Average salary: $37,629 /yearly
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- ...service member or a military spouse, and you must obtain eligibility to participate in these DOW sponsored programs. The Prior Authorization, Registered Nurse, RN, Intern will report to a manager of the National Medicaid team. You will utilize training and engage formerly...SuggestedFull timeFor contractorsApprenticeshipWork experience placementInternshipRemote workWork from homeHome officeWeekday work
Humana
Providence, RI1 day ago - A healthcare institution in Providence is seeking a responsible individual to manage the prior authorization processes for Adult Ambulatory Services. The role involves working closely with insurance carriers, coordinating necessary authorizations, and ensuring patients...Suggested
$17 - $34.15 per hour
A healthcare service provider is seeking a Prior Authorization Representative to manage inbound calls, assist with the criteria-based prior authorization process, and document reviews accurately. Candidates should have customer service experience and strong communication...SuggestedRemote jobFull timeWork from home- ...Authorization Specialist This position will transition to a hybrid role once the employee is fully trained and receives management approval... ...Friday 9:30 AM-6:00 PM. SUMMARY: Responsible for obtaining prior authorizations, verifying insurance, and the collection of...SuggestedWork at officeLocal areaMonday to FridayFlexible hours
$20.31 per hour
...through the inquirer's concerns which may require research to fulfill the call, such as verifying benefit coverage, creation of a prior authorization case in Highmark's Utilization Management system for Prior Authorization clinical review, status research, etc. Ensures all...SuggestedFor contractorsWork at officeLocal areaHighmark Health
Providence, RI15 hours ago- A confidential managed care organization is seeking a Remote Prior Authorization Pharmacist. This role involves reviewing prescription requests, collaborating with healthcare providers, and ensuring compliance with regulations. Ideal candidates possess a PharmD or Bachelor...SuggestedRemote jobFlexible 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...SuggestedRemote jobWork from homeFlexible hours
$19.03 - $31.39 per hour
...criteria and recommendations to ordering providers Daily review of exams changed due to protocol updates and obtain new order and prior authorization as needed Responsible for approving add-on imaging studies using predetermined criteria as specified by the respective...SuggestedShift work- ...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....SuggestedRemote job
$27 per hour
...candidate will have at least 2 years of clinical experience and be responsible for processing and communicating Commercial Prior Authorizations. Key skills include excellent communication, proficiency in computer applications like MS Office, and the ability to multitask...SuggestedRemote jobHourly payContract work$76k - $85k
...for future health care costs associated with birth-related neurological injuries. Duties and Responsibilities Performs prior authorization, concurrent and retrospective reviews Use clinical documentation and clinical review criteria to make determinations regarding...SuggestedFor contractorsH1bWork at officeLocal areaRemote workPublic Consulting Group
Providence, RI1 day ago- ...submits bills in a timely manner, confirms eligibility, and obtains authorization in accordance with the requirements of third‑party payers.... ...utilizing electronic access when available. Understands prior approval and all authorization requirements and timeframes. Investigates...SuggestedWork at officeImmediate start
- ...to the Medical Assistant scope of education including but not limited to scheduling, check in/out, referrals, chart prep and prior authorizations. Performs administrative duties and covers front desk based on business needs. Floats to other offices based on...SuggestedDaily paidWork at officeFlexible hours
Hartford HealthCare at Home
Westerly, RI15 hours ago - ...prescribed by the team physician/psychiatrist; evaluate and chart medication effectiveness, complications, and side effects. Complete Prior Authorization procedures based on patient’s insurance requirements as needed. Develop and maintain disease or problem-focused patient plans...SuggestedFull timeWork at office
$118k - $206.25k
...Clinical Development Pharmacist will develop clinically and ethically based content for drug coverage programs in support of prior authorization, step therapy, quantity and formulary review programs for CVS Health. The UM pharmacist will participate in the interpretation...SuggestedHourly payFull timeTemporary workWork at officeLocal areaWork from homeFlexible hours- ...ensuring the financial stability of the organization by managing the authorization processes for surgical procedures and patient admissions. This... .... Obtaining timely and accurate authorization information, prior to performing services, reduces claim denials, ensures payer...
