Average salary: $108,261 /yearly

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  •  ...inpatient and/or outpatient) - per program assignment, including but not limited to record review, medication refills and/or prior authorizations; patient education, review of test/procedure/lab results • Makes referral for medically necessary services, consults,... 
    Suggested
    Weekly pay
    Holiday work
    Permanent employment
    Fixed term contract
    Shift work

    LanceSoft

    San Francisco, CA
    5 days ago
  •  ...Conducts inpatient reviews to determine financial responsibility for Molina Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed. Processes requests within required timelines. Refers appropriate cases to Medical... 
    Suggested
    Hourly pay
    Work experience placement
    Shift work
    Day shift
    3 days per week
    Monday to Friday

    Molina Healthcare

    San Francisco, CA
    17 days ago
  •  ...$150,000.00/yr - $165,000.00/yr Additional compensation types Annual Bonus and RSUs Patient Engagement Specialist (includes prior authorizations) is a key field-based member of the Market Access Patient Services team responsible for contacting designated accounts and providing... 
    Suggested
    Full time

    HealthCare Recruiters International

    San Francisco, CA
    3 days ago
  •  ...clinical guidelines. Identifies appropriate benefits and eligibility for requested treatments and/or procedures. Conducts prior authorization reviews to determine financial responsibility for Molina Healthcare and its members. Processes requests within required... 
    Suggested
    Hourly pay
    Holiday work
    Work experience placement
    Rotating shift

    Molina Healthcare

    San Francisco, CA
    3 days ago
  •  ...accurately and clearly explain to prescribers and office staff Provide best practices to pursue coverage for patients via the prior authorization process Triage, resolve, and respond to order-related escalations or one-off requests De-escalate providers by using active... 
    Suggested
    Remote job
    Flexible hours

    Phil, Inc.

    San Francisco, CA
    12 hours ago
  •  ...coverage support. Offer assistance from physician order to reimbursement, supporting the entire reimbursement journey through payer prior authorization to appeals/denials requirements and forms. Review patient-specific information in cases where the site has specifically... 
    Suggested
    Remote job
    Work from home
    Home office
    Flexible hours
    2 days per week
    3 days per week

    Initial Therapeutics, Inc.

    San Francisco, CA
    12 hours ago
  •  ...communications requiring specialized pharmacy technical ability and expertise related to medication coordination. Reviews and processes prior authorization requests for physician-administered drugs, which includes intake, triage, and associated correspondence, using established... 
    Suggested
    Holiday work
    Full time
    Temporary work
    Part time
    Local area
    Remote job

    Central California Alliance for Health

    San Francisco, CA
    1 day ago
  •  ...Remote Prior Authorization Pharmacist **Job Description:** We are actively seeking a dedicated Pharmacist to join our remote team with a focus on Prior Authorization. In this role, you will play a crucial part in evaluating medication requests, ensuring adherence to... 
    Suggested
    Remote job

    Pharmacy Careers

    San Francisco, CA
    a month ago
  •  ...for longitudinal obesity care. Collaborate with a multidisciplinary team, including nutritionists, genetic counselors, and prior authorization specialists. Stay updated with the latest clinical research through our monthly academic lecture series (optional).... 
    Suggested
    Contract work
    Remote job
    Flexible hours

    Mochi Health

    San Francisco, CA
    a month ago
  •  ...in resolution of patient-specific access barriers to Insmeds products as prescribed by HCP Educate HCP office staff about prior authorization & appeals process, how to access related forms, and high-level information about submission procedures and reauthorization... 
    Suggested
    Holiday work
    Temporary work
    Remote job
    Flexible hours

    Insmed Incorporated

    Daly City, CA
    12 hours ago
  •  ...and tests Maintains immunization records on EHR and CAIRS Coordinates patient's treatment plans, i.e. specialist's referrals, prior authorizations, follow up appointments, etc Assist physicians with medical treatments, procedures, and exams Performs insurance... 
    Suggested
    Hourly pay

    Chinese Hospital

    San Francisco, CA
    4 days ago
  • JOB DESCRIPTION The Prior Authorization Representative is responsible for verifying prior authorization requirements and obtaining authorization when required. Works directly with physician offices and payers to facilitate patient access to various therapies. Representative... 
    Suggested

    Hire Talent

    San Francisco, CA
    3 days ago
  •  ...protocols to enhance patient care. Collaborate with a dedicated support team, including lab testing, genetic counseling, and prior authorization specialists. Stay updated on obesity medicine advancements through our optional monthly academic lecture series. Who... 
    Suggested
    Contract work
    Remote job
    Flexible hours

    Mochi Health

    San Francisco, CA
    a month ago
  • We have an opportunity to join the Alliance as a Prior Authorizations Nurse (RN) in Utilization Management. This position can be filled in any of our Alliance offices (Merced, Salinas or Scotts Valley). WHAT YOU'LL BE RESPONSIBLE FOR Reporting to the Utilization Management... 
    Suggested
    Holiday work
    Full time
    Temporary work
    Part time
    Local area
    Remote job

    Central California Alliance for Health

    San Francisco, CA
    12 hours ago
  •  ...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... 
    Suggested
    Remote job

