Average salary: $84,285 /yearly
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- ...A leading home infusion service provider in the United States is seeking a Remote Authorization Specialist. This role involves obtaining and maintaining prior authorization for patient medications. Ideal candidates will have at least two years of authorization experience...SuggestedRemote work
New England Life Care
Woburn, MA1 day ago - ...Our Client, a Retail Phamacy company, is looking for a Prior Authorization/Insurance Verification Specialist for their Remote location. Responsibilities: This position takes in-coming calls from members, providers, etc providing professional phone assistance to all callers...SuggestedLocal areaRemote work
ICONMA
Los Angeles, CA2 days ago - ...policies to ensure all the payer required guidelines are met prior to the service being rendered to ensure maximum reimbursment.... ...authorizaiton of services. Responsible for any required retro-authorizations as well as communicating any peer-to-peer review requirements...SuggestedWork experience placementWork at office
Bryan Health
Lincoln, NE1 day ago - ...Schedule M-F Day Shift - 8:30am to 5pm Position Summary An Authorization & Account Verification Specialist reviews radiology orders to verify demographic information, insurance eligibility, review prior?authorization requirements, initiate or verify authorization...SuggestedWork at officeWork from homeDay shift
Advanced Radiology Consultants
Shelton, CT1 day ago $22.14 - $28.78 per hour
...Location: UCHealth Admin Lowry, Denver, CO Department: Pharmacy Authorization Center and Pharmacy Atrium Work Schedule: Full Time, 80.00... ...Technician experience or 1 year of experience performing prior authorizations or refill renewals. Summary:...SuggestedFull timeTemporary workLocal areaRemote workMonday to FridayFlexible hoursShift workUC Health
Denver, CO1 day ago$27 per hour
...deliver accurate benefit estimates, verify coverage, obtain pre-authorizations, and help maximize insurance reimbursement for both the clinic... ...procedures. Obtain Pre-Authorizations: Facilitate the prior authorization process by submitting necessary clinical and coding...SuggestedHourly payFull timeRemote workDrSnip
Seattle, WA23 hours ago$36 per hour
...peace of mind." – LaKita, Health Services Manager What You'll Do Conduct intake assessments and submit documentation for prior authorization based on pay sources Develop care plans with nursing diagnoses, physician input, and measurable goals Review medical...SuggestedPart timeImmediate startRemote workRelocation packageFlexible hoursRotating shiftSevita
Lees Summit, MO23 hours ago$50 - $55 per hour
...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...SuggestedHourly payLocal areaWork from homeFlexible hoursShift work$25 - $28 per hour
...Duration: 24 months Location: Virtual Connecticut 06355 (Remote) Pay Rate: $25 - 28/hr Patient Access Representative The Prior Authorization Representative is responsible for verifying prior authorization requirements and obtaining authorization when required. Works...SuggestedRemote workArtech
Denver, CO4 days ago$37 per hour
...part of the Utilization Management team, primarily responsible for inpatient medical necessity reviews, concurrent reviews, and prior authorization activities. The role ensures members receive the right care at the right time in the most appropriate setting, while...SuggestedRemote workCareers Integrated Resources Inc
Atlanta, GA3 days ago$54k - $70.88k
...setting ~ Experience implementing process improvements ~ Prior healthcare or health insurance experience ~ Proficiency navigating... .... Experience in utilization management and/or prior authorization processes. At Oscar, being an Equal Opportunity Employer...SuggestedFull timeWork at officeRemote workOscar Health
Albuquerque, NM23 hours ago$54k - $70.88k
...setting ~ Experience implementing process improvements ~ Prior healthcare or health insurance experience ~ Proficiency navigating... .... Experience in utilization management and/or prior authorization processes. At Oscar, we cultivate an environment where people...SuggestedFull timeWork at officeRemote workOscar Health
Dallas, TX23 hours ago$24 - $25 per hour
...Customer Service Rep II Location: Virtual CT (Remote) Duration: 24 months Payrate: $24.00-25.00/hr The Prior Authorization Representative is responsible for verifying prior authorization requirements and obtaining authorization when required. Works directly with physician...SuggestedRemote workArtech
Salt Lake City, UT1 day ago- ...Prior Authorization Medical Director Physician Opportunity in the Los Angeles Area Please consider this unique opportunity to join a well-established and respected group of innovators in value-based care. This group of thought-leaders are in search of physician leaders...SuggestedLive inRemote workWork from homeRelocation package
Curative
