Average salary: $73,171 /yearly
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$20.31 - $30.12 per hour
A leading healthcare provider is seeking a customer service representative in Lansing, Michigan. This role involves handling inbound phone inquiries for utilization management review, ensuring compliance and accurate data entry. Candidates must have at least three years...Suggested- A prominent educational institution in Michigan seeks a Prior Authorization Specialist for its healthcare team. This role involves facilitating referrals, processing prior authorizations efficiently, and working closely with patients and healthcare providers. Candidates...SuggestedHourly payFull timeTemporary work
- ...related to pharmacy benefits and customer coverage. Responsibilities include verifying patient eligibility, assisting with prior authorizations, and providing exceptional service to patients and healthcare providers. Ideal candidates will have a high school diploma and...SuggestedRemote job
- ...for biologics medications. Navigates the complexities with the insurance companies and the pharmacies in order to obtain prior authorizations quickly. Is also able to appeal decisions as needed. Keeps up with manufacturer recommendations, formulary changes, claim...SuggestedWork at office
West Michigan Dermatology
Grandville, MI1 day ago - A leading healthcare practice is seeking a Medical Authorization Specialist in West Bloomfield, MI. This hybrid role includes managing prior authorization requests and ensuring accurate documentation for surgical procedures. Candidates should have at least 1-2 years of...Suggested
$18.5 - $42.35 per hour
...leading healthcare provider is looking for a Business Configuration Sr. Coordinator to oversee the operational development of prior authorization criteria. The role entails managing configuration data and collaborating with various teams to ensure project success....SuggestedHourly pay$23.82 per hour
Prior Authorization Specialist - UW Medicine Primary Care at Northgate Join to apply for the Prior Authorization Specialist - UW Medicine Primary Care at Northgate role at University of Washington Job Description Full‑time, 100% FTE (40 hours per week) Monday - Friday...SuggestedHourly payFull timeTemporary workWork at officeMonday to FridayShift workDay shiftAfternoon shift- ...all calls are handled or routed as appropriate. (10%) Processes the insurance company authorization per the preferred method (electronic, fax, telephone) for any referral requiring prior authorization. Notifies specialist office or testing facility of prior auth approval...SuggestedFull timeWork at officeFlexible hoursWeekend workAfternoon shift
Great Lakes Bay
Saginaw, MI5 days ago $26.41 - $61.79 per hour
...eligibility, benefits, and expected length of stay for requested treatments and procedures. Conduct thorough reviews to determine prior authorization and financial responsibilities. Process requests promptly within the required timelines. Refer complex cases to medical...SuggestedHourly payWork experience placementWork at officeMolina Healthcare
Grand Rapids, MI5 days ago- ...professional to train employees on Aria and Beacon EHR systems at the West Branch Infusion Center. This role includes obtaining prior authorization for chemotherapy and radiation treatments, as well as testing system upgrades. Candidates should have a high school diploma,...SuggestedWork at office
$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
Grand Rapids, MI2 days ago$21 per hour
...support highvolume inbound calls for a leading organization in the pharmacy benefits industry. You'll answer questions about prior authorizations, benefits, prescription coverage, and other confidential healthcare inquiries. This position offers *industryleading...SuggestedPermanent employmentFull timeContract workTemporary workFor contractorsMonday to FridayShift workTEKsystems
Plymouth, 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...SuggestedFull timeWork at office
West Michigan Dermatology
Grandville, MI4 days ago - Responsibilities Obtain prior-authorization for medications, including specialty and Hepatitis B & C medications. Obtain prior-authorization for radiology, CT/US Guided biopsies, Paracentesis and Capsule Endoscopies. Schedule, review and mail instructions and medications...Suggested
- ...Identify benefits, eligibility, and expected lengths of stay for requested treatments/procedures. Conduct reviews to establish prior authorization and financial responsibilities for our members. Process requests promptly to meet required timelines. Refer complex...SuggestedWork at office
