Average salary: $119,085 /yearly
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$20.31 - $30.12 per hour
A healthcare provider in Columbus, Ohio, is seeking a dedicated individual to manage inbound phone inquiries for utilization management review. The role includes assessing requests, verifying benefit coverage, and ensuring compliance with regulations. The ideal candidate...SuggestedWork at 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
Genesis HealthCare System (ohio)
Somerset, OH3 days ago - A major educational institution in Ohio seeks a Prior Authorization Coordinator to handle complex medical necessity denials and support reimbursement for oncology services. The role involves providing clinical education to payers and working closely with various departments...SuggestedDay shift
- A prominent educational institution in Columbus, Ohio, is seeking a Prior Authorization Coordinator to manage complex denials in the oncology department. Responsibilities include providing clinical education to payers, supporting clinicians with evidence-based therapies...SuggestedFull time
- ...Patient Account Coordinator Coordinates patient accounts from prior authorization to point of bill payment or referral to collection, including processing billing for home health agencies to appropriate agencies, including Medicaid and self-pay. Maintains current knowledge...SuggestedFlexible hours
$300 per month
...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...SuggestedFull timeMonday to FridayDay shiftSelect Specialty Hospital
Cleveland, OH23 hours ago- ...verification for patients with medical or auto insurance as well as authorizations. Essential job functions: Greets, screens, schedules,... ...system according to physician and office protocol. Obtain prior authorization for patients and verify all insurance based on...SuggestedWork at office
Ortho Louisville
Cincinnati, OH2 days ago - ...leading healthcare company is seeking a Business Configuration Sr. Coordinator to oversee the development and performance of prior authorization criteria. The role involves managing projects related to configuration data and collaborating with cross-functional teams within...Suggested
$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
Cleveland, OH5 days ago- ...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...SuggestedFlexible hours
Alora Pharmaceuticals, LLC
Cleveland, OH5 days ago - ...documents actions taken and activities performed Provides continuity of care to each patient and their family members Completes Prior Authorizations/Pre-Certification for procedures for that patients are referrals This job description is not designed to cover or contain a...SuggestedCasual workWork at officeLocal areaMonday to Friday
Heart of Ohio Family Health Centers
Columbus, OH23 hours ago - ...sending all referrals to Specialists via fax and/or by phone if needed. Completes requests for specialty care ensuring any prior authorizations are obtained. Calls patients to notify them of the referral and follow-up as well. Maintains patientfiles in EHR and electronic...SuggestedHourly payFull timeAfternoon shift
Rocking Horse Center
Springfield, OH23 hours 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...SuggestedWork at officeLocal area
PhyNet Dermatology LLC
Mason, OH3 days ago $34.01 - $58.5 per hour
...patient discharges, makes post discharge phone calls to ensure patient is doing well and has what they need for success. Obtain prior authorizations for swing bed patients, maintain the work ques, and address denials. RMH: make follow up appointments with primary care...SuggestedWork experience placementLocal areaShift workCarle Health
Urbana, OH12 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- ...as 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 each...Full timeMonday to FridayRotating shift
- ...right place and time. Provides daily review and evaluation of members requiring hospitalization and/or procedures, including prior authorizations and/or concurrent review. Assesses services for members to ensure optimal outcomes, cost-effectiveness, and compliance with...
$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...Hourly payWork experience placementWork 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- ...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
$45.43 - $101.54 per hour
A healthcare company is seeking a Clinical Pharmacist to handle prior authorizations in a fully remote position. Responsibilities include reviewing cases, collaborating with colleagues, and providing client support. Applicants must have an active pharmacist license, a...Remote jobHourly pay- ...businesses/agencies are required to contact GSK's commercial and general procurement/human resources department to obtain prior written authorization before referring any candidates to GSK. The obtaining of prior written authorization is a condition precedent to any...Local area
- A leading healthcare solutions provider is seeking a Manager, Preservice Review to oversee daily operations of prior authorization reviews. The role involves training nursing staff, ensuring compliance with regulatory requirements, and optimizing performance within the...Remote jobWork at office
$26.01 - $56.14 per hour
...platforms/systems 1+ year of experience with Microsoft Office Applications (Outlook, Teams, Excel) Preferred Qualifications Prior authorization utilization experience preferred Outpatient clinical experience Knowledge of Medicare/Medicaid Managed care experience...Hourly payFull timeTemporary workWork at officeLocal areaRemote workWork from homeFlexible hoursShift workAfternoon shift- ...building a general neurology practice at OBleness Hospital Highly supportive staff who manage clerical duties including prior-authorizations, routing of referrals and orders, patient phone calls, etc. No stroke call is required; tele neurology responds to all acute...Work at office
OhioHealth
Athens, OH1 day ago - ...in EHR system. Supports Program Coordinator with program issues and process adherence/risk management. Assist with prior authorizations for treatment. Performs program prescreen on patients. Calls to check on patients after initiation of treatment...Live outLocal area
Lower Lights Christian Health Center
Columbus, OH1 day ago - ...oversees, and counsels clinical employees in the performance of task related to Due Process and Prior AuthorizationsFormulates training material for Due Process and Prior Authorizations and conducts training for Clinical Team as necessaryProvides guidance to staff related to...Full timeLocal areaRemote workWork from home
CareStar
Hamilton, OH23 hours ago - ...anticipate at least 50% of volume would come from headache patients. Highly supportive staff who manage clerical duties including prior-authorizations, routing of referrals and orders, patient phone calls, etc. Majority outpatient position with some inpatient coverage....
OhioHealth
Pickerington, OH1 day ago $115k - $145k
...Strong account based selling skills with demonstrated success in prior sales roles ~ Working knowledge of strategies and tactics to... ...pull-through local formulary wins. ~ Understanding of prior authorization process and experience partnering with key healthcare...Work at officeLocal areaCollegium Pharmaceutical, Inc.
Dayton, OH4 days ago- ...periodicals, flyers, and handouts. Assist with applicable forms and patient paperwork (not limited to processing of referrals, prior authorizations or pre-certifications, etc.). Respond to patient phone calls, as appropriate. Maintain a clean and well-organized work...Full timeMonday to FridayDay shift
Central Ohio Primary Care
Columbus, OH4 days ago
