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Internship Remote Prior Authorization Jobs in Ohio

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Internship Remote Prior Authorization information

What is the difference between Internship Remote Prior Authorization vs Medical Billing Specialist?

AspectInternship Remote Prior AuthorizationMedical Billing Specialist
CredentialsTypically no formal credentials required; may include healthcare or insurance knowledgeCertification often preferred (e.g., CPC, CPC-H)
Work EnvironmentRemote, administrative setting, healthcare or insurance companiesOffice or remote, healthcare facilities or billing companies
Employer & IndustryHospitals, insurance companies, healthcare providersHospitals, clinics, billing service providers
Search & Comparison IntentUnderstanding internship roles involving prior authorization processesLearning about billing processes and insurance claim management

Internship Remote Prior Authorization focuses on assisting with approval processes for healthcare services, often as a learning role. Medical Billing Specialists handle billing, coding, and insurance claims. While both roles involve healthcare administration, the internship is more educational and entry-level, whereas the billing specialist is a more experienced, operational position.

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Cities in Ohio with the most Internship Remote Prior Authorization job openings:

Internship Remote Prior Authorization jobs near you

Pharmacy Prior Authorization Specialist

Communicarehealth

Broadview Heights, OH • Remote

$17.50 - $23.25/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 28 days ago

Job description

Job Address:

9299 Market Place Broadview Heights, OH 44147


Job Description: Prior Authorization Specialist

Reports to: Pharmacy Prior Authorization Manager

Job Type: Full-Time - Remote - Pharmacies: West Virginia, Ohio, Indiana and Maryland

Position Overview: The Prior Authorization Specialist will maintain the Prior Authorization's workflow for a set of facilities assigned by the supervisor, while providing customer service to clients. He/she wil enter required information and submit Prior Authorizations to the respective plan, follow the prior authorization to completion, identify and clarify any discrepancies with a prior authorization, and participate in the appeal process.

Key Responsibilities Include but are not limited to:

  • Work in cohesion with the Adjudication, Claim Intervention and Billing Departments
  • Submit prior authorizations in accordance with Insurance regulations
  • Ensure accurate and timely processing of prior authorizations
  • Work directly with insurance companies for prior authorization resolution
  • Communicate with facilities to gain additional information
  • Any other duties assigned
  • Follow federal and state regulations
  • Adhere to company policies and procedures
  • Follow HIPPA guidelines and regulations

Qualifications and Requirements:

  • Prior Authorization experience (not required)
  • Previous Long-Term Care pharmacy experience a plus (not required)
  • Knowledge of Framework LTC a plus (not required)

Salary and Benefits:

  • Competitive salary commensurate with experience
  • Comprehensive benefits package, including health, dental, and vision insurance, 401(k) with company match, paid time off, and more

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