Average salary: $37,629 /yearly
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- ...including coordination between providers, insurance verification, authorization processing, and scheduling. This position requires experience... ...NextGen EHR system Verify insurance coverage and obtain prior authorizations for services Schedule patient appointments when...SuggestedFull timeFlexible hours
East Bay Community Action Program (EBCAP)
Barrington, RI19 days ago $37.66 - $44.33 per hour
...Working under technical direction and within significant limits and authority, adjudicate workers' compensation claims of higher technical... ...400. Notice to Recruitment Agencies: Resumes submitted without prior authorization will be considered unsolicited. Our company will...SuggestedHourly payTemporary workRemote work$16.75 - $21.75 per hour
Cardinal Health is looking for a Senior Coordinator, Prior Authorization, to manage payer approvals for durable medical equipment orders. Responsibilities include preparing and submitting prior authorization requests, following up with payers, and ensuring compliance with...SuggestedRemote jobHourly pay- ...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 workFlexible hours
Pharmacy Careers
Providence, RI1 day ago $50 - $53 per hour
...may vary., RI Contract Job Description: ~ This position is responsible for reviewing and completing criteria based on prior authorization as per policy and procedure. Responsibilities: ~ Reviewing and completing criteria based on prior authorization as per...SuggestedHourly payContract workUS Tech Solutions
Providence, RI3 days ago- ...Opportunity Duration: 6+ months contract Job Description: Responsible for reviewing and completing criteria based on prior authorization as per policy and procedure. Responsibilities: This individual must have excellent interpersonal skills. Will be...SuggestedContract workRemote work
US Tech Solutions
Providence, RI2 days ago - ...: ~ The clinical pharmacist is an operation based role that conducts clinical reviews of medical data collected to perform prior authorization for specialty medications. The clinical pharmacist will apply clinical knowledge to plan approved criteria for prospective and...SuggestedContract work
US Tech Solutions
Providence, RI21 hours ago - ...Contract 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...SuggestedContract workRemote workMonday to FridayShift work
US Tech Solutions
Providence, RI3 days ago $53 - $58 per hour
...Summary: The clinical pharmacist is an operation based role that conducts clinical reviews of medical data collected to perform prior authorization for specialty medications. The clinical pharmacist will apply clinical knowledge to plan approved criteria for prospective...SuggestedHourly payContract workWork experience placementUS Tech Solutions
Providence, RI21 hours ago$138k - $198k
...leading broker and client engagement, making pricing and underwriting decisions, and managing deals end-to-end within established authority. The ideal candidate thrives in a fast-paced environment, demonstrates strong judgment and commercial acumen, and effectively balances...SuggestedFull timeFor contractorsWork at officeFlexible hoursFM
Johnston, RI5 days ago$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
- A healthcare organization in Warwick, Rhode Island, seeks a Financial Clearance Specialist to manage authorization processes for surgical procedures and patient admissions. You will play a vital role in evaluating payer policies and ensuring compliance with regulations...Suggested
- ...submits bills in a timely manner, confirms eligibility, and obtains authorization in accordance with requirement of third-party payers. Conducts... ...utilizing electronic access when available. Understands prior approval and all authorization requirements and timeframes. Investigates...SuggestedWork at officeImmediate start
$20 - $23 per hour
...verify all surgical procedure times, finalize patient logistics, and act as a liaison with O.R. staff. Secure all required prior authorizations and confirm insurance benefits for all scheduled cases. Deliver comprehensive pre-operative instructions to patients and...SuggestedHourly payWeekly payTemporary workLocal areaImmediate startCity Personnel
East Greenwich, RI12 days ago- ...answering inbound phone calls, processing cases and electronic authorizations, loading authorizations, and making follow-up phone calls... ...management, and reporting. Experience: · Review criteria-based prior authorizations following policy and procedure. · Provide on-...Contract workRemote workWork from homeShift work
US Tech Solutions
Providence, RI1 day 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 jobWork from homeFlexible hours
$18 - $19 per hour
...hour Remote, RI Contract Job Description: The Tech I Prior Auth takes in-bound calls from providers, pharmacies, members,... ...assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation...Hourly payContract workRemote workUS Tech Solutions
Providence, RI3 days ago$115.2k - $158.4k
...Research, understand and apply laws, regulations, and regulatory guidance for HCS operations, including, but not limited to prior authorizations, quality of care, and clinical programs for the Part C Medicare line of business. Serve as the subject matter expert on HCS...Full timeContract workTemporary workRemote workHumana
Providence, RI1 day ago$15.9 - $17 per hour
...the much‑needed care as soon as possible. Requests health plan authorizations/information as required; either electronically or verbally.... ...equipment outside of the United States is not permitted without prior authorization. Teammate Benefits As an Accendra Health...Hourly payTemporary workWork at officeLocal areaImmediate startRemote workHome officeFlexible hours- ...courteous manner Answer phones and manage appointment scheduling Verify insurance information and process referrals Handle prior authorizations for procedures (MRI, CT scans, etc.) Assist with TDI/FMLA paperwork and related documentation Maintain accurate patient...Work at officeMonday to FridayWeekday work
HW Staffing Solutions - Cumberland RI
Warwick, RI14 days ago - ...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...Full timeWork at office
East Bay Community Action Program (EBCAP)
Barrington, RI19 days ago $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...Hourly payContract workWork experience placementRemote workShift workSonya M. Recruiting
Providence, RI1 day ago- ...health care providers preparing Bone Marrow Specimens, laboratory specimens, disposing of contaminated supplies. Obtain prior authorizations for genetic testing, medications. Must be able to work closely with Prior Authorization team to ensure prior authorization...
IntelyCare
Providence, RI4 days ago $24.29 - $40.07 per hour
...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 workBrown University Health
Providence, RI3 days ago- ...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, RI21 hours ago $202k - $303k
...stroke teams, including neurology, cardiology, pharmacy, and care coordinators Understanding of formulary management and prior authorization for chronic secondary prevention therapies Familiarity with population health, adherence challenges, and real-world evidence...Local areaFlexible hoursBayer
Cumberland, RI4 days ago- ...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...
$70k - $90k
...coverage options Follow up consistently to close opportunities Requirements Property and Casualty insurance license required Prior insurance sales experience Strong work ethic and customer-focused mindset Ability to meet and exceed sales goals Strong...Monday to FridayWeekend workAfternoon shiftAllstate - Espejo Agency, Llc
Johnston, RI8 days ago$116k - $151k
...coverage, reimbursement, and policy dynamics across Commercial, Medicare, and Medicaid channels. Assess access barriers (e.g., prior authorizations, step edits, denials) and quantify impact to patient access. Generate insights from claims, hub, and patient services data...Temporary workWork experience placementRemote work
