Prior Auth Jobs (NOW HIRING)

Performs initial receipt and review of non-formulary or prior authorization requests against pharmacy plan approved criteria; requests additional information from providers as needed to properly ...

Oversees data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non-clinical staff ...

M-F day shift * 3-5+ years high volume retail experience required/ 1+ year prior auth experience required * CPht highly preferred/ required- Certified Pharmacy Tech (Required) * H.S. Diploma/GED ...

SUMMARY: As an integral member of the pharmacy team and under the supervision of a pharmacist, the prior authorization pharmacy technician is responsible for providing clinic-based prior ...

... Prior Auth Pay Range: $12.19 - $26.42 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Functional SME in referrals + prior auth * Strong collaboration with operations, access teams, and revenue cycle stakeholders * Experience working in new build or optimization environments

Review documents multiple times throughout shift to perform prior auth submission through appropriate website (i.e. Cover My Meds). * If there is a day(s) working remote, communicate and send any ...

Haw many Prior Auth cases have you handled in your last role? * Do you have experience in handling calls regarding prior authorization and appeals? About Us Tech Solutions US Tech Solutions is a ...

Haw many Prior Auth cases have you handled in your last role? * Do you have experience in handling calls regarding prior authorization and appeals? About US Tech Solutions: US Tech Solutions is a ...

Review rejected prior authorization cases that have gone to appeal, with a focus on medical authorizations and injectable therapies administered in provider offices. * Access and manage the ...

Previous prior authorization experience strongly preferred * Managed care experience preferred * Experience working with health plan auditors preferred * Working knowledge of InterQual preferred

Review rejected prior authorization cases that have gone to appeal, with a focus on medical authorizations and injectable therapies administered in provider offices. * Access and manage the ...

Previous prior authorization experience strongly preferred * Managed care experience preferred * Experience working with health plan auditors preferred * Working knowledge of InterQual preferred

Previous prior authorization experience strongly preferred * Managed care experience preferred * Experience working with health plan auditors preferred * Working knowledge of InterQual preferred

Review rejected prior authorization cases that have gone to appeal, with a focus on medical authorizations and injectable therapies administered in provider offices. * Access and manage the ...

Previous prior authorization experience strongly preferred * Managed care experience preferred * Experience working with health plan auditors preferred * Working knowledge of InterQual preferred

Previous prior authorization experience strongly preferred * Managed care experience preferred * Experience working with health plan auditors preferred * Working knowledge of InterQual preferred

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 ...

The role will mainly focus on Production, with an opportunity to learn other roles such as patient outreach, intake, shipping, or prior auth. * This position takes in-coming calls from members ...

The role will mainly focus on Production, with an opportunity to learn other roles such as patient outreach, intake, shipping, or prior auth. * This position takes in-coming calls from members ...