Providence, RI · On-site
$18 - $19/hr
The Tech I Prior Auth. takes in-bound calls from providers, pharmacies, members, etc providing professional and courteous phone assistance to all callers through the criteria based prior ...
Providence, RI · On-site
$18 - $19/hr
The Tech I Prior Auth. takes in-bound calls from providers, pharmacies, members, etc providing professional and courteous phone assistance to all callers through the criteria based prior ...
$12.19 - $26.42/hr
You will review prior auth requests that are submitted. Schedules for these role will vary between Monday through Friday from 9am CST to 530p CST or or 12p to 830p CST. Qualified candidates must have ...
$12.19 - $26.42/hr
You will review prior auth requests that are submitted. Schedules for these role will vary between Monday through Friday from 9am CST to 530p CST or or 12p to 830p CST. Qualified candidates must have ...
Louisville, KY · On-site
$17.25 - $21.25/hr
At HealthCare Support, we specialize in offering healthcare professionals a seamless, red-carpet experience throughout their travel journey. Whether you're a nurse, therapist, or allied health ...
Louisville, KY · On-site
$17.25 - $21.25/hr
At HealthCare Support, we specialize in offering healthcare professionals a seamless, red-carpet experience throughout their travel journey. Whether you're a nurse, therapist, or allied health ...
Houston, TX · On-site
$20 - $23/hr
Utilization Review Care Coordinator Remote Texas HealthCare Support is actively seeking a Utilization Review Care Coordinator Remote Texas to fill an opening in Houston, Texas. Daily Responsibilities ...
New
Houston, TX · On-site
$20 - $23/hr
Utilization Review Care Coordinator Remote Texas HealthCare Support is actively seeking a Utilization Review Care Coordinator Remote Texas to fill an opening in Houston, Texas. Daily Responsibilities ...
New
$12.19 - $26.42/hr
You will review prior auth requests that are submitted. Schedules for these roles will be Mon through Fri 11am-7:30pm MST or 12:30pm-9pm MST. The training schedule will be approximately 7 weeks 9am-5 ...
$12.19 - $26.42/hr
You will review prior auth requests that are submitted. Schedules for these roles will be Mon through Fri 11am-7:30pm MST or 12:30pm-9pm MST. The training schedule will be approximately 7 weeks 9am-5 ...
$12.19 - $26.42/hr
You will review prior auth requests that are submitted. Schedules for these roles will be Mon through Fri 11am-7:30pm MST or 12:30pm-9pm MST. The training schedule will be approximately 7 weeks 9am-5 ...
$12.19 - $26.42/hr
You will review prior auth requests that are submitted. Schedules for these roles will be Mon through Fri 11am-7:30pm MST or 12:30pm-9pm MST. The training schedule will be approximately 7 weeks 9am-5 ...
Stony Brook, NY · On-site
$299 - $395/wk
$299 - $395 weekly margin Reason for Opening: Covering LOA We are working through MSP Ringo BUT we have direct manager contact. Process: * We submit through Ringo * Wait for name clearance 1-2 days
Stony Brook, NY · On-site
$299 - $395/wk
$299 - $395 weekly margin Reason for Opening: Covering LOA We are working through MSP Ringo BUT we have direct manager contact. Process: * We submit through Ringo * Wait for name clearance 1-2 days
Brooklyn, NY · On-site
$55K - $65K/yr
Reviews prior auth packet for completeness and is responsible for ensuring correct documentation is submitted to insurance. Is responsible for ensuring only clinical documentation required by ...
Quick apply
Brooklyn, NY · On-site
$55K - $65K/yr
Reviews prior auth packet for completeness and is responsible for ensuring correct documentation is submitted to insurance. Is responsible for ensuring only clinical documentation required by ...
The Prior Authorization Specialist performs the duties of working with the Insurance companies for the purpose of getting testing and procedures approved for the patient before it can be scheduled.
Quick apply
The Prior Authorization Specialist performs the duties of working with the Insurance companies for the purpose of getting testing and procedures approved for the patient before it can be scheduled.
Saint Cloud, FL · On-site
$20.30 - $27.41/hr
Oversees data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non-clinical staff ...
Saint Cloud, FL · On-site
$20.30 - $27.41/hr
Oversees data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non-clinical staff ...
Rochester, NY · On-site
$20.30 - $27.41/hr
Oversees data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non-clinical staff ...
Rochester, NY · On-site
$20.30 - $27.41/hr
Oversees data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non-clinical staff ...
The Prior Authorization Registered Nurse (RN) is responsible for conducting initial clinical reviews of preservice authorization requests, focusing on continuity of care and the proper utilization of ...
Quick apply
The Prior Authorization Registered Nurse (RN) is responsible for conducting initial clinical reviews of preservice authorization requests, focusing on continuity of care and the proper utilization of ...
Buffalo, NY · On-site
$16.50 - $18.75/hr
If there is a day(s) working remote, communicate and send any prior auth requests to a nursing team member in the office to print, perform and submit via electronic fax. * Perform training for ...
