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- ...surgical procedures. Duties will include obtaining referrals and authorizations prior to the service, verifying insurances at least 1-2 weeks in... ...(no weekends, no holidays) Work setting: in-office only, remote work is not offered. Looking for full time 40 hours/ week...Remote workFull timePart timeWork at officeRelocation
Surgical Specialists Group of Michigan
Saint Clair Shores, MI2 days ago - ...Arrangement: This is a hybrid position (4 days in office and 1 day remote) reporting to our office in Atlanta, GA. Professional... ...claims issues and aid with the appeals process. Assist with prior authorizations, ID card requests, and network searches. Ensure...Remote workTemporary workWork at officeLocal areaFlexible hours
Patriot Growth Insurance Services
Atlanta, GA4 days ago $22 per hour
...text, and patient portal messages Complete a high volume of prior authorizations Perform clinical administrative functions within scope of... ...Medical Assistant - huge plus if you have telehealth and/or remote work experience! ~2+ years of current Athenahealth...Remote workFull timeWork experience placementImmediate startWork from homeMonday to FridayMidi Health
United States4 days ago- ...: 12 Months Job Type: Temporary Assignment Work Type: Remote Dept: MA Inpatient Precertifi Engagement Description... ...processes, including claims management, benefits coordination, and prior authorization procedures Customer service experience is required...Remote workTemporary workWork at office
Tekwissen
Detroit, MI4 days ago - ...Prior Authorization Medical Director Physician Opportunity in the Los Angeles Area Please consider this unique opportunity to join a well... ...organization forward. Requirements MD/DO degree required Remote position, but candidate must live in the greater L.A. area...Remote workLive inWork from homeRelocation package
Curative
Los Angeles, CA3 days ago - ...Accountability Act of 1996 (HIPAA) requires that all insurance payers exchange transactions such as claims, eligibility checks, prior authorizations, and remittances using a standardized EDI format called X12 HIPAA. A small group of legacy clearinghouses process the...Remote work
STEDI LLC
United States2 days ago $25 - $28 per hour
...Customer Service Rep II Duration: 24 months Location: Virtual Connecticut 06355 (Remote) Pay Rate: $25 - 28/hr Patient Access Representative The Prior Authorization Representative is responsible for verifying prior authorization requirements and obtaining authorization...Remote workArtech
Buffalo, NY2 days ago$24 - $25 per hour
...Customer Service Rep II Location: Virtual CT (Remote) Duration: 24 months Payrate: $24.00-25.00/hr The Prior Authorization Representative is responsible for verifying prior authorization requirements and obtaining authorization when required. Works directly with physician...Remote workArtech
Albuquerque, NM2 days ago- ...Clinical Administrative Coordinator (Pre-Authorization / Prior Authorization Specialist) Positions in this role are responsible for determining... ...necessary information for pre-authorization. Location: Remote Purpose of Job: Positions in this role are responsible...Remote work
Diverse Lynx
Atlanta, GA2 days ago - ...while reducing costs. About the Role This position is 100% remote, and it is a Contract to hire role. Candidates who have experienced... ...experience are given importance. Responsibilities Review prior authorization requests and make determinations for drug products according...Remote workContract workWork from home
Motion Recruitment
New York, NY3 days ago $87.7k - $137.83k
...Responsibilities include negotiating agreements with payors, managing prior authorizations, and collaborating with healthcare providers. Candidates... ...communication and relationship-building skills. This fully remote position offers a salary range of $87,700 to $137,830, along...Remote workCardinal Health
United States4 hours agonew$140k - $180k
...crucial role in providing operational leadership to the UM/Prior Authorization and Inpatient Teams (50 FTEs in total). Youll be responsible... ...vision, and life insurance. This is an onsite position- no remote options are available at this time. Requirements: ~ Healthplan...Remote workFull timeAmi Network
Pasadena, CA4 days ago- ...benefits, eligibility and expected length of stay for requested treatments and/or procedures./liliConduct reviews to determine prior authorization/financial responsibility for Molina and its members./liliProcess requests within required timelines./liliRefer appropriate...Remote workWork at officeMonday to Friday
New Mexico Staffing
United States2 days ago $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...Remote workHourly payWork experience placementWork at officeMolina Healthcare
Kearney, NE4 days ago- ...front-end intake, operations compliance, authorizations submission, clinical review, or audit/... ...independently and value open communication within a remote team setting Preferred ~4+... ..., etc.) ~ Experience with audits, prior authorizations, and appeals is a strong...Remote workWork at office
Tennr
Cleveland, OH4 days ago $37 per hour
...Job Title: Care Review Clinician Location: 100% Remote Duration: 3 Months+ (Possible Extension) Pay Rate: $37/hr (W2)... ...inpatient medical necessity reviews, concurrent reviews, and prior authorization activities. The role ensures members receive the right care...Remote workWork at officeIntegrated Resources
