Manager Prior Authorization Jobs in Georgia (NOW HIRING)

... prior authorization (PA) form completions. The Nurse also will manage, instruct and educate mentally and emotionally disabled clients. He/she will work with child, adolescent, and adult clients.

Obtain, track, and manage prior authorizations for scheduled diagnostic testing and physician services. * Verify patient insurance eligibility, benefits, coverage, and authorization requirements ...

Review pharmacy prior authorization requests for coverage determination across multiple health ... Enter coverage decisions accurately into the Pharmacy Benefit Management (PBM) system and other ...

Manage inbound and outbound inquiries related to eligibility, benefits, claims, and prior authorizations, resolving moderately complex issues and determining appropriate next steps * Escalate ...

Key operational duties include managing prior authorizations through payer portals, maintaining up-to-date insurance requirement files, and scheduling specialized imaging such as CT and MRI scans at ...

Obtain, track, and manage prior authorizations for scheduled diagnostic testing and physician services. * Verify patient insurance eligibility, benefits, coverage, and authorization requirements ...

Provide clinical support for utilization management, prior-authorization criteria, and step-therapy guidelines. What You'll Bring * Education: PharmD or Bachelor of Pharmacy. * Licensure: Active U.S ...

Provide clinical support for utilization management, prior-authorization criteria, and step-therapy guidelines. What You'll Bring * Education: PharmD or Bachelor of Pharmacy. * Licensure: Active U.S ...

Our model is built around responsive service, personalized medication management, customized medication packaging, clinical coordination, prior authorization support, and strong relationships with ...

Prior Authorization ManagementPrior authorization management is an important component of our service model, particularly within behavioral health and serious mental illness populations.The ...

Managing denial and/or appeal escalations and communicating delays to the Director, Utilization ... Understanding of prior authorization regulatory requirements and turnaround time expectations (CMS ...

Management Consulting, Systems Integration Consulting or Technology Consulting. These workgroups ... You have working knowledge across the full revenue cycle: patient access, prior authorization, mid ...

The Field Reimbursement Manager (FRM) is responsible for managing an assigned territory focused on ... Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare ...

The Field Reimbursement Manager (FRM) is responsible for managing an assigned territory focused on ... Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare ...

The Field Reimbursement Manager (FRM) is responsible for managing an assigned territory focused on ... Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare ...

The Field Reimbursement Manager (FRM) is responsible for managing an assigned territory focused on ... Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare ...

... Prior Authorization, or Patient Financial Engagement * Hands-on Experience With Payer Contracting ... Managed Care Optimization, or Underpayment Recovery * Proficient With Data Visualization & Analytic ...

The Field Reimbursement Manager (FRM) is responsible for managing an assigned territory focused on ... Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare ...

Communicate relevant data to clinical liaisons, case managers, prior authorization team, and physicians to help prepare for admission. * Point of coordinator on day of admissions to guarantee that ...

Completes prior authorizations, tracks the status, and communicates outcome with patients and ... Utilizes Southwell Pharmacy order entry system to manage refills to maximize patient adherence.