Average salary: $90,966 /yearly
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- ...and ideas, and we invite participation on a variety of projects. The Job: Using appropriate methods, obtains prior authorizations for diagnostic studies, procedures, surgeries, and testing as required by each particular insurance company including Worker...SuggestedFull timePart timeMonday to FridayFlexible hours
BayCare Clinic
Green Bay, WI5 days ago - A leading company in workforce solutions is seeking a dedicated individual to manage prior authorization requests within a clinical environment. The role involves processing requests, communicating with healthcare providers, and ensuring documentation is accurate. Ideal...SuggestedWork at office
- ...responsible for preparation, submission, and follow up of payer authorization requests. Responsibilities include: Perform benefit... .../or company self-pay pricing Initiate, follow-up, and secure prior authorization, pre-determination, or medical review including...SuggestedFull timeContract workImmediate startRemote workMonday to Friday
$22.4 per hour
A leading healthcare services provider in the U.S. is seeking a skilled professional to oversee Prior Authorization Specialists. The ideal candidate will have 3-5 years of healthcare experience, with strong communication skills and leadership experience preferred. Competitive...SuggestedRemote jobHourly pay$17 - $25.25 per hour
...in, registration, coverage management, patient portal sign-up, patient message collection and routing, departmental support, prior authorization and WQ (work queue) management. Schedules, reschedules and cancels patient appointments Executes pre-arrival registration by...SuggestedWork at officeFroedtert Health
Kenosha, WI1 day ago$17 - $25.25 per hour
...in, registration, coverage management, patient portal sign-up, patient message collection and routing, departmental support, prior authorization and WQ (work queue) management. Schedules, reschedules and cancels patient appointments Executes pre-arrival registration by...SuggestedWork at officeNight shiftAfternoon shiftFroedtert Health
Pleasant Prairie, WI1 day ago$96.19k - $144k
...$96,186 - $144,000***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...SuggestedWork at officeLocal area$18 - $23 per hour
...strong background in medical insurance benefit verification, pre-authorization for durable medical equipment (DME), and the ability to... ...benefits for orthopedic-related DME products and services. Obtain prior authorizations and address denials and appeals. Review...SuggestedFull timePart timeWork at officeRemote workWeekday work- A healthcare services company is seeking a Business Configuration Sr. Coordinator to oversee operational development for prior authorization criteria within their Medical Claims platform. This role involves managing configuration data, working across departments on project...Suggested
- A leading health services company seeks a Business Configuration Sr. Coordinator to oversee the operational development of prior authorization criteria within their Medical Claims and Prior Authorization platform. The role requires strong MS Office skills, the ability to...Suggested
$26.41 - $61.79 per hour
...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...SuggestedHourly payWork experience placementWork at officeMolina Healthcare
Green Bay, WI2 hours agonew- ...documentation to ensure insurance guidelines are met for the equipment or supplies ordered Obtain purchase and initial rental prior authorizations Convey insurance benefits and out of pocket costs to the patient Complete accurate and timely sales order entry of the...Suggested
Chartwell Midwest Wisconsin
Middleton, WI3 days ago $26.41 - $61.79 per hour
...eligibility, benefits, and expected length of stay for requested treatments and procedures. Conduct thorough reviews to determine prior authorization and financial responsibilities. Process requests promptly within the required timelines. Refer complex cases to medical...SuggestedHourly payWork experience placementWork at officeMolina Healthcare
Madison, WI5 days ago- ...Provide phone triage and clinic nursing support for neurosurgery patients (symptom assessment, medication refill coordination, prior authorizations, imaging/appointment scheduling, post-op follow-up and care coordination). Act as a central resource for patients and their...SuggestedFull timeShift workDay shift
ProHealth Care
Waukesha, WI14 hours ago - ...network is available. Completes paperwork and documentation for authorized referrals within two (2) business days. Enters referrals into... ...practice protocol, who have emergencies or have self-referred without prior authorization. About Texas Children’s Texas Children’s...SuggestedFull timePart timeWork at officeLocal areaShift work