United States3 days ago- ...member population. This 13-week locum assignment begins 100% remote , with the intention to transition into a permanent hybrid... ...process improvement Key Responsibilities Review and determine prior authorizations, appeals, and medical necessity Conduct peer-to-peer...Remote workWeekly payPermanent employmentLocumLocal areaImmediate start
LanceSoft
United States2 days ago $26.41 - $61.79 per hour
...benefits, eligibility and expected length of stay for requested treatments and/or procedures. Conduct reviews to determine prior authorization/financial responsibility for Molina and its members. Process requests within required timelines. Refer appropriate...Remote workHourly payWork experience placementWork at officeMonday to FridayFort Worth Staffing
United States3 days ago$19 - $20 per hour
...Remote Pharmacy Technician Job Description We are seeking a dedicated Pharmacy Technician to track and triage all coverage determination requests for prior authorizations and Medicare Part D recipients. This role is essential in ensuring efficient processing and decision...Remote workContract workTemporary workDallas Staffing
Dallas, TX2 days ago$19 - $20 per hour
...crucial role in managing coverage determination requests for prior authorizations and Medicare Part D recipients. This position requires an... ...Vacation or Sick Leave) Workplace Type: This is a fully remote position. Application Deadline: This position is...Remote workContract workTemporary workRemote Staffing
Tampa, FL2 days ago- ...Medical Services Authorization Reviewer Mass General Brigham relies on a wide range of professionals... ...patient of authorization concerns prior to admission/procedure, coordinating... ...Additional Job Details (if applicable): Remote Type Hybrid. Work Location 75 Francis Street...Remote workShift work
Massachusetts General Hospital
Boston, MA1 day ago $14 - $24.02 per hour
...hiring a Pharmacy Customer Service Representative. This role is remote for those who live in Florida only. Bilingual- Spanish... ...standards. # Provides coordination and processing of pharmacy prior authorization requests and/or appeals. # Explains point-of-sale claims...Remote workHourly payWork experience placementLive inWork at officeMonday to FridayShift workMolina Healthcare
Saint Petersburg, FL2 days ago$55 per hour
...Utilization Management requests, including formulary exceptions, prior authorization, step therapy, and quantity limit exceptions. This role... ...Vacation or Sick Leave) Workplace Type: This is a fully remote position. Application Deadline: This position is...Remote workContract workTemporary workHouston Staffing
United States2 days ago$36 per hour
...Conduct intake assessments and submit documentation for prior authorization based on pay sources Develop care plans with nursing diagnoses... ...Hybrid Work Environment offering a balance of fieldwork and remote flexibility ~ Flexible Scheduling with no 12-hour shifts...Remote workPart timeImmediate startRelocation packageFlexible hoursRotating shiftSevita
Lees Summit, MO2 days ago- ...Title: Care Review Clinician I Location: Chicago, IL (Remote) Duration: 2-3 Months+ (Possible Extension) Pay Rate:... ...responsibility for Client Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed. Processes...Remote workContract workWork at officeWeekend work
Integrated Resources
United States3 hours agonew $19 - $20 per hour
...for a certified pharmacy technician to join their team! This remote opportunity offers the chance to grow within managed care... ...tracking and triaging all coverage determination requests for prior authorizations and Medicare Part D recipients. The successful candidate will...Remote workContract workTemporary workMonday to FridayShift workPhoenix Staffing Services
United States3 days ago$120k - $125k
...clinical policies and utilization management programs such as Prior Authorization, Step Therapy, Quantity Limit, and/or Coverage Determination... ...Base Salary: $120,000-125,000 Offer amounts for both remote and in office roles are influenced by geographic location...Remote workWork experience placementWork at officeNight shiftWeekend workAfternoon shiftWeekday workRightway Healthcare
Virginia Beach, VA1 day ago$2,281 per month
...Job Description Utilization Review Case Manager RN - Remote Location Remote Assignment Duration This is... ...guidelines. Utilize InterQual and Milliman criteria for prior authorizations and admission criteria. Participate in virtual meetings,...Remote workWeekly payContract workLocal areaShift workDay shiftUMMS Upper Chesapeake Medical Center Aberdeen
Aberdeen, MD4 days ago$36 per hour
...Conduct intake assessments and submit documentation for prior authorization based on pay sources Develop care plans with nursing diagnoses... ...Hybrid Work Environment offering a balance of fieldwork and remote flexibility ~ Flexible Scheduling with no 12-hour shifts...Remote workPart timeImmediate startRelocation packageFlexible hoursRotating shiftVivian Health
Lees Summit, MO1 day ago- ...Accurate document coverage details, copayments, deductibles, prior authorization requirements, and plan limitations. Prepare and submit... ...confidentiality. Other tasks as assigned. Travel: 100% Remote Supervisory Responsibilities: ~ N/A Qualities...Remote workHourly payWork at office
Senior Care Therapy
Marlton, NJ4 hours agonew
