Average salary: $73,171 /yearly
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- ...service member or a military spouse, and you must obtain eligibility to participate in these DOW sponsored programs. The Prior Authorization, Registered Nurse, RN, Intern will report to a manager of the National Medicaid team. You will utilize training and engage formerly...SuggestedFull timeFor contractorsApprenticeshipWork experience placementInternshipRemote workWork from homeHome officeWeekday work
Humana
Frankfort, KY3 days ago $47.69 - $56.78 per hour
...under limited technical direction and within broad limits and authority, adjudicate moderately complex commercial environmental claims,... ...Agencies: Resumes submitted for this or any other position without prior authorization from Human Resources will be considered...SuggestedHourly payContract workTemporary workLocal area- ...Coordinator 1 to ensure insurance verification and precertification for patient services. Responsibilities include obtaining prior authorization for outpatient procedures and communicating with patients regarding insurance details. The ideal candidate should possess a high...SuggestedFull time
- ...for upcoming surgical procedures and diagnostic tests by accurately and efficiently completing all necessary steps related to prior authorization, medical necessity determination and financial clearance for the hospital system and physician services for clinics, adult...SuggestedFull timeLocal areaFlexible hoursShift workDay shift
- ...patient care.* Educate providers on Accredo’s specialty pharmacy programs, including access solutions, patient support services, prior authorization assistance, and therapy‑specific workflows.* Develop strategic account plans using prescribing trends, payer dynamics, and...SuggestedRemote jobWork at officeLocal areaWork from home3 days per week
$18.5 - $42.35 per hour
A leading healthcare organization is hiring a Business Configuration Sr. Coordinator to handle prior authorization criteria and collaborate with various departments. The role requires at least 3 years of MS Office experience, strong communication skills, and the ability...Suggested- ...health system in Louisville is seeking a Precertification Specialist to facilitate positive patient experiences by managing prior authorizations and financial clearances. The ideal candidate has at least one year of experience in patient access or insurance verification...SuggestedFull timeFlexible hours
- ...notes and patient information accurately in the EMR system. Perform administrative tasks such as appointment scheduling, prior authorizations, and follow-ups. Provide patients with pre- and post-procedure instructions. Ensure a high standard of infection control...SuggestedFull timePart timeWork at officeWeekend workDay shift
Dhvaj Inc
Louisville, KY1 day ago $26.41 - $61.79 per hour
...benefits, eligibility and expected length of stay for requested treatments and/or procedures. - Conducts reviews to determine prior authorization/financial responsibility for Molina and its members. - Processes requests within required timelines. - Refers appropriate...SuggestedHourly payWork experience placementWork at officeMolina Healthcare
Owensboro, KY3 days ago$215k - $235k
...to therapy. As a trusted resource and advocate, the PAL provides education, guidance, and support across insurance coverage, prior authorization, medical exceptions, appeals, affordability programs, and adherence to ensure patients can begin and continue therapy with confidence...SuggestedWork at office- ...(EPIC), scheduling and following-up with appointments and assisting with medication fill and refill requests, checking for prior authorizations and scheduling tests, procedures, consultations, and other in basket types as assigned. The MA will communicate with pharmacies...SuggestedTemporary workWork experience placementRelocation package
Baptist Health
Paducah, KY2 days ago - ...determine medical necessity of services, pre and post service as well as pre and post billing. Obtains pre‑determinations, prior authorizations, and retro authorizations when required by payor. Responds to all account reviews with the best possible efforts to ensure reimbursement...SuggestedWork experience placementRemote work
$37.65k
...emergency room visits, or loss of independence in vocational, academic, and/or social functioning. Complete requests for prior authorizations as indicated to provide necessary services. Participate in the development of an individualized interdisciplinary plan of...SuggestedFull timeMonday to FridayFlexible hoursNorthKey Community Care
Covington, KY2 days ago- A confidential managed care organization is seeking a Remote Prior Authorization Pharmacist to evaluate prescription requests and ensure medical necessity. This fully remote position offers flexibility and the chance to build expertise in managed care. Candidates should...SuggestedRemote job
- ...patients. Conduct medication reviews to identify gaps in therapy, adherence concerns, or potential drug interactions. Support prior authorization and appeals processes when needed. Educate patients and caregivers on medication regimens and disease state management....SuggestedRemote job
- ...Utilization Management to lead clinical and operational strategies. The ideal candidate will have over 10 years of experience in prior authorization operations, including at least 5 years in a leadership role. In this position, you will drive utilization management programs...