Los Angeles, CA3 days ago - ...resolve adjudication errors and rejections. Completes pharmacy benefits investigation and coordination, initiates and completes prior authorization approval and/or denials (appeals), tracks progress, expediting responses from insurance carriers and payers, and coordinates...SuggestedWork experience placementWork at officeShift work
VCU Health
Richmond, VA1 day 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). You'll be responsible for CMS + Health Plan audits, and ensuring compliance with...Part timeRemote workAmi Network
Pasadena, CA1 hour agonew$60 - $68 per hour
...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...Hourly payRemote workShift work$65 - $70 per hour
...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...Hourly payRemote workShift work- ...email addresses and telephone numbers, including their relationship to the candidate. References will not be contacted without prior authorization from the candidate. Please direct any nominations, expressions of interest, or questions regarding the application process...Full timeRelocation packageFlexible hours
AGB Search
Belmont, CA1 day ago - ...locum assignment with the hope that the provider will transition into a permanent role. Responsibilities: ~ Reviews prior authorization and appeals request for approval or denial of claims payment based on medical necessity. ~ Performs peer to peer...Permanent employmentLocumLocal areaRemote workWeekend work
Med Ninjas
Dallas, TX23 hours ago - ...no exceptions) NPDB - REQUIRED Texas Medical License (or willingness to obtain) Experience in Managed Care & Prior Authorization - REQUIRED Experience in Utilization Management committees - PREFERRED Knowledge of Texas Medicaid Regulations...Permanent employmentLocumLocal areaImmediate startRemote workMonday to Friday
RecruitWell LLC
Dallas, TX23 hours ago - ...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 areaRemote work
GSK LLP
Shreveport, LA23 hours ago $68.9k - $93.2k
...preferred Skills and Attributes: Demonstrated knowledge of claims processing systems, Cambia systems (medical claims, prior authorization, PBM vendor systems), MS Office products, and other corporate software; ability to implement and support RFP data management...Immediate startWork from homeFlexible hoursCambia Health Solutions
Oklahoma City, OK23 hours ago- ...use of resources and appropriateness of care. Case review types include workers' compensation, disability, and health plan prior authorizations and appeals. As part of our reviewer network, you would provide evidence-based medical reviews regarding subjects such as...For contractorsRemote workFlexible hours
ExamWorks
New York, NY1 day ago - ...Physicians, who are licensed in Minnesota to join our industry-leading peer review panel to conduct Medical Claims Reviews and Prior Authorization Reviews.Review cases from your home or office anywhere in the USA, around your current clinical activities typically 2-5...Work at officeRemote work
Medical Review Institute
West Valley, UT2 days ago $39k
...level utilization review for all inpatient and outpatient services requiring authorization: Prospective Review Urgent/ Non-urgent, Concurrent Review and Retrospective Review. Completes prior authorizations as appropriate in a timely manner. Conducts an initial...Full timeContract workRemote workeQHealth Solutions
Doral, FL2 days ago$16 - $27.69 per hour
...phone calls per day from members and identify the type of assistance needed. Will be taking calls to verify benefit coverage, prior authorization approval, checking on status of prior authorization and educating members on appeal option. Ask appropriate questions and...Hourly payMinimum wageFull timeWork experience placementLive inWork at officeLocal areaRemote workMonday to FridayShift workCPS Solutions , LLC
Costa Mesa, CA2 days ago- ...conjunction with MTF Physical Evaluation Board Liaison Officer and MTF monitors). Verifies appropriate paperwork is on file prior to authorization. Initiate, receive, and coordinate, (telephone/computer/written), communication between beneficiaries, team members,...Full timeContract workLocal areaRemote work
Cherokee Federal
Anchorage, AK3 days ago $106.9k - $147k
...technical orchestrator for new client partnerships. You will not author detailed technical designs, but you must deeply understand... ...understanding of pharmacy operations, PBM models, benefits coordination, prior authorization workflows, and specialty care dynamics...Full timeTemporary workApprenticeshipRemote workWork from homeHome office$150k - $170k
...Job Description Job Description Reporting to the Director of Clinical Operations, the Nurse Manager, Prior Authorizations, provides clinical and operational leadership to the Prior Authorizations (PA) team within the Utilization Management (UM) function. You will...Work at officeRemote workSan Francisco Health Plan
San Francisco, CA15 days ago