$55 - $60 per hour
...Medicare Part D Clinical Pharmacist is responsible for the processing and documenting of Utilization Management (UM) requests (e.g. prior authorization, step therapy, formulary exceptions) for delegated products and services. The work is detail-oriented, and candidates will be...Hourly payPermanent employmentContract workLocal areaRemote workClinical Consulting Solutions
River Falls, WI1 day ago$19 - $23 per hour
...questions regarding coding and billing and navigating complex reimbursement issues. This position also provides support for Prior Authorizations (PA) for an assigned caseload and helps navigate the appeals process to access medications. Responsibilities Ensure cases move...Temporary workLocal areaImmediate start$215k - $235k
...to therapy. As a trusted resource and advocate, the PAL provides education, guidance, and support across insurance coverage, prior authorization, medical exceptions, appeals, affordability programs, and adherence to ensure patients can begin and continue therapy with confidence...Work at office$22.4 per hour
...Responsibilities): Provide clear and respectful communication to support patients, staff, and clinical teams Oversee the daily work of Prior Authorization Specialists, ensuring efficient insurance verification and authorization processes Monitor productivity, quality, and...Immediate startRemote work- ...Specialist I may also be responsible for obtaining information and assisting providers and insurance companies in triaging prior authorizations for patients of the specialty pharmacy. The Specialty Pharmacist is accountable for verifying the prescription entry. This position...Flexible hoursShift work
$155k - $160k
...extension of the product to provide live one‑on‑one coverage support. Assisting from physician order to reimbursement, covering prior authorization to appeals and denials procedures and forms. Reviewing patient‑specific information and insurance benefit options when...Work at officeFlexible hours$174.07k - $374.92k
...precertification, concurrent review, and appeal request. This position is primarily responsible for Utilization Management, including prior authorization as well as concurrent review. Cases could focus on inpatient or outpatient services, acute and post acute services, pharmacy,...Hourly payFull timeTemporary workLocal areaWork from homeFlexible hoursWeekend work$76k - $85k
...leading public sector solutions firm is seeking a Utilization Review Nurse to work remotely. This role involves conducting prior authorizations, performing reviews, and using medical management software. The ideal candidate will have a nursing degree, at least 2 years...Remote job- A healthcare organization is seeking a Clinical Pharmacist to evaluate prior authorization requests and collaborate with healthcare teams. This fully remote role requires an active pharmacist license and a Board Certified Oncology Pharmacist credential upon hire. Candidates...Remote job
- ...organization is seeking a Program Manager to lead initiatives in optimizing health services. This role is focused on the electronic prior authorization (ePA) business, driving process improvements and coordinating cross-functional teams. Candidates should have a bachelor's...Work at office3 days per week
- ...This role involves working directly with healthcare providers to gather patient insurance information and provide support for prior authorizations and reimbursement issues. Successful candidates will have 2 to 3 years of experience in benefit investigation and possess...
- ...supporting the clinical team by managing documentation and administrative tasks essential for processing Utilization Management prior authorizations and appeals. This position requires strong organizational skills and effective communication with providers to ensure...Remote job
- Remote Prior Authorization Pharmacist - Work From Home in Managed Care A c onfidential 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
- ...hospitals as needed Maintain provider schedules within the EMR system Prepare and send required documentation prior to procedure dates Obtain prior authorizations for applicable procedures Coordinate pre-op and post-op appointments Ensure patient accounts and scheduling...Temporary workCasual workWork at officeImmediate startFlexible hours
Ear, Nose & Throat Specialists of Wisconsin, SC
Winneconne, WI4 days ago - ...and regulations. We are looking for a Medical Assistant with prior administrative experience, strong initiative, and the ability... ...directed. Assist Patient Services team as needed to obtain prior authorizations for prescribed treatments and documents. Triage patient phone...Full timeTemporary workMonday to Friday
Vivo Infusion®
Milwaukee, WI1 day ago
