Average salary: $84,285 /yearly
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- ...Coordinator 1 - 210120 Address: Various, CA, 99999 Job Description Receive and respond to provider and pharmacy calls regarding the prior authorization and formulary process. Perform review of pharmacy and override process in compliance with pharmaceutical related company and...SuggestedFull timeRemote work
A-Line Staffing Solutions
California City, CA1 day ago $137k - $165k
...collaboration. Support: Our dedicated care teams support your practice, allowing you to focus on patient care while they handle prior authorizations, medication refills, insurance, billing, and so much more. Our clinician team provides coverage for each other, so you never...SuggestedMinimum wageWork experience placementWork at officeLocal areaRemote workWork from homeFlexible hoursOptum
Everett, WA6 days ago$19.71 - $26.28 per hour
...organization in Denver is seeking a detailed-oriented team member to evaluate referral and pre-certification requests and assist with prior authorizations. The ideal candidate will possess strong customer service and communication skills, along with knowledge of medical...SuggestedHourly payRemote workAlpine Physician Partners
United States1 day ago- ...Prior Authorization Specialist, Onsite - This is not a remote position HMC Offers: Tuition Reimbursement Excellent benefits - health, dental, vision, and life and disability insurance Quality childcare located on site HMC Wellness Center membership...SuggestedHourly payContract workWork at officeRemote workFlexible hours
Hopedale Medical Complex
United States2 days ago - ...needs, health equity that ensures access to care for all, price transparency to make healthcare more affordable, streamlined prior authorizations for medications, the availability of therapeutic alternatives, health literacy to promote informed decision-making, reduced...SuggestedRemote workShift work
ClinDCast
Delray Beach, FL19 hours ago - ...employees perform various services and duties, including pharmacy administration, pharmacy primary care services, medication prior authorization, sterile and non-sterile compounding, unit dose packaging, and specialty/mail service program. /n /n/n Job Description/n/...SuggestedWork experience placementRemote workShift workWeekend workDay shift
UW Health
Middleton, WI6 days ago - ..., payer portals, and direct insurance carrier communication. Accurate document coverage details, copayments, deductibles, prior authorization requirements, and plan limitations. Prepare and submit claims in a timely and accurate manner. Obtain Authorizations as required...SuggestedWork at officeRemote work
Senior Care Therapy
Franklin, Somerset County, NJ3 days ago - ...Authorization Specialist (Remote) Kolmac Integrated Behavioral Health and Concerted Care Group (CCG) is a leading outpatient treatment... ...office. The Authorization Specialist's main function is to secure prior authorization for our patients from commercial and government...SuggestedWork at officeRemote work
Kolmac Clinic
United States3 days ago Physician / Not Specified / Utah / Locum Tenens / Remote 1099 Utilization Review Work for Physicians
...Week! An active, unrestricted California, Texas or Nebraska medical license are required. We are seeking Family Medicine or Internal Medicine board certified physicians to review Prior Authorizations for treatments, DME requests, SNF admissions, medications, and more.SuggestedFor contractorsLocumRemote workFlexible hoursMRIoA
Salt Lake City, UT18 hours agonew- ...GENERAL SUMMARY: Responsible for verifying patient insurance and benefits and obtaining prior authorization for scheduled medical services and hospital admissions following payer specific guidelines. Responsible for ensuring urgent/emergent cases are worked within...SuggestedWork experience placementWork at office
Bryan Health
Lincoln, NE2 days ago $40.89k - $47.1k
...for accuracy. Reviews case specific information to enter the prior approval for claim adjudication. ~ Resolve complex collections... ...medical claims, denials, rejections, referrals, and prior authorizations. # Preferred Qualifications To Apply: For...SuggestedWork experience placementWorldwideMonday to FridayShift workUniversity of Illinois Chicago
Chicago, IL1 day ago$150 - $180 per hour
...are rendered by qualified medical personnel and medical care meets quality standards. The Medical Director will also lead the prior authorization medical necessity review process and develop utilization management, Case Management, and Disease Management criteria and...SuggestedHourly payContract workWork from homeThe Jacobson Group
San Diego, CA13 days ago- ...to manage their support and services with increased choice and authority. What You'll Do: The Verification Specialist will... ...providers as well as Medicaid billings. Coordinates referrals for prior authorization and services covered. Who You Are:...SuggestedPart timeRemote workFlexible hoursShift workWeekend work
Easterseals
Jamesburg, NJ3 days ago $23.69 - $32 per hour
...Authorization Specialist Ii The 61st Street Service Corporation provides administrative and clinical support staff for ColumbiaDoctors... ...status or denials. Submits appeals in the event of denial of prior authorizations or denial of payment following procedures....SuggestedHourly payFull timeWork at officeLocal areaRemote work61st Street Service Corp