Molina Healthcare
Warren, MI3 days ago - ...Position Summary Daily clinical Nurse Clinician I duties will include, but are not limited to, RN triage, medication refills, prior authorizations, referrals, buckets (labs, orders etc,) administering medications as well as pre and post operative care of patients and...Temporary work
Michigan State University
East Lansing, MI1 day ago - ...insurance information. Obtains pre-certifications and insurance authorizations for medical procedures. Generates referral information for... ...MINIMUM EXPERIENCE: 4 years' experience with insurance referrals, prior authorization or other relevant medical office experience....Work at officeWork from home
Trinity Health
Ann Arbor, MI22 hours 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
$174.07k - $374.92k
...precertification, concurrent review, and appeal request. This position is primarily responsible for Utilization Management, including prior authorization as well as concurrent review. Cases could focus on inpatient or outpatient services, acute and post acute services, pharmacy,...Hourly payFull timeTemporary workLocal areaWork from homeFlexible hoursWeekend work- ...candidate will have a minimum of 3 years of customer service experience and must be a registered pharmacy technician. Key responsibilities include handling medication insurance coverage and prior authorization processes to ensure client satisfaction. #J-18808-Ljbffr Meijer Inc.Remote jobFull timeFlexible hours
- ...organization is seeking a Utilization Management Coordinator to support clinical teams with essential tasks for processing prior authorizations and appeals. The role emphasizes strong organizational skills and adaptability in a dynamic environment, making a significant...Remote job
- 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 jobFlexible hours
- ...pharmaceutical/medical sales. Preferred specialty sales experience calling on pediatrics and psychiatrist. Knowledge of working with prior authorizations/steps as well as pharmacy pull-through is also preferred. Must be authorized to be employed in the United States and must...Flexible hours
- ...the hiring process. Maintain accurate and up-to-date employees Requirements Prior experience in a healthcare setting preferred Hiring, Recruiting experience Prior experience in authorizations Strong organizational and communication skills Attention to detail and ability...
- ...% to eliminate holds and keep the hospital financially viable.Communicate relevant data to clinical liaisons, case managers, prior authorization team, and physicians to help prepare for admission.Point of coordinator on day of admissions to guarantee that all equipment,...Full timeMonday to FridayDay shift
Select Medical
Saginaw, MI10 hours ago - ...operatory and storage room. Informs the individual in charge of ordering of any supplies needed. # Completes and submits Medicaid prior authorizations. Maintains detailed spreadsheets logging and tracking prior authorizations and referrals. Note: This job description is...Full timeApprenticeshipInternshipWork at officeRemote workFlexible hours
Great Lakes Bay
Owosso, MI2 days ago - ...and other non-routine questions. Educates customers on drug formulary guidelines, including drug formulary alternatives and prior authorization criteria. Consistently create an exceptional experience with each contact, via inbound and outbound calls, face-to-face interactions...Full timeWork at officeMonday to FridayShift workWeekend work
Corewell Health
Grand Rapids, MI5 days ago $20.31 per hour
...through the inquirer's concerns which may require research to fulfill the call, such as verifying benefit coverage, creation of a prior authorization case in Highmark's Utilization Management system for Prior Authorization clinical review, status research, etc. Ensures all...For contractorsWork at officeLocal areaHighmark Health
Lansing, MI5 days ago- ...within the EMR or via phoneEnsure the clinic runs smoothly by assisting with various administrative and clinical tasks such as prior authorizations, scribing, and patient schedulingWhat You Bring:High School Diploma or GED is requiredCertified Medical Assistant (CMA)...
Clarkston Medical Group
Clarkston, MI22 hours ago $16 - $18 per hour
...strong organizational skills, excellent customer service, and prior medical office experience. Key Responsibilities: Greet and check... ...reminder and follow-up calls to patients. Assist with prior authorizations as needed. Maintain accurate patient records and ensure confidentiality...Hourly payWork at officePMC Medical
Flint, MI22 hours ago