- Medication Access Pharmacist Help patients overcome the cost barrier—become their healthcare advocate. Key Responsibilities: Manage prior authorizations and appeal processes. Coordinate with insurance companies, providers, and support staff. Enroll patients in manufacturer...Remote work
- ...of experience as an RN · 1+ years of inpatient hospital experience · Registered Nurse in state of residence · Must have prior authorization utilization experience · Able to work in multiple IT platforms/systems Skills: · MUST HAVE MEDCOMPASS or ASSURECARE...Contract work
US Tech Solutions
Providence, RI4 days ago $50.52k - $83.35k
...families during the referral process. Contacts third party review agencies as necessary to obtain patient-specific information and prior authorization to appropriately advocate for the patient.Updates the patient pharmacy information for patient discharging to SNF.Completes...Work at officeShift workWeekend workBrown University Health
Providence, RI2 days ago$18.13 - $29.9 per hour
...testing as required. Responsible to inform manager of clinical supply needs or assists with ordering. Responsible to obtain prior authorizations and/or insurance referrals as per practice need. Works assigned clinical buckets timely. Must be able to work...Work at officeRemote workMonday to FridayRotating shiftDay shiftLifespan
Providence, RI4 days ago$18.66 - $30.77 per hour
...information is received including patient demographics, insurance and authorizations. Communicates promptly with referring provider and/or... ...by practice protocols and specifically those that require prior authorization (i.e. office, procedural, drug, etc.). Maintains...Work at officeMonday to FridayShift workWeekend work- ...operational efficiency, and patient experience improvements to the DME Coordinator ~ Performs functions required for prior authorization, eligibility, and verification of DME products. ~ Maintain an understanding and cross trained proficiency to assist the...Work at officeLocal area
ORTHOPAEDIC & NEUROSURGERY SPECIALISTS P.C.
Providence, RI2 days ago $18.13 - $29.9 per hour
...information. Provides routine information to callers and gives only authorized medical advice from a provider. Provides a high level of... ...Collects required insurance co-pays from patients including any prior balances. Follows scheduling notes and direct schedules patient...Work at officeMonday to FridayDay shiftBrown University Health
Providence, RI3 days ago$18.13 - $29.9 per hour
...Responsible to inform manager of all clinical or administrative supply needs or assist with ordering. Responsible to obtain prior authorizations and/or insurance referrals as per practice need. Must be able to work independently with little supervision....Work at officeShift workLifespan
Providence, RI3 days ago- ...supplies. Perform general office duties, such as answering telephones, and completing insurance forms. Completing pre authorizations and prior authorizations. Maintain ongoing tracking and appropriate documentation of referrals. Review details and...Full timeImmediate startRelocation packageFlexible hoursDay shift
Wood River Health Services Inc
Hope Valley, RI15 hours ago $17 - $25.82 per hour
SUMMARY The Referral Coordinator reports to the Prior Authorization Supervisor. Under the general supervision, coordinates the effective and efficient patient flow regarding pre‑registration scheduling appointments with specialist and testing per physician request. Obtains...Work at officeShift work$17 - $34.15 per hour
Position Summary The Prior Authorization colleague takes in-bound calls from providers, pharmacies, members, etc. providing professional and courteous phone assistance to all callers through the criteria based prior authorization process. You will maintain complete, timely...Hourly payFull timeTemporary workWork at officeLocal areaWork from homeHome officeFlexible hoursShift work$27 per hour
...2 Months) Pay Rate USD 27 hourly The Licensed Practical Nurse (LPN) will provide processing and communication of Commercial Prior Authorizations (PA) reviewed by the Commercial PA team for Pharmacy benefits. Reporting to the Pharmacy Operations Manager, working with physician...Remote jobHourly payContract workWork experience placementShift work$19.85 - $30.05 per hour
...in providing outcome-oriented care Preferred Skills/Qualifications/Training/Experience: Knowledge and comfort managing prior authorization and referral process Ability to prepare the medical chart including importing medications from pharmacy, preloading vaccines...Full timeWork at office$66.58k - $142.58k
...may or may not be physically present Utilize standardized protocols for medication management, prescription refills and prior authorizations. Conduct thorough and accurate reviews of patient medications and update as needed Provide comprehensive education and...Hourly payFull timeTemporary workLocal areaFlexible hoursCVS Health
Woonsocket, RI1 day ago
