- Kepro (AL)
- …being a vital partner for health solutions in the public sector. Acentra seeks a Prior Authorization Reviewer to join our growing team. Job Summary: The Prior ... Authorization Reviewer: + Reviews verbal and electronic prior authorization requests based upon pre-established criteria...to 4:00 PM Central. ** ** This is a Remote position within the state of Alabama, where the… more
- CVS Health (Austin, TX)
- …and other Windows based computer applications.* Ability to receive phone calls from prior authorization pharmacy technicians and/or providers for clinical ... Non-Specialty Pharmacy programs administered within the Commercial Prior Authorization and Case Review Unit (CRU)...employee discount at all CVS stores. This is a remote role open to candidates within the United States.… more
- CVS Health (Austin, TX)
- …and other Windows based computer applications.* Ability to receive phone calls from prior authorization pharmacy technicians and/or providers for clinical ... Non-Specialty Pharmacy programs administered within the Commercial Prior Authorization and Case Review Unit (CRU)...employee discount at all CVS stores. This is a remote role open to candidates within the United States.… more
- University of Michigan (Ann Arbor, MI)
- Prior Authorization Specialist Apply Now **Summary** Processes referrals and prior authorizations using established insurance company guidelines. Obtains ... queues. Responds to patient inquires and manages referral and/or prior authorization related issues in a timely...and employees. + Ability to effectively work in a remote environment and connect via multiple communication channels (phone,… more
- Actalent (Plano, TX)
- …Skills: retail pharmacy , insurance verification, pharmacy technician certificate, Pharmacy , Customer service, Cpht, Prior authorization , Call center, ... Job Title: Pharmacy Technician II REMOTE /WORK FROM HOME...pharmacy , insurance verification, pharmacy technician certificate, Pharmacy , Customer service, Cpht, Prior authorization… more
- Marshfield Clinic (Marshfield, WI)
- …Specific Responsibilities: + Interpret clinical guideline criteria to make clinical prior authorization and appeal determinations in accordance with medical ... Pharmacy Specialist - Temporary Position from Mid-May to Mid-August ( Remote or Hybrid Option) **Cost Center:** 682891381 SHP- Pharmacy **Scheduled Weekly… more
- Prime Therapeutics (Columbus, OH)
- …clients in all Medical Pharmacy programs such as Fee Schedule Management, Prior Authorization , Post Service Claim Edits, Site of Service and any additional ... decision we make. **Job Posting Title** Director, Specialty Clinical Solutions/Med Pharmacy exp required- REMOTE **Job Description Summary** Responsible for… more
- SSM Health (Madison, WI)
- …service experience through the provision of benefits investigations and conducting prior authorization services. Develops a thorough understanding of payer ... developing client-based relationships with clinical staff and patients, presenting pharmacy service options through customized financial analysis, and facilitating… more
- Health First (Rockledge, FL)
- …includes, all Formulary Exception, Prior Authorization and Administrative Authorization requests for both the pharmacy and medical benefit, as ... *Position Summary * Apply proper authorization requirements and pharmacy benefits for...and disease management. *Primary Accountabilities * 1. Apply proper authorization requirements to all prior authorization… more
- G-TECH Services, Inc. (Detroit, MI)
- … Pharmacy * Experience in provider/member call center or helpdesk * Process prior authorization requests Required Skills/Experience - The rest of the required ... facing webtool. Preferred Skills/Experience - Optional but preferred skills/experience. Include: * Prior Authorization on Pt B specialty medications * Knowledge… more
- Elevance Health (Chicago, IL)
- …for the interpretation and data entry of moderately complex prescriptions, prior authorization processing, and troubleshooting adjudication issues. **Hours:** ... ** Pharmacy Tech II** **This position will work a...prescriptions and medication resources or assistance programs. + Processes prior authorization requests from physicians offices and… more
- Elevance Health (Chandler, AZ)
- …is responsible for the interpretation and data entry of basic prescriptions, prior authorization processing, and troubleshooting adjudication issues. **How you ... ** Pharmacy Technician l** **Location** : This position will...prescriptions and medication resources or assistance programs. + Processes prior authorization requests from physicians' offices and… more
- Elevance Health (Tucson, AZ)
- …outreach to patients and prescribers for resolution on open issues. + Processes prior authorization requests from physicians and ensures compliance with all ... ** Pharmacy Technician III- Escalations ( Pharmacy Tech...regulatory requirements; informs relevant parties of all prior authorization determinations. + Provides resolution to… more
- AdventHealth (Apopka, FL)
- …The Specialty Pharmacy Supervisor oversees the intake, claims adjudication, prior authorization coordination and patient management processes to ensure ... staff and physician office(s) on any questions regarding formulary coverages, eligibility, prior authorization , or general plan guidelines. + Maintains an… more
- Vanderbilt University Medical Center (Nashville, TN)
- …Residence in the middle Tennessee region is preferred. . KEY RESPONSIBILITIES + Evaluate prior authorization requests for key barrier + Determine best route for ... pharmacy challenges. More specifically this person will manage prior authorizations for primary care patients from initial request...medication access including prior authorization or alternative path + Review… more
- BrightSpring Health Services (Great Falls, MT)
- …customer chain. Duties include staff development and accountability, billing quality, Prior Authorization , Claim Overrides and customer service* Validate ... The ideal candidate will be a customer service focused Pharmacy Technician or someone who has worked in a...Work in conjunction with Account Management to communicate billing, Prior Authorization and Payer information with the… more
- GEHA (Lee's Summit, MO)
- …following: * Insuring evidence-based medication utilization among our membership through prior authorization criteria development and implementation * Upholding ... Management and Quality. Primary external contact will be the health plan pharmacy benefit manager (PBM). \#LI- Remote Work-at-home requirements + Must have… more
- Adecco US, Inc. (Woonsocket, RI)
- …** Adecco is currently assisting a National Pharmaceutical client, searching for REMOTE Pharmacy Techs. Must have State License and/or Certifications** This ... professional phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation… more
- Prime Therapeutics (Columbus, OH)
- …and Therapeutics (P&T) Committees. + Develops and maintains client specific prior authorization criteria as part of the Pharmacy and Therapeutics process. + ... functions, DUR committees and responsibilities. Supports elevated customer service and prior authorization inquiries specific to assigned accounts. Directly… more
- The Cigna Group (Memphis, TN)
- …Distributes work requests to team members and monitors for completion + Processes prior Authorization requests, new referrals and answers general questions + ... Provider Relations Analysts. You'll be responsible for promoting our Specialty Pharmacy Services to; Physicians, Nurses, Social Workers, Office Managers, and Case… more