Average salary: $75,000 /yearly
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- ...benefits, eligibility and expected length of stay for requested treatments and/or procedures. Conducts reviews to determine prior authorization/financial responsibility for Molina and its members. Processes requests within required timelines. Refers appropriate...SuggestedWork at office
Molina Healthcare
Washington DC3 days ago $112.32k - $181.06k
...Practitioners. The team also includes excellent support staff who can assist with everything from patient scheduling to insurance prior authorizations. The psychologist in this role will help injured workers to address health behaviors impacting their care and collaborate...SuggestedFull timeMonday to FridayFlexible hoursShift workProvider Solutions & Development
Washington DC5 hours ago$47.69 - $56.78 per hour
...Working under technical direction and within significant limits and authority, adjudicate workers' compensation claims of higher technical... ...: Resumes submitted for this or any other position without prior authorization from Human Resources will be considered unsolicited...SuggestedHourly payContract workTemporary workLocal area- ...reimbursement landscape associated with psychedelic treatment delivery models. This role involves leading coverage policy development, prior authorization strategy, and partnering with cross-functional teams to establish evidence-based coverage policies. The VP, Market Access...Suggested
$70k - $80k
...Job Description Prior Authorization Supervisor Job description: Lead a Team That Keeps Patient Care Moving Forward Are you a healthcare professional with a passion for accuracy, leadership, and patient access excellence? Networks Connect is seeking...SuggestedFull timeLocal areaFlexible hoursNetworks Connect Healthcare Staffing
Silver Spring, MD10 days ago- ...benefits, eligibility, and expected duration of treatments or procedures requested. Conduct thorough reviews to establish prior authorization/financial responsibilities for Molina and its members. Process requests efficiently and within established timelines. Refer...SuggestedWork at office
Molina Healthcare
Washington DC20 hours ago - ...healthcare claims lifecycle from the provider’s perspective: including processes such as provider credentialing, network setup, prior authorizations, billing, claims submission, adjudication, and payment. ~ MS Office experience (Word, Excel, Teams, Outlook) ~ Excellent...SuggestedCurrently hiring
GeBBS Consulting
Columbia, MD7 days ago $61.36 - $90.18 per hour
...these recommendations to patients and pharmacists in appropriate language. Develops protocols for the use of drugs requiring prior-authorization. Responds to clinical inquiries in a professional and accurate manner. Minimum Qualifications Graduation from an accredited school...SuggestedHourly payMonday to FridayFlexible hoursShift workWeekend workAfternoon shiftIntermountain Health
Washington DC13 hours ago$34.57 - $40.34 per hour
...exercise their independent discretion and, within broad limits and authority, be creative in developing solutions and treat each case as the... ...Resumes submitted for this or any other position without prior authorization from Human Resources will be considered unsolicited...SuggestedHourly payTemporary workLocal areaImmediate start$25 - $30 per hour
Description + Precertification is the pre-service checklist + Authorizations is setting up the auths, they would love if they have experience... ...preparation of the medical record and billing information prior to the time of appointment or procedure. + Answers the telephone...SuggestedContract workTemporary workWork at officeLocal area- ...Specialist I to support billing operations across multiple locations. Primary Responsibilities may include: Insurance Verification/Prior Authorization Accurately perform insurance verifications, pre‑certification/pre‑authorization functions as required/assigned in a timely...SuggestedTemporary workWork at office
- ...and administrative support functions across the market, such as customer service, scheduling, registration, referrals, and prior authorizations. Serves as a Synapticure's representative to our members, external healthcare organizations, payer partners, and other partners...SuggestedFull timeRemote work
Synapticure
Washington DC2 days ago $25 - $30 per hour
...and play a key role in ensuring timely and accurate pre-service authorizations for oncology, radiation oncology, and radiology services.... ...attention to detail, and empathy for patients. Preferred Experience Prior authorizations experience. Experience with single case...SuggestedHourly payContract workTemporary workLocal area$126.94k
...be able to travel within a designated territory, including Washington DC, Virginia, Maryland, Tennessee, and North Carolina Prior Authorization Certification Specialist (PACS) credentials required or to be obtained within the first six months of employment How to Stand...SuggestedWork at officeImmediate start$25.96 - $38.94 per hour
...Assist with patient check-out and follow-up duties. Perform both clinical and administrative duties, including referrals, prior authorizations, scheduling, and phone calls. Requirements: DOH Certified MA (CMA or MA-C). BLS/CPR certification from the...SuggestedPermanent employmentContract workTemporary workLocal areaMonday to FridayShift workMedix™
Washington DC4 days ago$35.68 - $64.71 per hour
...patients with postoperative instructions following routine surgery prior to postoperative follow-up care. Contributes to the... ...Collects clinical data relevant to initiate and complete prior authorization for oral medication. Participates in weekly case conferences...Work experience placementWork at officeRelocationAll shiftsMedStar Health
Washington DC3 days ago$88.7k - $126.94k
...office staff with understanding the payers' coverage management strategies for product, including coding, billing, formulary, prior authorization, and appeal processes. Probe to understand office processes and ability to discern root causes of access or reimbursement...Full timeWork at officeLocal areaNight shift- ...medical documentation for patients and their families. Coordinating with insurance companies for medication and diagnostic prior authorizations. Assisting providers with prescription refills. Specimen collection Provide support & assistance to the...Local areaMonday to Friday
COMPASS HEALTH CENTER, LLC.
