Utilization Management (UM), Prior Authorization (PA), Claims, Case Management and/or Medical...Remote workFull timeContract workWork experience placementWork at officeLocal area1 day per week
- ...Elevance Health is seeking an Authorization Representative II to manage prior authorization requests at BioPlus Specialty Pharmacy. This role requires a minimum of 2 years’ experience... ...work 1-2 days a week but may consider remote options for those within commuting distance...Remote workWork at office2 days per week1 day per week
- ...Soleo Health Inc is hiring a Prior Authorization Coordinator to support its Specialty Infusion Pharmacy, working remotely from the USA. This position requires specialty infusion prior authorization experience, with responsibilities including managing prior authorizations...Remote work
- ...Caremed-Specialty-Pharmacy in Houston, TX is looking for a Pharmacy Prior Authorization Specialist. This full-time position focuses on ensuring patients receive necessary... ...have at least 1 year of relevant experience. Remote work may be possible after initial training....Remote workFull timeRelocation package
$40k - $46k
...Soleo Health is seeking a Prior Authorization Coordinator to support our Specialty Infusion Pharmacy. This remote position requires expertise in specialty infusion prior authorization and customer service skills. Candidates must have at least 2 years of relevant experience...Remote work- ...Overview At St. Luke’s, our Pharmacy Technicians play a vital... ...Boise is seeking a Medication Authorization Specialist. These roles support... ...assistance programs or insurance prior authorizations. As part of... ...may be based on-site or work remotely. Medication Authorization...Remote work
- ...Itlearn360 is offering a remote Pharmacist 1 position primarily based in Phoenix, AZ, focusing on ensuring... ...will have a PharmD or Bachelor of Science Pharmacy degree, a valid license, and experience in prior authorization. The position includes various benefits such as...Remote work
$40 per hour
...Job Title: Intake Authorization Specialist Job Type: Full-time Pay: up... ...home infusion and specialty pharmacy services. We are accredited... ...Required: Prior experience in home infusion... ...holidays. Opportunity for remote work based on qualifications...Remote workHourly payFull time$18.92 - $23.46 per hour
...Vital Care is the premier pharmacy franchise business with franchises... ...Perform duties to initiate authorizations, focusing on accuracy, timeliness... ...to complete and submit prior authorizations timely for payer... ...This position is full-time and remote. The salary range for this...Remote workFull timeContract workTemporary workLocal areaFlexible hours- ...healthcare management company is seeking a Remote Coverage Review Pharmacist located in... .... This role requires a Doctor of Pharmacy (PharmD) degree, clinical experience,... ...for reviewing medication-related prior authorizations, appeals, and grievances, working independently...Remote work
- Soleo Health Inc is hiring a Prior Authorization Coordinator to support their Specialty Infusion Pharmacy remotely. The role requires specialty infusion experience, handling prior authorizations and coordinating benefits. Responsibilities include verifying insurance coverage...Remote jobMonday to Friday
$20 - $23 per hour
Soleo Health is looking for a Prior Authorization Coordinator to support their Specialty Infusion Pharmacy remotely in the USA. This position requires a high school diploma and at least 2 years of experience in specialty infusion intake or reimbursement. Responsibilities...Remote jobHourly pay$23 - $27 per hour
...Job Title Clearance Specialist – Full‑time, Remote (USA) Overview Soleo Health... ...our Specialty Infusion Pharmacy. Join us in simplifying complex... ..., and follow up on payer authorization requests. Perform... ...Initiate, follow up, and secure prior authorization, pre‑...Remote workHourly payFull timeContract workImmediate startMonday to Friday$23.49 - $30.53 per hour
...Pharmacy Technician Location: UCHealth Admin, Aurora, CO Work Schedule: Full Time... ...onsite role and does not offer a hybrid or remote option Summary: Responsible for... ...medications for patients by completing prior authorization requests (PAR), co-pay assistance programs...Remote workFull timeTemporary workLocal areaFlexible hoursShift work- ...Case Review Specialist OncoHealth is a leading digital... ...members Intake Pre-Authorization requests and/or... ...Experience working remote independently A minimum... ...and to process incoming Prior Authorization requests... ...landscape. OncoHealth offers Pharmacy Consulting services to...Remote workLocal areaMonday to FridayFlexible hoursShift workWeekend work
- ...the nation’s leading pharmacy care management companies... ...states.Job DetailsPAC Specialists in our Patient... ...multiple skillsets.This is a remote-based environment,... ...receive prescription authorizations, clarifications or transfers... ...duties such as prior authorizations, billing...Remote workFull timeTemporary workWork at officeLocal areaFlexible hours
$18.92 - $23.46 per hour
.... Vital Care is the premier pharmacy franchise business with franchises... ...Perform duties to initiate authorizations, focusing on accuracy,... ...included to complete and submit prior authorizations timely for payer... ...position is full‑time and remote. The salary range for this position...Remote workFull timeContract workTemporary workLocal areaFlexible hours$19.86 per hour
...Health by Gundersen is looking to add a Prior Authorization Specialist to our team! In this role you will... ...health services; vision centers; pharmacies; and air and ground ambulance services... ...the lives of our employees. Select Remote/Hybrid Eligible under More search to...Remote workFull timeLocal areaWork from homeMonday to FridayShift work- ...in health system pharmacy—designing pharmacy... ...THE POSITION (Fully Remote) (Requires... ...Medication Access Specialist Supervisor is an essential... ...review medication authorizations, conduct benefits... ..., submit prior authorizations, and support appeals for coverage denials...Remote workFull timeWork at office
- ...up actions as advised Research claim variances in hospital patient accounting systems (EPIC, Meditech, Cerner, Athena) Draft appeals to insurance carriers on denied or underpaid claims Review claim detail including coding, billing and insurance information for...Remote workPermanent employmentWork from homeFlexible hours
- ...A healthcare company is seeking a skilled Appeals Processor III to work remotely in the United States. This role involves reviewing and processing healthcare appeals related to Medicaid or Medicare coverage decisions. The ideal candidate will have at least 2 years of...Remote work
- ...Healthcare Legal Solutions, LLC is seeking a detail-oriented Revenue Cycle/Follow Up Specialist to manage unpaid claims and appeals in a remote setting. Ideal candidates should be organized, assertive, and interested in healthcare law, ensuring prompt payments and maintaining...Remote workFull timeWork at office
$27.88 - $36.06 per hour
A healthcare service provider is seeking an AR Follow-Up Specialist III, focusing on resolving coding-related denials and appeals while collaborating with coding professionals. This remote role requires strong customer service skills and a minimum of two years of relevant...Remote workHourly pay$125k - $130k
...corporation delivering full-service pharmacy benefit management (PBM)... ...coverage determination and appeals for different lines of... ...and thorough documentation in prior authorization cases, appeals cases, and overrides... ..., stay productive in a remote, high-volume, metric driven...Remote workTemporary workWork at officeLocal areaFlexible hoursShift work
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