    Pharmacy Careers

    San Francisco, CA
    29 days ago
  •  ...criteria. ?Collaborate with physicians, therapists, and case managers to align care plans with payer requirements. ?Manage prior authorizations, minimize claim denials, and lead appeals processes as needed. ?Ensure compliance with Medicare|Medicaid, CMS, and state|... 
    Hourly pay
    Private practice
    Flexible hours
    1 day per week

    Greenlife Healthcare Staffing

    San Francisco, CA
    20 days ago
  •  ...closely with the Grifols payor team to understand payer policies and facilitate patient access. Ensure providers understand prior authorization requirements, appeals processes and clinical criteria, including technology options for electronic submission of PA, Letter of... 
    Full time
    Local area
    Remote job

    Grifols Shared Services North America, Inc

    San Francisco, CA
    more than 2 months ago
  •  ...Field Reimbursement Manager (FRM) will be the field subject matter expert relating to patient support, access, reimbursement, prior authorization, appeal, financial assistance, and other business-related issues within the Dupixent Business Unit. The FRM is a critical... 
    Local area
    Remote job

    Sanofi

    San Francisco, CA
    4 days ago
  •  ...plan to address all symptoms and update plans as needed. Collaborate with Medical Assistants to ensure timely completion of prior authorization requests, requests from attorneys, and requests from patients. Requirements: Amiable personality is a plus Attention... 
    Holiday work
    Relocation
    Trial period
    Monday to Friday

    National Brain Injury Institute PLLC

    Berkeley, CA
    21 days ago
  •  ...and in follow up. Administrative support will include coordinating appointments with outside specialists and facilities, prior authorizations, occasional medical records support, and coordination of care through members personal and executive assistants Under the... 
    Holiday work
    Full time
    Local area
    Monday to Friday

    Private Medical

    San Francisco, CA
    28 days ago
  •  ...completion of new patient forms # Insurance verification and authorization fulfillment # Verify patient insurance information using...  ...and enter in EHR and related systems # Identify and complete prior authorizations for services and medications # Monitor insurance... 
    Hourly pay
    Remote job

    Upward Health

    San Francisco, CA
    13 days ago
  •  ...physician with corresponding reminders Coordinate and track outside consults, tests, and imaging studies for patients Obtain prior authorizations for prescriptions and diagnostic companies Upload labs and other outside documentation into Electronic Medical Record (... 
    Holiday work
    Full time
    Local area
    Shift work
    Monday to Friday

    Private Medical

    San Francisco, CA
    9 days ago
  •  ...as a complimentary service to the patients. Covers Clinical Assistant and Patient Services duties as needed. Initiates Prior Authorization with insurance companies for testing. Triages patient inquiries & provides patients with high level of customer service.... 
    Holiday work
    Full time
    Work experience placement
    Flexible hours
    Monday to Friday

    RMA Network

    San Francisco, CA
    12 days ago
  •  ...standards. Conduct review of routine/urgent medical service requests based on medical necessity including but not limited to prior authorizations, inpatient care, DRG reviews, quality reviews and grievances.a. Determinations shall be completed prior to the due date... 
    Holiday work
    Temporary work
    Immediate start
    Remote job
    Flexible hours

    Inland Empire Health Plan

    San Francisco, CA
    12 hours ago
  •  ...inventory and procurement of medications and supplies, ensuring proper storage and handling. Assist patients with insurance claims, prior authorization processes, and finding cost-effective medication alternatives. Participate in the development and implementation of community... 

    Pharmacy Careers

    San Francisco, CA
    2 days ago
  •  ...Reaches out to members telephonically to assist with referrals, authorizations, HHC, DME needs, medication refills, make provider...  ...Health Care IPAs. Minimum 1 year experience entering referrals and prior authorizations. • Preferred: Education: • Required: High School... 
    Full time
    Remote job

    Alignment Health

    San Francisco, CA
    12 hours ago
  •  ...offices, hospitals and SNF's and attaches medical records to authorizations. Enters referral requests/authorizations in system Creates cases...  ...: • Required: Minimum 1 experience entering referrals and prior authorizations in a healthcare setting. • Preferred: 2+ years... 
    Remote job
    Monday to Friday

    Alignment Healthcare

    San Francisco, CA
    1 day ago
  •  ...not of best interest to the hospital.2. Demonstrates knowledge in cap contract related to rates, stop loss, reinsurance, PMPM prior authorization, UR requirement, Knox-Keene requirement.3. Able to analyze and interpret general business journals, professional journals,... 
    Contract work
    Local area
    Immediate start

    Ahmc Healthcare Inc.

    Daly City, CA
    4 days ago
  •  ...operational teams, where integrated) performing one or more of the following activities: care review/utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), case management, transition of care, health management and/or member... 
    Work experience placement

    Molina Healthcare

    San Francisco, CA
    a month ago
  •  ...Prepare and label prescriptions under physician direction Collaborate with clinical teams to manage and submit medication prior authorizations Oversee pharmaceutical inventory: ordering, stocking, labeling, and proper disposal Receive and verify medication... 
    Holiday work
    Full time
    Local area
    Work from home
    Home office
    Monday to Friday

    Private Medical

    San Francisco, CA
    21 days ago