Average salary: $42,500 /yearly
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- ...Utilization Review Specialist in Roseburg, Oregon. This full-time role involves supporting the medical management team with prior authorizations. Responsibilities include managing documentation, communicating with providers, and ensuring compliance with regulations. Candidates...SuggestedFull time
$22 - $32 per hour
...patients by navigating insurance portals and obtaining necessary authorizations for treatment. Key responsibilities include reviewing medical... ...have a high school degree and a minimum of three years of prior authorization experience. The position offers a salary range of...SuggestedHourly payFull time$23 - $25 per hour
...Boulder Care**, located in Portland, Oregon, is looking for a Prior Authorization Specialist. In this role, you will ensure patients receive timely medication approvals by obtaining insurance prior authorizations and troubleshooting submissions with healthcare providers...SuggestedHourly payRemote work- ...A healthcare facility is seeking a Prior Authorization Specialist in Eugene, Oregon. This role involves managing insurance approvals for medical and ancillary services while ensuring accurate submissions of clinical documentation. The ideal candidate will have 2 to 5 years...Suggested
$2,412 per week
.../Rehab/Skilled Nursing*, NCQA (National Committee for Quality Assurance)*, Needs Assessment/ Order DME, OSHA, Plan of Care, Prior Authorizations, The Joint Commission/ Core Measure/National Safety Goals Unit Details Staffing & Scheduling Scheduling Type : block Patient...SuggestedDaily paid16 hoursPermanent employmentFull timeContract workTemporary workLocal areaShift workNight shiftWeekend work$2,412 per week
.../Rehab/Skilled Nursing*, NCQA (National Committee for Quality Assurance)*, Needs Assessment/ Order DME, OSHA, Plan of Care, Prior Authorizations, The Joint Commission/ Core Measure/National Safety Goals Unit Details Staffing & Scheduling Scheduling Type : block Patient...SuggestedDaily paid16 hoursPermanent employmentFull timeContract workTemporary workLocal areaShift workNight shiftWeekend work- ...Health Care is seeking an Insurance Verification Specialist who will verify insurance for incoming referrals and coordinate prior authorization requirements. The ideal candidate should possess extensive knowledge of Medicare, Medicaid, and Commercial Products, alongside...SuggestedWork at office
- ...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
- Insurance Verification Specialist Responsibilities & Duties: Verifying insurance for incoming referrals. Communicate prior authorization and referral requirements and request when necessary. Work with billing team on post-authorizations. Request single case agreements...SuggestedWork at office
$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$22 - $32 per hour
...by navigating insurance portals and obtaining all appropriate authorizations. With a focus on authorizations for infusion drugs, radiation... ...rate is dependent on many factors, including but not limited to: prior work experience, education, job/position responsibilities,...SuggestedFull timeWork experience placementWork at officeShift work- ~ Submits, tracks, and manages prior authorization requests for medical and ancillary procedures, within strict timeframes. ~ Researches and resolves authorization and referral claim denials, while coordinating with physicians, providers, and insurance payers to file...SuggestedWork at officeRemote work
- ...A confidential managed care organization is seeking a Remote Prior Authorization Pharmacist to evaluate prescription requests and improve patient access to therapies. This fully remote position allows pharmacists to build expertise in managed care. Responsibilities include...SuggestedRemote workFlexible hours
$301.4k - $335k
...first model that lets you reclaim your time and passion for medicine. What does this look like for your practice? ~ No prior authorizations. Seamless collaboration with specialty care ~ No call. You can unplug while team physicians cover your patients and your...SuggestedPart timeImmediate startRelocation package$2,734 - $2,889 per week
...contribute to population-based disease management and policy development. You will conduct drug utilization reviews, support prior authorizations and care coordination, and craft patient-specific medication action plans while communicating recommendations clearly to...SuggestedContract workTraineeshipRemote workWork from homeFlexible hoursShift workWeekday work- ...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
- ...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 work
$121.6k - $164.5k
...value in efficacy, safety and affordability. This may include providing coverage recommendations for medications subject to prior authorization, appeals, retrospective claim reviews, and audits based on applicable medication coverage policies, member benefit contracts,...Immediate startRemote workWork from homeFlexible hours$85.99k - $105.34k
...Utilization Review Nurse for a full-time remote position. The role involves evaluating clinical service requests, conducting prior authorization reviews, and collaborating with interdisciplinary teams. Applicants should have an active RN license and at least five years...Full timeRemote work$49.34 - $76.59 per hour
A leading healthcare organization is seeking a Utilization Review RN for a fully remote role in Oregon. Candidates must hold an Oregon Registered Nurse License and have at least 5 years of clinical nursing experience, particularly in collaboration with physicians. This...Remote work$23.16 - $31.26 per hour
...insurance, or other payment types. Verifies coverage and ensures all insurance requirements are met, as well as obtaining all prior authorization and/or referrals as appropriate prior to patient arrival. Responds to customer’s inquiries. Assists with departmental...Daily paidWork at officeLocal area$41.6k - $47k
...Utilization Review Specialist provides support to the Umpqua Health Alliance (UHA) for the intake, processing and finalization of all prior authorizations received by Medical Management in compliance with regulatory requirements. Essential Job Responsibilities Provide support...Full timeWork at officeLocal areaImmediate startRemote workMonday to FridayFlexible hoursShift work- ...personal computer and various software programs applicable to the position* Demonstrates basic understanding of insurance and prior authorization requirements.* Demonstrate knowledge and skills needed to provide appropriate levels of service to Radiology customers in...Full timeWork at officeShift workDay shift
- ...from an accredited program. OR an equivalent combination of training and experience. Desired Attributes Experience submitting prior authorization requests for Medicaid billing. Ability to apply administrative rules for audit and quality assurance. Experience...
$24.42 - $29.91 per hour
...days. Enter information in the system for reverse billing Complete the third-party billing form and contact the Provider if prior authorization is required Perform other duties as assigned Perform clinical responsibilities in alignment with The Joint Commission (...InternshipWork at office$20.5 - $22.5 per hour
...referrals at the request of the providers, obtains/reviews pre‑authorization/pre‑certification, and coordinates communications with... ...Resolve pre‑certification, registration and case‑related concerns prior to a patient’s appointment. Gather pertinent information from...Work at officeLocal areaRemote workMonday to FridayFlexible hours- ...experience within relevant practice setting Required Skills 3+ Years in a Managed Care Environment Required (meaning dealing with Prior Authorizations, Audits, Appeals, ALJ Court hearings, etc) Experience in writing, including research protocols, medical papers for...Contract workRemote workShift work
- ...in OR, WA, or CA required PGY-1 Residency OR equivalent clinical experience required Minimum 3 years managed care experience (prior authorization, audits, appeals, drug utilization review, etc.) Strong knowledge of clinical pharmacy, pharmacotherapy, and evidence-based...Contract workWork at officeShift workWeekend workDay shift
$23.43 - $33.5 per hour
...such as initial patient registration, scheduling evaluation(s), referral, insurance authorization, charge and coding review. Key Responsibilities Processing of all referrals and prior authorizations to ensure timely handling in order to meet the department’s financial...Work at office$17.98 - $32.12 per hour
...improving prescription capture, providing follow-up counseling, and ensuring smooth communication. Key duties include processing prior authorizations, assisting with financial aid, updating clinical data, and supporting administrative tasks. The liaison collaborates closely...Hourly payMinimum wageFull timeWork experience placementWork at officeLocal area