- A leading health services company is looking for a Clinical Pharmacist to evaluate prior authorization requests and collaborate with healthcare teams. This fully remote role requires a BCOP credential at hire, clinical experience involving oncology and prior authorizations...Remote jobWork at office
- ...considerable autonomy and critical thinking to help patients navigate financial barriers and ensure treatment accessibility. Competitive candidates will have a solid understanding of pharmacy operations and prior authorization processes. #J-18808-Ljbffr Norton Healthcare
- Remote Prior Authorization Pharmacist - Work From Home in Managed Care A confidential managed care organization is seeking a motivated Remote Prior Authorization Pharmacist to evaluate prescription requests, ensure medical necessity, and improve patient access to safe and...Remote jobWork from homeFlexible hours
$76k - $85k
...for future health care costs associated with birth-related neurological injuries. Duties and Responsibilities Performs prior authorization, concurrent and retrospective reviews Use clinical documentation and clinical review criteria to make determinations regarding...For contractorsH1bWork at officeLocal areaRemote workPublic Consulting Group
Frankfort, KY3 days ago$52.1k
...functioning. Provide education to clients to promote improved functioning skills and development. Complete requests for prior authorizations as indicated to provide necessary services. Participate in staff meetings and consultation with other clinicians to...Full timeMonday to FridayFlexible hoursWeekend workAfternoon shiftNorthKey Community Care
Covington, KY16 days ago- ...eligibility, and benefits. Address any discrepancies in coverage and communicate with patients or facilities when needed. Request prior authorization on drugs that are denied for prior authorization. Notify facilities of changes and exceptions when appropriate. Other...Local areaHome officeShift work
- ...duties involve managing the electronic health record (EPIC), scheduling appointments, processing medication requests, handling prior authorizations, and coordinating tests and procedures. Upon successful completion of clinical competency, the role may also require...Part timeTraineeshipWork experience placementWork at officeRelocation package
Baptist Health
Somerset, KY4 days ago - ...area. Our department provides mentoring from senior partners in a collegial environment. Full time practice manager and prior authorization specialist on site. There are opportunities for community outreach and to provide care to underserved populations....Full timePrivate practiceWork at office
Britt Medical Search LLC Defunct
Bowling Green, KY4 days ago $18.5 per hour
...document. • Can be responsible for documenting, faxing, following up, and providing documentationrequired for all authorizations for each entity requiring prior authorization for any and all medical care. • Perform glucose testing by glucometer as directed. • Perform...Shift workNight shiftWeekend workMadison Health and Rehabilitation Center
Richmond, KY4 days ago- ...duties involve managing the electronic health record (EPIC), scheduling appointments, processing medication requests, handling prior authorizations, and coordinating tests and procedures. Upon successful completion of clinical competency, the role may also require...TraineeshipWork experience placementWork at officeRelocation package
Baptist Health
Bardstown, KY2 days ago - ...confidentiality. Verify information on prescriptions received prior to processing (correct prescriber, name of patient, patient... ...management software, PrimeRx, to complete claims processing and prior authorizations. Perform patient level benefits verifications as applicable...Hourly payWork at officeFlexible hours
Knipper Health
Louisville, KY2 days ago - ...reconcile aged accounts, and resolve payment discrepancies. Additionally, the Billing Coordinator handles insurance verification, prior authorization submissions, and keeps trackers updated to ensure eligibility and compliance for client services. Billing Operations &...Weekly pay
Kentucky United Methodist Children's Homes
Nicholasville, KY5 days ago - ...supplies, navigating electronic health record system (EPIC), scheduling and following-up with appointments and checking for prior authorizations and scheduling tests, procedures and consultations. The PCT will communicate with pharmacies, insurance companies, patients...Full timeWork experience placementDay shift
Baptist Health
Louisville, KY5 days ago - ...duties involve managing the electronic health record (EPIC), scheduling appointments, processing medication requests, handling prior authorizations, and coordinating tests and procedures. Upon successful completion of clinical competency, the role may also require...TraineeshipWork experience placementWork at officeRelocation package
Baptist Health
Paducah, KY1 day ago
