Average salary: $78,728 /yearly
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- ...Overview Summary Authorization Denial Specialist ensures that chemotherapy (specialty group) and other infusions/radiation... ...NCCN guidelines. Initiates and coordinates pre-certifications/prior-authorizations per payer guidelines prior to services being...SuggestedPart timeFlexible hours
Baptist Memorial Healthcare Corporation
Memphis, TN12 hours ago $47.69 - $56.78 per hour
...under limited technical direction and within broad limits and authority, adjudicate moderately complex commercial environmental claims,... ...Agencies Resumes submitted for this or any other position without prior authorization from Human Resources will be considered...SuggestedHourly payContract workTemporary workLocal area- ...responsible for verifying insurance benefits, eligibility, and authorization requirements to ensure accurate billing and reimbursement for... ...Knowledge of healthcare reimbursement practices, including prior authorization and referral processes. Proficiency in electronic...SuggestedWork at officeLocal area
Community Health Systems
Franklin, TN12 hours ago - ...Patient Access Representative 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...Suggested
Hire Talent
Nashville, TN1 day ago - ...to CPT/HCPCS production coding, and other consulting projects. Perform assigned work within internal service areas such as prior authorization, remote coding, research, and administrative clerical functions/support. Apply ICD-10-CM guidance accurately when coding is...SuggestedRemote work
- ...relevant claims and appeal documentation is uploaded into OnBase Verify all identified insurance carriers for policy related to prior authorization requirements as needed for claims adjudication Work collaboratively with other Coding, Billing, Patient Access, and Cash...SuggestedFull timeWork at office
- ...therapies. The responsibilities include developing pharmacy capabilities, negotiating with payors on coverage, and managing prior authorizations. Candidates should have experience in specialty pharmacies and strong communication skills. This position offers competitive...Suggested
$19.01 - $24.19 per hour
A healthcare services provider seeks a Prior Authorization Specialist in Nashville, TN. The role entails completing outbound call tasks regarding Prior Authorizations and logging results in compliance with regulatory guidelines. Candidates should possess strong telephonic...SuggestedRemote jobHourly pay$20 per hour
A leading health care partnership is seeking a Coordinator for Intake Utilization Management to process prior authorization requests. The role involves reviewing workflows, entering data into a system, and communicating with physician’s offices for missing information....SuggestedRemote job- A prominent healthcare organization in Tennessee is seeking a qualified Pharmacy Technician responsible for the precertification of eligible prescriptions. The ideal candidate should have 3-5 years of pharmacy experience, be certified as a Pharmacy Technician in Tennessee...Suggested
- ...necessity and appropriateness per insurance medical policies/ FDA/NCCN guidelines. Initiates and coordinates pre-certifications/prior-authorizations per payer guidelines prior to services being rendered. The Financial Counselor counsels patients regarding their financial...SuggestedWork at officeFlexible hours
Baptist Memorial Healthcare Corporation
Memphis, TN2 days ago - ...the treatment needs to parent and patient utilizing the prescribed treatment plan. ● Must be able to recognize and identify prior authorization requirements, along with ensuring signed consent forms. ● Maintain awareness of comfort and safety needs of patients. ● Provide...SuggestedSummer workWork at officeFlexible hours
- ...Notify patients of test results as directed by doctor/provider. • Authorize medications and procedures if needed. • Chart all... ...pharmacy as directed by doctor/provider, order lab work. • Complete prior authorizations for medications, MRI's, etc. • Schedule, reschedule...SuggestedFull timeWork at officeFlexible hours
Murfreesboro Medical Clinic
Murfreesboro, TN3 days ago - ...setting. What You'll Do: Assist physicians with patient care and ensure smooth office operations Handle scheduling, prior authorizations, and pre-certifications for MRIs and CTs Communicate test results and perform phlebotomy Maintain professional...SuggestedFull timeWork at officeImmediate start
UNIVERSITY PHYSICIANS ASSOC INC.
