- Seattle Children's (Seattle, WA)
- Responsibilities: The Prior Authorization (PA) Specialist is responsible for all aspects of the prior authorization process while continuously ... year Seattle Children's Outpatient Pharmacy experience. + Specialty Pharmacy and/or Centralized Prior Authorization Services knowledge. Min to Max Hourly… more
- Penn State Health (Hershey, PA)
- …more detailed steps for assistance._ **Union:** Non Bargained **Position** Insurance Authorization Specialist - Pharmacy Outpatient **Location** ... equivalent required. + Two (2) years of experience in Prior Authorizations in either a Pharmacy or...experience in Prior Authorizations in either a Pharmacy or a Clinical setting required. **KNOWLEDGE, SKILLS, &… more
- University of Michigan (Ann Arbor, MI)
- Prior Authorization Specialist Apply Now **Summary** Processes referrals and prior authorizations using established insurance company guidelines. Obtains ... action employer. **Job Detail** **Job Opening ID** 246886 **Working Title** Prior Authorization Specialist **Job Title** Patient Services… more
- BrightSpring Health Services (Englewood, CO)
- …patients nationwide through our growing network of branches and healthcare professionals. The Prior Authorization Specialist role will be responsible for ... of prior authorizations. This role requires working knowledge of pharmacy benefits and prior authorization process. NOTE: Work Schedule: Monday - Friday… more
- Sharp HealthCare (San Diego, CA)
- …patients, medical providers, insurance companies and pharmacies requesting prior authorizations.Collaborate with ancillary and operational departments to research ... patient's insurance eligibility, benefits and requirements.Request, track and obtain pre- authorization from insurance carriers within time allotted for medical and… more
- University of Colorado (Aurora, CO)
- …agency (https://www.jobelephant.com/) As a key member of the Revenue Cycle Team, the Prior Authorization and Payer Reimbursement Specialist (PAPR) at the ... info, etc., as necessary. + Work closely with the Pharmacy Revenue Cycle Specialist to coordinate and...a key member of the Revenue Cycle Team, the Prior Authorization and Payer Reimbursement Specialist… more
- Health First (Rockledge, FL)
- …includes, all Formulary Exception, Prior Authorization and Administrative Authorization requests for both the pharmacy and medical benefit, as ... with 1 year of Managed Care, or Pharmacy Benefit Specialist experience. *Licensure:*See above. *Certification:*None Required. *Work Experience:* Prior managed… more
- Baptist Memorial (Memphis, TN)
- Summary Authorization Denial Specialist ensures that chemotherapy (specialty group) and other infusions/radiation therapy/radiology/ surgical services meet ... education + Employee referral program Job Summary: Position: 18063 - Specialist - Authorization Denial Facility: BMHCC Corporate Office Department: HS Revenue… more
- Trinity Health (Fort Wayne, IN)
- …and provides information to patients and providers as it pertains to the patient's pharmacy benefits. Determines if prior authorization is needed for the ... documentation and ensures completeness of the prior authorization questionnaires. Collaborates with Integrated Specialty Pharmacy Staff located… more
- Henry Ford Health System (West Bloomfield, MI)
- …Specialist is responsible for handling drug claim adjudication issues, prescription prior authorization , and pharmacy benefit inquiries from ... in the resolution of pharmacy benefit coverage issues and coordinating prior authorization and exception processes. PRINCIPLE DUTIES AND RESPONSIBILITIES: +… more
- Henry Ford Health System (Bingham Farms, MI)
- …place referral for patient follow-up in specialty clinics/departments, and facilitate prior authorization with appropriate pharmacy partners across ... GENERAL SUMMARY: The Pharmacy Specialist provides oversight and leadership...primary care or managed care is strongly desired. . Prior experience and knowledge or integrated health systems .… more
- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: The Authorization Specialist works with providers, patients, ancillary departments, pharmacy and insurance carriers to ensure that all ... orders and insurance claim submission. Experience with healthcare insurance prior authorization /coding and performing insurance carrier/managed care review… more
- Henry Ford Health System (Rochester Hills, MI)
- …Specialist is responsible for handling drug claim adjudication issues, prescription prior authorization , and pharmacy benefit inquiries from ... in the resolution of pharmacy benefit coverage issues and coordinating prior authorization and exception processes. PRINCIPLE DUTIES AND RESPONSIBILITIES: +… more
- Marshfield Clinic (Marshfield, WI)
- …to support the most exciting missions in the world!** **Job Title:** SHP Clinical Pharmacy Specialist - Temporary Position from Mid-May to Mid-August (Remote or ... 5:00 pm (United States of America) **Job Description:** **JOB SUMMARY** The Clinical Pharmacy Specialist works with physicians, staff, and committees to optimize… more
- COFMC (Ada, OK)
- …claims to appropriate carrier for all commercial, federal, and state insurance plans. Submit prior authorization requests, follow up on submitted prior ... DEPARTMENT: Pharmacy NATURE OF POSITION: The Pharmacy Billing Specialist is responsible for performing tasks related to the management of third-party billing… more
- MD Anderson Cancer Center (Houston, TX)
- …to comply with institutional standards, initiatives, and guidelines (ABN's, prior authorization requirements, reimbursement optimization, formulary management, ... a one to one basis. **Preferred Experience:** Experience as a clinical pharmacy specialist **Onsite Presence: Is Required** **WORKING CONDITIONS** Frequency… more
- US Tech Solutions (RI)
- …of experience using Microsoft Word and Excel. **Skills:** + Calling + PBM + Prior authorization **Education:** Verifiable High School Diploma or GED. **About US ... **Job Description:** As a Pharmacy Insurance Specialist , you will be responsible for ensuring that all required third party insurance settings are coded and… 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
- SSM Health (St. Louis, MO)
- …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
- University of Rochester (Rochester, NY)
- …clinics. Duties will include collaboration with clinical staff to acquire prior authorization for relevant providers, benefit investigation, enrollment of ... able to establish strong collaborative working relationships. **SPECIFIC RESPONSIBILITIES:** **A. Prior Authorization Management** 1. Highly knowledgeable of the… more