Average salary: $108,261 /yearly
More stats- ...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,...SuggestedWeekly payHoliday workPermanent employmentFixed term contractShift work
- ...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...SuggestedHourly payWork experience placementShift workDay shift3 days per weekMonday to Friday
Molina Healthcare
San Francisco, CA17 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...SuggestedFull time
- ...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...SuggestedHourly payHoliday workWork experience placementRotating shift
Molina Healthcare
San Francisco, CA3 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...SuggestedRemote jobFlexible hours
- ...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...SuggestedRemote jobWork from homeHome officeFlexible hours2 days per week3 days per week
- ...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...SuggestedHoliday workFull timeTemporary workPart timeLocal areaRemote job
- ...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...SuggestedRemote job
- ...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)....SuggestedContract workRemote jobFlexible hours
Mochi Health
San Francisco, CAa 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...SuggestedHoliday workTemporary workRemote jobFlexible hours
- ...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...SuggestedHourly pay
- 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
- ...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...SuggestedContract workRemote jobFlexible hours
Mochi Health
San Francisco, CAa 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...SuggestedHoliday workFull timeTemporary workPart timeLocal areaRemote job
- ...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...SuggestedRemote job
- ...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 payPrivate practiceFlexible hours1 day per week
- ...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 timeLocal areaRemote job
- ...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 areaRemote job
- ...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 workRelocationTrial periodMonday to Friday
National Brain Injury Institute PLLC
Berkeley, CA21 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 workFull timeLocal areaMonday to Friday
Private Medical
San Francisco, CA28 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 payRemote job
- ...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 workFull timeLocal areaShift workMonday to Friday
Private Medical
San Francisco, CA9 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 workFull timeWork experience placementFlexible hoursMonday to Friday
RMA Network
San Francisco, CA12 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 workTemporary workImmediate startRemote jobFlexible hours
- ...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...
- ...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 timeRemote job
- ...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 jobMonday to Friday
- ...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 workLocal areaImmediate start
- ...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
- ...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 workFull timeLocal areaWork from homeHome officeMonday to Friday
Private Medical
San Francisco, CA21 days ago