Knoxville, TN4 days ago $25 per hour
...stakeholders the necessary information to obtain benefit information, authorization, reauthorization, and reimbursement by e-mailing and scanning... .... Follow up on authorizations to ensure they are achieved prior to dispensing. Schedule dispensing calendar for new or...SuggestedFull timeTemporary workWork at officeFlexible hoursMaxor
Columbia, TN4 days ago- ...medical necessity, DRG recoupments/downgrades, denials for no authorization, and denials related to an audit review. The DMS collaborates... ...review, medical/clinical denials and appeals. Experience with the prior authorization process for all providers, ordering and...Work at officeLocal area
- ...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...Full timeRemote work
Synapticure
Chattanooga, TN4 hours ago - ...services # Secures consultations and specialists. # Triages phone calls and addresses patient portal messages. # Obtain prior authorization for medications and diagnostic testing # Assists physician with med/surg procedures # Observes universal precautions #...Full timeWork at officeFlexible hours
Williamson Health
College Grove, TN29 days ago - ...services. # Secures consultations and specialists. # Triages phone calls and addresses patient portal messages. # Obtain prior authorization for medications and diagnostic testing. # Maintains quality assurance for office lab. # Assists physician with office/...Work at officeFlexible hours
Williamson Health
Spring Hill, TN12 days ago $80 per hour
...These notes must be completed within 24 hours of the patient’s last appointment. Completing and signing labs, letters, forms, prior authorization requests, or other medical records for patients. We seek people eager to bring their gifts and passions to this exciting...Hourly payFor contractorsLocal areaRemote workShift work$17 - $25.65 per hour
...pm. Required Qualifications ~ Valid Tennessee Pharmacy Technician Registration Preferred Qualifications ~ Prior authorization experience ~6+ months experience required in a customer service position within in healthcare, social services, or a...Hourly payFull timeTemporary workLocal areaMonday to FridayFlexible hoursCVS Health
Collierville, TN1 day ago- ...knowledge of medical claims analysis, critical-thinking skills, and healthcare experience/expertise Analyze claims, membership, and prior authorization data to identify early signs of trends or other issues related to medical care costs and quality of care Provides actuarial...
- ...seamless patient experience. Job duties include but are not limited to: assisting physicians with patient care, scheduling, prior authorizations, obtaining pre-certs for MRIs, CTs, and surgery cases, tracking results, and various other tasks. This position also...Full timeWork at office
UNIVERSITY PHYSICIANS ASSOC INC.
Knoxville, TN1 day 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
Memphis, TN2 days ago- ...highly organized, safe, and clean work area Ability to work well with a supportive team that includes our Centralized Intake/Prior Authorization team, our Purchasing Team, Home Infusion/Specialty Pharmacy team, and Mid-Level provider/s on-site to provide the best...Full time
CivicMinds, Inc
Murfreesboro, TN1 day ago - A leading insurance firm is seeking an Underwriter for its Tennessee territory, focused on the middle market segment. This role involves building relationships with independent agents, evaluating insurance submissions, and managing agencies. Candidates should have a strong...
- Elevate Your Career with Zander At Zander, we believe top talent deserves top pay. We offer industry-leading compensation packages and a supportive, dynamic work environment designed to help you succeed and grow. As a 100-year-old company experiencing remarkable...Part timeWork at officeLocal areaImmediate startRemote workWork from homeFlexible hours
Zander Insurance Agency
Nashville, TN10 hours ago $87.9k - $146.5k
About the role In this role you will be responsible for risk-based underwriting of new and/or existing accounts. You’ll be accountable for the achievement of profit, persistency, and growth goals through financial analysis of employer groups. What you will do Determine ...Remote jobFull timeWork at officeImmediate startWork from homeFlexible hoursShift work- ...understanding of treatment initiation processes, patient identification etc. Collaborate with partners, internally and externally, on prior authorization, payor restrictions, reimbursement stipulations, and patient referrals to support patient access. Manage the sales budget...Local areaRemote workRelocation packageFlexible hours
$20 per hour
...What You’ll Be Doing: The Coordinator, Intake Utilization Management at Evolent will serve as a point of contact for processing prior authorization requests in accordance with departmental policies, regulatory requirements, and client contractual agreements. Collaboration...Work at officeRemote workShift work
