- St. Luke's University Health Network (Allentown, PA)
- …PCP and Specialty service lines. + Utilizes specific Epic Work Queues designed for Prior Authorization and Insurance Referral workflows to ensure correct ... Responsible for reviewing medical necessity of genetic testing/infusion services in addition to prior authorization to ensure revenue for services. + Monitors a… more
- Atlantic Health System (Morristown, NJ)
- Overview: We are seeking a skilled Medical Prior Authorization Specialist to join our team. The ideal candidate will be responsible for obtaining prior ... entire authorization process. Responsibilities: 1. Initiate and manage the prior authorization process for all obstetrical patients and gynecological… more
- Atlantic Health System (Morristown, NJ)
- We are seeking a skilled Medical Prior Authorization Specialist to join our team. The ideal candidate will be responsible for obtaining prior authorizations ... specialized tasks. Position Principal Accountabilities: 1. Initiate and manage the prior authorization process to include medications, diagnostic testing,… more
- Select Medical (Peoria, AZ)
- …A joint venture with Select Medical & Banner Health Phoenix, Arionza ** Prior Authorization Specialist / Payor Relations Specialist** **Remote position - ... and independent judgment, the Payor Relations Specialist manages the pre-certification and prior authorization of referrals scheduled for admission to the Acute… more
- Centene Corporation (Austin, TX)
- …polices to identify preferred in- network providers and requirements for referral authorization ; provides supporting documentation to health plan + Provides ... Works with the utilization management team and supports the prior authorization request process to ensure that...such as history, diagnosis, and prognosis based on the referral to the clinical reviewer for determination + Maintains… more
- UPMC (Pittsburgh, PA)
- …values of UPMC in the performance of duties. **Responsibilities:** + Prior authorization responsibilities1. Reviews and interprets medical record documentation ... UPMC system and insurance payor or contracted provider web sites to perform prior authorization , edit, and denial services.4. Utilize authorization resources… more
- UPMC (Pittsburgh, PA)
- …occur to limit the ability to work remotely. Responsibilities: + Prior authorization responsibilities1. Reviews and interprets medical record documentation ... UPMC system and insurance payor or contracted provider web sites to perform prior authorization , edit, and denial services.4. Utilize authorization resources… more
- UPMC (Pittsburgh, PA)
- …daylight position. No nights, weekends, or holidays!** **Responsibilities:** + Prior authorization responsibilities: 1. Reviews and interprets medical ... UPMC system and insurance payor or contracted provider web sites to perform prior authorization , edit, and denial services.4. Utilize authorization resources… more
- AdventHealth (Denver, CO)
- …ongoing, new, or altered. After gathering clinical information, responsible for obtaining prior authorization for infusion and injectable medications based on ... medication-based referrals as well as expiring medication-based referrals. + Verifies Prior authorization requirements based on patient's specific insurance… more
- HonorHealth (Phoenix, AZ)
- …as necessary to become proficient. Perform tasks related to the management of prior authorization for patients served by infusion clinics. Reviews medical ... a respectful demeanor. Facilitates problem solving with clinical departments, providers, referral sources, insurance companies and authorization staff. Assists… more