Average salary: $87,182 /yearly
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$37.66 - $44.33 per hour
...Working under technical direction and within significant limits and authority,adjudicateworkers' compensation claims of higher technical... ...Resumes submitted for this or any other position without prior authorization from Human Resources will be considered unsolicited...SuggestedTemporary workLocal areaRemote workArgonaut Management Services, Inc
Detroit, MI6 days ago- ...data interpretation***PLEASE NOTE:***Applicants must be legally authorized to work in the United States. At this time, we are not able to... ...Agencies:** Resumes submitted for this or any other position without prior authorization from Human Resources will be considered...SuggestedLocal areaFlexible hours
$22 per hour
...providers (physicians and other healthcare providers rendering medical care) with Medicare Part B drug coverage inquiries, and prior authorizations. Top 3 Required Skills/Experience: 2-4 years Specialty and/or Retail Pharmacy Experience in provider/member call center or...SuggestedHourly payContract workTemporary workWork at officeRemote workWork from homeNight shiftTekwissen
Detroit, MI2 days ago- ...Location: Silver Pine Medical Group PLC - CANAL - Sterling Heights, MI 48313 Salary Range: $18.50 - $26.00 Hourly Job Title: Prior Authorization Specialist Job Summary We are seeking an experienced Medical Assistant to work in our referral department to assist our patients...SuggestedHourly payFull timePart time
- ...A healthcare organization is seeking a Full Time Authorizations Specialist based in Warren, Michigan. The role emphasizes ensuring timely... ...providers, and maintaining meticulous records. Candidates must have prior experience in insurance authorizations and a high school...SuggestedFull time
RADX Corporation
Warren, MI2 days ago $80k
...Access Specialist II to offer timely support to patients and healthcare providers. You will verify insurance coverages, obtain prior authorizations, and ensure patients have access to necessary resources for their care. This remote role offers a competitive salary of $80k...SuggestedRemote workCycle Pharmaceuticals
Detroit, MI2 days ago- ...Perform financial clearance of patient accounts by verifying insurance eligibility and benefits. Ensure all notifications and authorizations are completed within the required timeframe. Completes appropriate payor forms related to notification and authorization....SuggestedWork at officeImmediate start
Baylor Scott & White Health
Lansing, MI4 days ago - ...Verification Specialist to join their healthcare team. The successful candidate will perform insurance verification, obtain prior authorizations, and document patient benefits accurately. A minimum of 1-2 years experience in medical insurance verification is required,...Suggested
- ...Infusion Prior Authorization Specialist Responsible for ensuring all pre-service accounts are financially cleared and secured prior to the date of service. The specialist is responsible for obtaining and verifying accurate insurance information, benefit validation,...SuggestedFull timeWork at officeMonday to Friday
Michigan Institute for Neurological Disorders
Farmington Hills, MI4 days ago - ...as the crucial link between patients, providers, and payers, ensuring accurate insurance coverage verification and obtaining prior authorizations to reduce claim denials. Key Responsibilities Verification & Eligibility: Perform high-volume, real-time insurance...SuggestedHourly payWork at office
- ...will participate in the following assignments in this role: Clinical Review: Conduct comprehensive clinical reviews of prior authorization requests to determine medical necessity and benefit eligibility. Apply advanced evidence-based clinical guidelines in review...SuggestedFull timeFor contractorsApprenticeshipWork experience placementInternshipRemote workWork from homeHome officeWeekday work
Humana
Lansing, MI7 days ago - ...Team (MCC) is a centralized team that works closely with Specialty Clinics across all Corewell Health regions to help obtain prior authorizations (PA's) for high-cost medications, quantity limits, tier exceptions, and non-formulary medications that are ordered by...SuggestedFull timeWork at officeRemote workWork from homeMonday to FridayShift work
Corewell Health
Grand Rapids, MI2 days ago $68.5k - $88.02k
...with URAC and ACHC specialty pharmacy accreditation standards and survey readiness ~ Experience optimizing patient access, prior authorization, and reimbursement workflows ~ Strong analytical skills with experience using data to drive operational and performance improvements...SuggestedTemporary workLocal areaImmediate startFlexible hoursCardinal Health
Lansing, MI2 days ago- Silver Pine Medical Group in Sterling Heights is seeking an experienced Prior Authorization Specialist to assist patients within the referral department. You will maintain documentation of referrals and advocate for patients with insurance carriers. The ideal candidate...SuggestedFull timePart time
