Prior Auth Jobs in New York (NOW HIRING)

1 year of experience Pharmko is looking for a DME coordinator to handle intake, product selction, prior auth, software input, client relationship, logistic, delivery, patient setup, compliance. Must ...

Competitive pay, benefits, and pathways into prior auth, clinical review, or leadership. About Us We partner with health plans and PBMs nationwide to deliver high-quality MTM services. Our ...

Competitive pay, benefits, and pathways into prior auth, clinical review, or leadership. About Us We partner with health plans and PBMs nationwide to deliver high-quality MTM services. Our ...

Competitive pay, benefits, and pathways into prior auth, clinical review, or leadership. About Us We partner with health plans and PBMs nationwide to deliver high-quality MTM services. Our ...

GCP (Vertex AI, Cloud Run, GKE), Python, Agentic Frameworks (LangChain/LangGraph, LlamaIndex, AutoGen), Vector DBs, Payer Systems (EDI/FHIR, Claims, Prior Auth) Required Qualifications & Experience ...

GCP (Vertex AI, Cloud Run, GKE), Python, Agentic Frameworks (LangChain/LangGraph, LlamaIndex, AutoGen), Vector DBs, Payer Systems (EDI/FHIR, Claims, Prior Auth) Required Qualifications & Experience ...

Review claims, prior auth requests, and ADT (admission/discharge/transfer) data to identify members who would benefit from case management * Conduct clinical assessments and build individualized care ...

You'll be embedded within oncology and radiology practices - delivering hands-on training, building lasting trust with clinical teams, and ensuring Risa workflows (prior auth, radiology, medical ...

Prior Auth * Bilingual Spanish/English Education Requirements: * High School Graduate or equivalent or 5 years of Medical Assistant/PCT experience * Completion of an accredited program for Medical ...

Prior Auth Education Requirements: * High School Graduate or equivalent or 5 years of Medical Assistant/PCT experience * Completion of an accredited program for Medical Assistant/Patient Care ...

Prior Auth * Bilingual English/Spanish Education Requirements: * High School Graduate or equivalent or 5 years of Medical Assistant/PCT experience * Completion of an accredited program for Medical ...

... prior to submission. The coordinator will support the needs of the Stanford Medicine Partner ... Pharmacy Medicine Pre-Auth Coordinator: * Responsible for confidentially reviewing medical records ...

Prior Auth experience * flexible travel to two offices (Ramsey and Ridgewood) Education Requirements: * High School Graduate or equivalent or 5 years of Medical Assistant/PCT experience * Completion ...

Prior Auth * Epic Knowledge * Phelbotomy experience Education Requirements: * High School Graduate or equivalent or 5 years of Medical Assistant/PCT experience * Completion of an accredited program ...

... prior auth/step edit impact, prescription abandonment, and net price dynamics • Mine wholesaler EDI 852 (inventory) and EDI 867 (sales-out) data to identify channel trends, demand signals, and ...

Analyze payer patient claims data to surface coverage trends, prior auth/step edit impact, prescription abandonment, and net price dynamics Mine wholesaler EDI 852 (inventory) and EDI 867 (sales-out ...

... prior auth handled Integrated EMR (CureMD) with custom reporting, eSign, Surescripts, and UB-04 billing infrastructure Marketing engine -- dedicated Growth & Marketing Lead, content production ...

A unified claim activity timeline across submissions, payer status, remittances, appeals, and prior auth * Embedding AI where it removes real friction--claim comparison, submission-error reasoning ...

... auth models, and database safety practices. • Establish runbooks and operational guides that ... Prior experience building or owning internal tools for operations environments, logistics ...

Upgrade/downgrade certification's as needed prior to and at time of study. * Maintain updated knowledge of participating insurances and user operations for office pre-auth worklist, and Exchange EDI ...