Silver Spring, MD5 hours ago - Commercial and personal line insurance carriers rely on EXL as a key business partner through our Castle High Value and EXL Risk Control service offerings. We offer a variety of field inspections and risk control services to support our clients’ underwriting processes....For contractorsWork at officeLocal areaWork from home
EXL
Washington DC18 hours ago - Job Description Job Description National Insurance Carrier client is looking for an experienced Commercial Surety Underwriting professional for the Mid-Atlantic region. Will handle account type commercial surety underwriting accounts. This is an addition to staff...
Questor Consultants, Inc.
Washington DC3 days ago $73k - $149k
...00 and $149,000.00***PLEASE NOTE:***Applicants must be legally authorized to work in the United States. At this time, we are not able to... ...Agencies:** Resumes submitted for this or any other position without prior authorization from Human Resources will be considered...Local area- 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...Remote jobWork from homeFlexible hours
$180k - $190k
...reimbursement, access, and specialty distribution for assigned geography. Provide education to HCP offices on coverage status, prior authorization processes, appeals, and alternate funding options for uninsured/underinsured patients. Build and maintain productive...Temporary workWork experience placementWork at officeLocal areaRemote workFlexible hours- Please ensure traveler is aware of below prior to submitting: Traveler is expected to have their own reliable transportation. Candidate... ..., admin/IB Department is supported by some centralized services that assist with medication refills and medication prior authorizationsImmediate startShift workWeekend 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....Remote job
- ...conjunction with MTF Physical Evaluation Board Liaison Officer and MTF monitors). Verifies appropriate paperwork is on file prior to authorization. Initiate, receive, and coordinate communication between beneficiaries, team members, internal staff and providers, network...Full timeContract workLocal area
- Overview Title: Clinical Review Nurse - Prior Authorization Review Location: Fully Remote (PST Time Zone - WA/OR Resident) Duration: 12-Month (Potential for Extension) About the Role We are seeking an experienced Clinical Review Nurse for Prior Authorization Review to join...Contract workRemote work
$30 per hour
...health care needs, use of community resources and responsibilities of membership in managed care Completes necessary paperwork, prior authorizations and/or scheduling of appointments for patients who are ordered diagnostic and therapeutic services Quadrant is an...Hourly pay$400 per month
At Allstate, great things happen when our people work together to protect families and their belongings from life’s uncertainties. And for more than 90 years our innovative drive has kept us a step ahead of our customers’ evolving needs. From advocating for seat belts,...Full timeContract workWork at officeLocal areaWork visaFlexible hoursAllstate
Washington DC4 days ago$25 per hour
...are scheduled. This role will be primarily based in Mt. Laurel. The ideal candidate will have prior experience reading medical charts and working on insurance pre-authorizations. The Infusion Guide role is perfect for those wishing to remain at the forefront of...Full timeTemporary workWork at officeLocal areaFlexible hoursNight shiftLocal Infusion
Laurel, MD1 day ago
