Average salary: $119,085 /yearly
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- A leading healthcare solutions provider in Dublin, Ohio is seeking a Senior Coordinator for Prior Authorization. This role focuses on obtaining and tracking payer approvals for durable medical equipment orders, ensuring adherence to HIPAA regulations. The ideal candidate...SuggestedHourly pay
- A growing healthcare staffing agency is seeking a detail-oriented Remote Prior Authorization Support Clerk. This position involves gathering clinical documents for insurance prior authorizations, submitting requests, and ensuring HIPAA compliance. The ideal candidate will...SuggestedRemote job
- Overview PHIL is looking for a full-time Prior Authorization Specialist with a focus on pharmacy support for Monday through Friday shifts. About The Company: Founded in 2015, PHIL is a San Francisco-based Series D health-tech startup, pioneering the first Software Therapy...SuggestedFull timeWork at officeRemote workMonday to FridayShift work
- A growing healthcare staffing agency is seeking a detail-oriented Remote Prior Authorization Coordinator. This role involves reviewing documentation, submitting authorization requests, and communicating with clinics to ensure timely patient care. Applicants should have...SuggestedRemote job
$19.01 - $24.19 per hour
A leading healthcare company in Columbus, Ohio is seeking a candidate responsible for completing Prior Authorization tasks involving outbound calls and case creations. The role requires no prior experience but prefers individuals with customer service, call center, or healthcare...SuggestedRemote jobHourly payWork at office$48k - $50k
A healthcare service provider is seeking a Central Intake Prior Authorization Specialist based in Westerville, Ohio. This role focuses on managing multi-facility referrals and supporting admissions for skilled nursing facilities. Candidates should have experience in admissions...SuggestedMonday to Friday$59.3k - $80.9k
...issue resolution, including, where necessary, collaboration with appropriate enterprise business teams (ex., claims payment, prior authorizations & referrals). Work with internal resources and systems (e.g., claims, reimbursement, provider enrollment) to provide the...SuggestedFull timeContract workTemporary workApprenticeshipWork at officeRemote workWork from homeRelocationHome office- ...for verifying benefits and/or obtaining pre-certification/pre-authorization for all exams scheduled at the facility. Assists with coordinating... ...center including pre-screening and preparation instructions prior to and after patient arrival. Handles correspondence regarding...SuggestedWork at officeAll shiftsShift workRotating shiftWeekend work
- ...operations of the Claims Adjudication Center (real time-Adjudication) Work in cohesion with the Claims Intervention Center, Prior Authorization, and Billing Departments Adress Batch/Claim submissions and corrections Ensure accurate and timely processing of real time claims...SuggestedFull timeRemote work
- ...the adjudication process.**Key Responsibilities Include but are not limited to:*** Work in cohesion with the CIC Department, Prior Authorization, and Billing Departments* Submit claims and add appropriate corrections* Ensure accurate and timely processing of real time claims...SuggestedFull timeRemote workNight shiftWeekend work
- ...If you've worked in front-end intake, operations compliance, authorizations submission, clinical review, or audit/appeals review in the specialty... ...and immunology, etc.) ~ Experience with audits, prior authorizations, and appeals is a strong plus ~ Familiarity with...SuggestedWork at officeRemote work
Tennr
Cleveland, OH5 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
Cleveland, OH3 days ago - ...no call Infusion center in Cancer Center on main campus in Gallipolis Access to Holzer specialty pharmacy assists with prior authorizations In-office pharmacist for patient education and prior authorizations Opportunity to work with residents and medical...SuggestedWork at officeRelocation package
Holzer Health System
Gallipolis, OH2 days ago - ...What will you do? Will work with supervisor for assignments in all the areas within the division that include Prior Authorization (PA), Nursing Tasking Inventory (NTI), State Funded Behavioral Add-on (SFBAO) and perform all duties of the RPS2. Reviewing assessments...SuggestedFull timePart timeWork at officeImmediate startWork from home
Ohio Department of Commerce
Columbus, OH5 days ago $38.2k - $51.6k
...objectives. Other duties, as assigned as they relate to complaints and grievances. Previous experience in claims billing or prior authorizations. Bachelor's degree in business, healthcare or equivalent. Keyboarding skills. Salary Range: $38,200 - $51,600. At our...SuggestedWork at officeLocal areaFlexible hours$21.65 - $28.82 per hour
...adhering to departmental policies, state regulations, and quality assurance guidelines. Facilitate the processing of pharmacy prior authorization requests and appeals. Provide clear explanations of claims adjudication processes and relevant policies to various...Hourly payWork experience placementWork at officeShift workMolina Healthcare
Akron, OH2 days ago$100.7k - $155.1k
...may vary. Activities may include, but are not limited to: Review patient insurance benefit options with appropriate authorizations Validate prior authorization requirements Understanding of Specialty Pharmacy processes Educate provider office staff and practice managers...Full timeWork at officeLocal area- ...experience doesn’t match every requirement. About the role The Pre-Certification Nurse is responsible for all aspects of the prior authorization process for members of Quantum Health’s employer groups. The nurse is responsible for acquiring all clinical documentation to...Permanent employmentFull timeCasual workWork at officeWork from home
quantum-health
Dublin, OH25 minutes ago - ...responsibilities, including inputting templates and chart notes as directed by physicians. Process prescription refills and manage prior authorizations. Log pathology samples and coordinate with appropriate laboratories. Operate specialized equipment such as Narrowband...Work at officeLocal area
PhyNet Dermatology LLC
Mason, OH4 days ago - ...directed via phone and EMR. Assist with applicable forms and patient paperwork (not limited to processing of referrals, prior authorizations.). All other duties as assigned. QUALIFICATIONS: To perform this job successfully, an individual must be able to perform...Full timeMonday to FridayNight shift
- We’re looking for a detail-oriented and motivated Remote Prior Authorization Coordinator to join New Paradigm Staffing, a growing healthcare staffing agency focused on remote clinical and insurance support roles. This role is perfect for someone who enjoys reviewing documentation...Remote job
$26.41 - $61.79 per hour
...services by assessing medical necessity and adherence to guidelines. The role involves analyzing service requests, determining prior authorizations, and collaborating with teams for optimal patient outcomes. Candidates should have at least two years of relevant experience...Hourly pay- A leading academic medical center in Columbus, Ohio is seeking a Pharmacy Authorization Coordinator. This entry-level, full-time position includes managing prior authorization requests and educating clinical staff on trends in denials. The ideal candidate must hold an active...Full time
- ...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....Remote job
$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 cases to...Remote jobHourly payWork experience placementWork at office- ...healthcare navigation organization in Dublin, OH is seeking an RN for the Pre-Certification role. Responsibilities include managing prior authorization processes, coordinating patient care services, and working closely with clinical teams. Candidates must hold an active RN...Full time
$26.01 - $62.32 per hour
...after approx 4-5 months of training Monday - Friday 8:30-5pm EST with occasional holiday rotation. Preferred Qualifications Prior Authorization or Utilization Management experience. Managed care experience. Experience using MedCompass. Ambulatory surgery experience....Hourly payFull timeTemporary workWork at officeLocal areaMonday to FridayFlexible hoursShift workWeekend workAfternoon shift- ...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
- 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
- ...compliance with clinical guidelines and provide member services. Responsibilities include analyzing service requests, conducting prior authorizations, and collaborating with teams for optimal member outcomes. Requires active RN license and at least 2 years of healthcare...Hourly pay
