Average salary: $73,171 /yearly
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- ...to determine medical necessity of services, pre and post service as well as pre and postbilling. Obtains pre-determinations, prior authorizations, and retro authorizations when required bypayor. Responds to all account reviews with the best possible efforts to ensure...SuggestedWork experience placementRemote work
Baptist Health
Louisville, KY1 day ago $26.41 - $51.49 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 officeShift workMolina Healthcare
Covington, KY1 day ago- ...coordination of patient therapies Integrated specialty pharmacy support team managing biologics, medication alignments, and prior authorizations Collaborative, team-based model for comprehensive, personalized patient care Highly efficient EMR (EPIC, Gold Star...SuggestedFull timeLive inRelocation packageFlexible hours
Inspire Healthcare
Lexington, KY2 hours agonew - ...guidelines, and Centers for Medicare and Medicaid Services (CMS) standards. Provides coordination and processing of pharmacy prior authorization requests and/or appeals. Explains point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any...SuggestedWork at office
Molina Healthcare
Louisville, KY2 days ago - ...Prior Authorization Representative The Prior Authorization Representative is responsible for verifying prior authorization requirements and obtaining authorization when required. Works directly with physician offices and payers to facilitate patient access to various...Suggested
Hire Talent
Louisville, KY3 days ago - ...(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 workRelocation package
Baptist Health
Paducah, KY4 days ago $20 - $25 per hour
...out scheduling appointments answering phones / phone triage managing referrals entering demographics securing prior authorizations facilitating communication between practice physicians, patients, and other healthcare providers other duties as...SuggestedHourly payPrivate practiceWork at officeFlexible hoursWeekday workLange Recruiting
Louisville, KY3 days ago$214.13k - $417.56k
...care. Essential Job Duties Leads and manages a team of medical directors and behavioral health clinicians responsible for prior authorization, inpatient concurrent review, discharge planning, care management, and interdisciplinary care team activities across a...SuggestedContract workWork experience placementWork at officeLocal areaMolina Healthcare
Owensboro, KY3 days ago$16 - $27.69 per hour
...professional verbal and written communication skills Other duties as assigned Resolving insurance issues Assisting with prior authorizations You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear...SuggestedHourly payMinimum wageFull timeWork experience placementLocal areaMonday to FridayOptum
Okolona, KY1 day ago$106.9k - $147k
...technical orchestrator for new client partnerships. You will not author detailed technical designs, but you must deeply understand... ...understanding of pharmacy operations, PBM models, benefits coordination, prior authorization workflows, and specialty care dynamics...SuggestedFull timeTemporary workApprenticeshipRemote workWork from homeHome officeKentucky Staffing
Frankfort, KY1 day ago$150k - $175k
.... General payer policy knowledge including public and private payers, foundational knowledge of benefit verifications and prior authorization/pre-determination requirements. All reimbursement activities are required to be conducted and managed within all appropriate...SuggestedContract workTemporary workWork at officeLocal areaWork visaNight shiftBausch + Lomb
Louisville, KY2 days ago- ...the outpatient setting Learn the process for MAT intake and follow up Learn the process for medication refills and prior authorizations and answering phones Education and Experience: Active RN Kentucky License Associates required, BSN preferred...SuggestedNight shiftWeekend work
RiverValley Behavioral Health
Owensboro, KY2 days ago - Job Description Commercial and personal line insurance carriers rely on EXL as a key business partner through our Castle High Value and EXL Risk Control service offerings. We offer a variety of field inspections and risk control services to support our clients’ underwriting...SuggestedFor contractorsWork at officeLocal areaWork from home
EXL
Louisville, KY23 days ago - ...Works closely with Financial Advocates to facilitate financial support for all modalities of treatments. Works closely with Prior Authorization team to facilitate authorizations for all needed treatments. Provides psychosocial support to and facilitates...SuggestedFull timeInterim roleWork at officeFlexible hours
The Christ Hospital Cardiovascular Associates
Fort Wright, 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...SuggestedTraineeshipWork at office
Kentucky Staffing
Richmond, KY3 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 officeLocal areaRelocation package
Kentucky Staffing
Paducah, KY1 day 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 at officeRelocation package
Baptist Health
Paducah, KY3 days ago $18.2 - $24.82 per hour
...navigate electronic health record system, schedule and follow-up with appointments and assist with medication fill requests, prior authorizations and schedule tests, procedures and consults. The MA will communicate with pharmacies, insurance companies, patients and...Full timeMonday to FridayShift workDay shiftUniversity of Kentucky
Lexington, KY2 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 at office
Kentucky Staffing
Frankfort, 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, KY3 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 timeDay shift
Baptist Health
Louisville, KY3 days ago - ...exchange and workflows between payer systems and Epic enabled provider organizations—covering eligibility, coverage discovery, prior authorization, claims status, clinical data retrieval, and care gap closure. You will manage operational runbooks, environment readiness,...Contract workRemote work
United Software Group Inc
Louisville, KY6 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
Richmond, KY1 day ago- ...(EPIC), scheduling and following-up with appointments and assisting with medication fill and refill requests, checking for prior authorizations and scheduling tests, procedures and consultations. May also perform other procedures such as EKG, phlebotomy, lab tests and...Full timeWork experience placementWork at officeRelocation packageDay shift
Baptist Health
Nicholasville, KY2 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 at office
Kentucky Staffing
Louisville, KY5 days ago $16.2 - $24.82 per hour
...navigate electronic health record system, schedule and follow-up with appointments and assist with medication fill requests, prior authorizations and schedule tests, procedures and consults. The MA will communicate with pharmacies, insurance companies, patients and...Temporary workMonday to FridayShift workKentucky Staffing
Lexington, KY5 days ago- ...and your knowledge of the program and industry rules and standards. This includes completing benefit investigations, tracking prior authorizations / denial appeals, and assisting patients or other callers/stakeholders through resolution (via email, inbound/outbound calls...Temporary workWork at officeImmediate startRemote workWork from homeHome officeMonday to FridayFlexible hoursShift work
PharmaCord
Lexington, KY3 days ago $69.15k - $123.92k
...market underwriter reviews risks, determines acceptability, and successfully writes profitable business accounts. Within designated authority, reviews insurance applications to evaluate, classify and rate each risk to determine acceptability, coverage and pricing....TraineeshipWork experience placementLive inRemote workFlexible hoursEncova Insurance
Louisville, KY4 days ago- ...years of experience in a medical office setting preferred ~ Prior experience in Allergy and/or Immunology strongly preferred ~... ...Handle patient phone calls, prescription refills, and prior authorizations for medications and biologics Provide patient education under...Work at office
Head and Neck Surgery, Assoc., PSC
Kentucky19 days ago - ...(EPIC), scheduling and following-up with appointments and assisting with medication fill and refill requests, checking for prior authorizations and scheduling tests, procedures and consultations. May also perform other procedures such as EKG, phlebotomy, lab tests and...Full timeWork experience placementWork at officeDay shift
Baptist Health
Richmond, KY4 days ago