- ...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 opportunity to work in managed care. Candidates should have...SuggestedRemote workWork from home
Pharmacy Careers
Ypsilanti, MI4 days ago - A confidential managed care organization is seeking a Remote Prior Authorization Pharmacist to evaluate prescription requests and ensure medical necessity. This role offers 100% remote work and flexible scheduling, with a focus on improving patient access to safe therapies...Remote workFlexible hours
Pharmacy Careers
Detroit, MI2 days ago - ...setting, interrogating devices, following up on labs and test results, following up on patients in rehab, medication refills and prior authorizations, phone calls, and troubleshooting the LVAD device. This position will also require on‑call for patients at home who call...Weekend work
Henry Ford Health System
Lansing, MI2 days ago $44.09 - $78.7 per hour
...and outcomes Coordinate care with providers, payers, and manufacturers to ensure therapy access and continuity Oversee prior authorizations and utilization management, ensuring compliance with payer and program requirements Monitor effectiveness and safety of...Hourly payDaily paidMinimum wageFull timeWork experience placementLocal areaMonday to FridayShift workUMR
Owosso, MI8 days ago- ...at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for members to ensure optimum outcomes, cost effectiveness and compliance with all...Work at office
Careers Integrated Resources Inc
Troy, MI4 days ago - ...Responsibilities Include: Obtaining patient history Room patients Maintain clinic area, clean and stock exam rooms Obtains prior authorizations and lab audits Benefits ~ Medical, Dental and Vision ~ Life Insurance ~ Flex Spending Account ~ Short- and...Full timeTemporary workWork at office
Huron Gastro
Whitmore Lake, MI5 days ago - ...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....Remote work
Pharmacy Careers
Ypsilanti, MI5 days ago - ...coordination of patient access to necessary medications. Responsibilities include managing telehealth appointments, handling prior authorizations, and ensuring effective communication among healthcare stakeholders. Candidates should possess a relevant Bachelor's degree...
INSIGHT HEALTH SYSTEMS, INC.
Flint, MI1 day ago - ...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...Remote workWork from homeFlexible hours
Pharmacy Careers
Ypsilanti, MI2 days ago - ...documenting the phone encounter in the EHR. • E-scribing medication refills in accordance with provider protocols. • Working on prior authorizations with insurance companies as needed. • Assisting with suture removals and post op appointments as needed. • Other duties...Full timeWork at office
West Michigan Dermatology
Grandville, MI4 days ago $106.2k - $225k
...support and input to clinical programs such as: Health Management (IDT), Drug Utilization Review, Formulary development, and Prior Authorization programs to encourage appropriate, high quality, cost effective drug therapy; and to identify opportunities for improvement in...Hourly payFull timeTemporary workLocal areaRemote workShift workWeekend workHispanic Alliance for Career Enhancement
Lansing, MI6 days ago$115.88k - $261k
...actions needed to ensure the programs are implemented correctly. Knowledge of utilization management interventions including prior authorization, step therapy, quantity limits, and Specialty Guideline Management UM processes is required. The leader will feel comfortable...Hourly payFull timeTemporary workWork at officeLocal areaHispanic Alliance for Career Enhancement
Lansing, MI2 days ago- ...their medications Following up with patients who may be missing doses or struggling with adherence Coordinating refills, prior authorizations, and medication access Updating patient records and documenting care in EHR systems Collaborating with pharmacists to...
MyCareer+
Southfield, MI4 days ago - ...fast-paced primary care setting. Preferred experience: Prior experience in a busy private primary care or specialty medical... ...phones and handling patient messages professionally Prior authorization, referral, and medical form experience helpful Basic medical...Part timeWork at officeFlexible hours
Center For Preventive Medicine
Grosse Pointe, MI3 days ago - ...the right time. · Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. · Assesses services for members to ensure optimum outcomes, cost effectiveness and compliance...Work at officeShift work
Careers Integrated Resources Inc
Troy, MI4 days ago - ...Health Primary Care - Gashland clinic is hiring a Referral/Pre-Authorization Coordinator . If you’re looking for a great opportunity to... ...coordinate outpatient referrals and obtain pre‑certifications or prior authorizations as necessary. Utilize the EMR system to capture...Work at officeMonday to FridayDay shift
NKC Health
Jackson, MI3 days ago
