- Kansas Surgery & Recovery Center (Wichita, KS)
- … to surgery. Requirements Applicant should have one year experience in medical prior authorization /precertification's, additional experience in third party ... reimbursement is preferred. Benefits Full and part-time employees are eligible for a variety of benefits, including health, dental, vision and 401(k). FROM OFFICE OF HUMAN RESOURCES Thank you for your interest in Kansas Surgery & Recovery Center. We are an… more
- Northwell Health (Lake Success, NY)
- …Lab, located in the Bronx, NY. Requirements: * Advanced knowledge of medical insurance verification, prior authorization processes, and reimbursement ... Senior Medical Office Administrator with experience in _Healthcare Insurance Authorization and Revenue Cycle Operations_ for our Client, a Prosthetics and… more
- Hartford HealthCare (Hartford, CT)
- …And this is *your moment*. **Job:** **Administrative* **Organization:** **Hartford HealthCare Medical Group Specialists* **Title:** * Prior Authorization ... you to become part of Connecticut's most comprehensive healthcare network. Hartford HealthCare Medical Group is one of the largest medical practices in New… more
- Beth Israel Lahey Health (Burlington, MA)
- …Assistance programs. 2. Collects and reviews all data needed for pharmacy and medical prior authorization approvals. Provides formulary assistance for clinic ... of Pharmacy 3-5 years related work experience required in specialty pharmacy and medical prior authorization experience or a minimum of 4 years of pharmacy… more
- US Tech Solutions (May, OK)
- …that conducts clinical reviews of medical data collected to perform prior authorization for specialty medications. The clinical pharmacist will apply ... Handles inbound phone calls and escalations from physicians or patients regarding Prior Authorization + Establishes and maintains communication among, health… more
- US Tech Solutions (GA)
- …medication prior authorization (PA) requests reviewed by the Specialty Medical Prior Authorization department. Reporting to the Pharmacy Operations ... staff and customer service, admissions and pharmacy operations departments to communicate prior authorization status. You will also oversee fax processing and… more
- Cabinet Peaks Medical Center (Libby, MT)
- Cabinet Peaks Medical Center is seeking a team-oriented Prior Authorization Specialist to work in the Business Office! Reporting to the Director of Revenue ... verify patient's insurance eligibility, benefits and requirements. Request, track and obtain prior authorization from insurance carriers within time allotted for… more
- Cardinal Health (Dover, DE)
- …+ 3-6 years of experience in healthcare payer-facing work such as prior authorization , insurance verification, medical documentation, revenue cycle, ... preferred. + Knowledge of payer criteria for DME prior authorization , including common documentation requirements and medical necessity standards, preferred… more
- Children's Clinics (Tucson, AZ)
- …AHCCCS, CRS, and private insurance guidelines + Knowledge of precertification, referrals, and prior authorization + Knowledge of medical terminology, CPT, ... Speech Therapy and Audiology. ESSENTIAL FUNCTIONS + Appropriately prioritize all prior authorization request/ referrals. Submits for onsite and offsite… more
- UCLA Health (Los Angeles, CA)
- …This position is responsible for reviewing and evaluating clinical documentation related to prior authorization requests for medical services. The UM Review ... utilization of resources. Key Responsibilities: + Conducts clinical reviews of prior authorization requests to evaluate medical necessity and benefit… more
- Elevance Health (Nashville, TN)
- …Outpatient medical office experience preferred. + Infusion experience preferred. + Medical billing, prior authorization and order verification experience ... ** Medical Assistant (MA)- Paragon Infusion Centers** **Location** :...pharmacies, our infusion centers, and the home setting._ The ** Medical Assistant (MA)- Paragon Infusion Centers** is responsible for… more
- Beth Israel Lahey Health (Westwood, MA)
- … guidelines and processes. 2. Collects and reviews all data needed pharmacy and/or medical for prior authorization approvals. 3. Resolves insurance related ... the prescribers to document, submit, communicate outcomes and appeal if necessary all pharmacy/ medical prior authorizations. Is also involved in all aspects of… more
- US Tech Solutions (May, OK)
- …that conducts clinical reviews of medical data collected to perform prior authorization for commercial and specialty medications. + The clinical pharmacist ... denied prior authorizations. **Responsibilities:** + Evaluate and review all prior authorization requests and render coverage determinations based on… more
- Beth Israel Lahey Health (Westwood, MA)
- … guidelines and processes. 2. Collects and reviews all data needed pharmacy and/or medical for prior authorization approvals. 3. Resolves insurance related ... the prescribers to document, submit, communicate outcomes and appeal, if necessary, all pharmacy/ medical prior authorizations. Is also involved in all aspects of… more
- Actalent (Oakland Park, FL)
- …phlebotomy, along with documenting patient care. Your role will involve completing medical prior authorization and documentation requirements while ... immunizations, injections, and phlebotomy. + Document patient care and complete medical prior authorization requirements. + Collaborate with clinic team… more
- TEKsystems (Dallas, TX)
- …in insurance verification, pharmacy benefit investigation, or related healthcare services ( medical billing, prior authorization support). * Preferred: ... campaign support may be requested during peak periods. Skills insurance verification, prior authorization , medical insurance, Customer service, Multi… more
- St. Peters Health (Helena, MT)
- …skills and compassionate competence. 4. Apply medical knowledge and experience for prior authorization requests. 5. Perform detailed medical reviews of ... cases where admission exceeds the GMLOS, documentation of avoidable, initiation of authorization request and submission of records for post-acute care facilities who… more
- TEKsystems (Woods Cross, UT)
- …Specialist with extensive experience in health insurance, including claims, patient access, medical billing, prior authorization , and medical ... fast-paced environment. + Good verbal and written communication skills. + Familiarity with medical ICD-9 codes and CPT medical billing codes. + Comprehensive… more
- SUNY Upstate Medical University (Syracuse, NY)
- …Upstate Medical University Hospital retail pharmacy revenue through provision of prior authorization services at Upstate Medical University Hospital ... medical necessity of medication use based on established criteria. Obtain prior authorization from intermediaries and payers, including managed care… more
- University of Utah (Salt Lake City, UT)
- Details **Open Date** 01/08/2026 **Requisition Number** PRN43980B **Job Title** Prior Authorization Representative I **Working Title** Prior Authorization ... 01/22/2026 **Job Summary** We are looking for an experienced Prior Authorization Representative to join our team.... authorization , as needed. + Review and summarize pre- authorization criteria for medical necessity to aid… more
Related Job Searches:
Authorization,
Medical,
Medical Prior,
Medical Prior Authorization Specialist,
Prior,
Prior Authorization