Quick apply
Buffalo, NY · On-site
$16.50 - $18.75/hr
If there is a day(s) working remote, communicate and send any prior auth requests to a nursing team member in the office to print, perform and submit via electronic fax. * Perform training for ...
If there is a day(s) working remote, communicate and send any prior auth requests to a nursing team member in the office to print, perform and submit via electronic fax. * Perform training for ...
If there is a day(s) working remote, communicate and send any prior auth requests to a nursing team member in the office to print, perform and submit via electronic fax. * Perform training for ...
$20.30 - $27.41/hr
Oversees data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non-clinical staff ...
$20.30 - $27.41/hr
Oversees data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non-clinical staff ...
Plano, TX · On-site
$22 - $26/hr
Prior Authorization Submission & Processing: Prepare and submit prior authorization requests through payer portals, fax, phone, or electronic systems, ensuring all required clinical and insurance ...
Plano, TX · On-site
$22 - $26/hr
Prior Authorization Submission & Processing: Prepare and submit prior authorization requests through payer portals, fax, phone, or electronic systems, ensuring all required clinical and insurance ...
Saint Clair Shores, MI · On-site
$15.25 - $19/hr
Duties will include obtaining referrals and authorizations prior to the service, verifying insurances at least 1-2 weeks in advance prior to service and ensuring any last-minute services have been ...
Quick apply
Saint Clair Shores, MI · On-site
$15.25 - $19/hr
Duties will include obtaining referrals and authorizations prior to the service, verifying insurances at least 1-2 weeks in advance prior to service and ensuring any last-minute services have been ...
$20.30 - $27.41/hr
Oversees data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non-clinical staff ...
$20.30 - $27.41/hr
Oversees data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non-clinical staff ...
Rochester, NY · On-site
$20.30 - $27.41/hr
Oversees data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non-clinical staff ...
Rochester, NY · On-site
$20.30 - $27.41/hr
Oversees data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non-clinical staff ...
$20.30 - $27.41/hr
Oversees data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non-clinical staff ...
$20.30 - $27.41/hr
Oversees data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non-clinical staff ...
$12.26 - $13.81
2% of jobs
$13.81 - $15.36
12% of jobs
$16.27 is the 25th percentile. Wages below this are outliers.
$15.36 - $16.91
19% of jobs
$16.91 - $18.47
14% of jobs
The median wage is $18.82 / hr.
$18.47 - $20.02
14% of jobs
$21.01 is the 75th percentile. Wages above this are outliers.
$20.02 - $21.57
22% of jobs
$21.57 - $23.12
7% of jobs
$23.12 - $24.67
4% of jobs
$24.67 - $26.22
2% of jobs
$26.22 - $27.78
2% of jobs
$27.78 - $29.33
1% of jobs
$12
$19
$29
| Aspect | Prior Auth | Medical Billing Specialist |
|---|---|---|
| Required Credentials | Knowledge of insurance policies, certifications vary | Certification often preferred, knowledge of billing codes |
| Work Environment | Healthcare offices, insurance companies | Medical offices, billing companies |
| Employer & Industry Usage | Used in healthcare to authorize procedures | Used to process and submit medical claims |
| Common Search & Comparison | Yes | Yes |
Prior Auth involves obtaining approval from insurance companies before procedures, while Medical Billing Specialists handle the billing process after services are provided. Both roles are essential in healthcare administration but focus on different stages of patient care and reimbursement.
$18 - $19/hr
Other
Re-posted 17 days ago
$18-$19 per hour
remote, RI
Contract
Job Summary:
The Tech I Prior Auth. takes in-bound calls from providers, pharmacies, members, etc providing professional and courteous phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of reviews. Transfers all clinical questions, escalations and judgement calls to the pharmacist team.
The Tech I will also assist with other duties as needed to include but not limited to: outbound calls, reviewing and processing Prior Auth's received via fax and ePA, monitoring and responding to inquiries via department mailboxes and other duties as assigned by the leadership team.
Responsibilities:
Effectively manage work volume by handling inbound calls/fax/ePA requests utilizing appropriate courteous and professional behavior based upon established standards. 40%
Comply with departmental, company, state, and federal requirements when processing all information to ensure accuracy of information being provided to internal and external customers. 40%
Communication with other internal groups regarding determination status and results (seniors, pharmacists, appeals, etc.). 10%
Identify and elevate clinical inquiries to the pharmacist team as appropriate. 5%
Other duties assigned, for example faxes, sorting, email boxes, CAS maintenance, etc. 5%
Experience:
Preferred 0-3 years work experience required in a customer service position with high volume call center experience; preferably in healthcare, social services, or a similar service position.
Education:
About US Tech Solutions:
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com (http://www.ustechsolutionsinc.com/) .
US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
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US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions.
It services
1,001 - 5,000 Employees
Jersey City, NJ, US
2000