United States2 days ago$140k - $180k
...reports on the IPA side (UM supervisors + coordinator), and play a crucial role in providing operational leadership to the UM/Prior Authorization and Inpatient Teams (50 FTEs in total). Youll be responsible for CMS + Health Plan audits, and ensuring compliance with...SuggestedFull timeRemote workAmi Network
Pasadena, CA16 days ago$11 - $20 per hour
...insurance, enter EOB payments, claims, and investigate insurance-related issues Send/receive email, faxes, dental lab cases, prior-authorizations Coordinate payment plans through third party Complete referral forms Complete deposit slip at the end of the day...Hourly payFull timePrivate practiceWork at officeRemote workMonday to FridayShift workNight shiftWeekend workDay shiftAfternoon shiftComfort Dental
Kansas City, MO2 days ago$100 - $120 per hour
...200~300 patients monthly) Admin Suppor t: Klarity care team will assist practitioners closely on scheduling, billing, prior authorizations, and insurance. Flexible hours : Klarity allows practitioners to see patients on their own schedule with no operation hour...Part timeFor contractorsRemote workFlexible hoursKlarity Health
Santa Monica, CA4 days ago$243.5k
...access to facilities with labs, radiology, physical therapy which are all useful to our patients support staff helping with prior authorizations for various drugs which is needed in Rheumatology work hours are Monday to Friday, in office only no inpatient...Full timeWork at officeMonday to FridayCleveland Clinic
Akron, OH4 days ago- ...Pharmacist Position Our client is looking for multiple Pharmacists with prior authorization experience. This is a remote position so you must have a secure and quiet place to work without interruptions. Responsibilities include evaluating and reviewing all prior authorization...Remote work
ICONMA
Lancaster, PA4 days ago - ...and retrospective chart reviews for clinical utilization and authorization. The Utilization Review Case Manager coordinates with the healthcare... ...and perform timely prospective review for services requiring prior authorization as well as timely concurrent review for...Full timeWork experience placementRemote workWorldwide
University of Miami
Minneapolis, MN4 days ago - ...A prestigious academic healthcare institution is seeking a Prior Authorization UM Case Manager who will manage the prior authorization process for medical services and medications. This role requires a graduate of an accredited nursing program with an RN license in California...Remote work
University of California San Diego
San Diego, CA2 days ago - ...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...Work at officeRemote workWork from homeFlexible hoursWeekend work
Molina Healthcare
Long Beach, CA19 hours ago - ...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
Pharmacy Careers
United States19 hours ago $16 - $27.69 per hour
...routing to the appropriate provider for approval. Manages patient's drug management agreements and updates accordingly. Processes prior authorizations for medications that are not covered by patients' insurance. Performs tasks focused on fostering teamwork and dedication to...Hourly payMinimum wageFull timeWork at officeLocal areaRemote workMonday to FridayShift workMassachusetts Staffing
Worcester, MA3 days ago- ...A leading academic medical center in Miami is seeking an experienced Oncology Prior Authorization Case Manager to work remotely. The role involves conducting utilization reviews and coordinating patient care to ensure efficient healthcare delivery. Candidates should hold...Remote work
University of Miami
United States4 days ago - ...Conduct Utilization Reviews to evaluate the medical necessity of requested dental treatments and procedures Review prior authorization and appeal cases based on clinical guidelines and standards of care Provide objective, evidence-based written determinations...Extra incomeFor contractorsRemote workFlexible hours
Dane Street
New York, NY4 days ago - ...Pharmacist Advisor Location: Fully remote Duration: 06+ months contract Note: Ideal candidates must have experience of Prior Authorization, Medicare Part D and Pharmacy Benefit Management experience. Shift Timing: Business Hours are 7am - 8pm EST Monday - Friday and...Contract workRemote workMonday to FridayShift work
US Tech Solutions
San Antonio, TX3 days ago - ...Prior Authorization Pharmacist Location: Remote The main focus of this position is to ensure that all prior authorizations are processed efficiently and accurately. This role requires a deep understanding of insurance policies and the ability to navigate complex...Remote work
US Tech Solutions
Rochester, NY3 days ago $65k - $78k
...work-life balance, continuous learning, and career development. We are seeking a skilled Utilization Review Nurse to conduct prior authorization, prospective, concurrent, and retrospective reviews for medical necessity and appropriateness of services, following clinical...Full timeContract workWork at officeRemote workWork from homeFlexible hoursIntelyCare
Nags Head, NC3 days 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
Honolulu, HI19 hours ago
