Cincinnati, OH · Hybrid
$18 - $22/hr
Coordinate with insurance entities, review organizations, and clinical contacts for effective ... prior authorization within a healthcare practice * Pain Management experience is a plus
Cincinnati, OH · Hybrid
$18 - $22/hr
Coordinate with insurance entities, review organizations, and clinical contacts for effective ... prior authorization within a healthcare practice * Pain Management experience is a plus
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Hudson, OH · On-site
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Hudson, OH · On-site
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Elyria, OH · On-site
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Elyria, OH · On-site
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Prior formal leadership experience required; two or more years of supervisory or management ... Knowledge of medical necessity, patient status, level-of-care review, authorization processes ...
Columbus, OH · On-site
Conducts prior authorization reviews to determine financial responsibility Qualifications * 2 years Inpatient background with Hospital Nursing (Med-Surg, ER) * Well versed in Utilization Management ...
Columbus, OH · On-site
Conducts prior authorization reviews to determine financial responsibility Qualifications * 2 years Inpatient background with Hospital Nursing (Med-Surg, ER) * Well versed in Utilization Management ...
... for prior authorization, utilization management, reporting, data tracking, and peer review ... functions for TCN Behavioral Health Services. Key Responsibilities: * Completes and submits prior ...
... for prior authorization, utilization management, reporting, data tracking, and peer review ... functions for TCN Behavioral Health Services. Key Responsibilities: * Completes and submits prior ...
... for prior authorization, utilization management, reporting, data tracking, and peer review ... functions for TCN Behavioral Health Services. Key Responsibilities: * Completes and submits prior ...
... for prior authorization, utilization management, reporting, data tracking, and peer review ... functions for TCN Behavioral Health Services. Key Responsibilities: * Completes and submits prior ...
Columbus, OH · On-site
... prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum ... Insurance Utilization Manager/Review and Millemen Experience (MCG). No case managers if that is ...
Columbus, OH · On-site
... prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum ... Insurance Utilization Manager/Review and Millemen Experience (MCG). No case managers if that is ...
... for prior authorization, utilization management, reporting, data tracking, and peer review ... functions for TCN Behavioral Health Services. Key Responsibilities: * Completes and submits prior ...
... for prior authorization, utilization management, reporting, data tracking, and peer review ... functions for TCN Behavioral Health Services. Key Responsibilities: * Completes and submits prior ...
| Aspect | Prior Authorization Utilization Review | Medical Reviewer |
|---|---|---|
| Credentials | Licensed healthcare professionals, often with certifications in utilization review | Licensed physicians or healthcare providers with clinical expertise |
| Work Environment | Insurance companies, healthcare organizations, or third-party review firms | Hospitals, clinics, insurance companies, or consulting firms |
| Primary Focus | Assessing the necessity of procedures or treatments before approval | Evaluating clinical records to determine medical necessity and appropriateness |
While both roles involve clinical assessment, Prior Authorization Utilization Review focuses on pre-authorization decisions for treatments, whereas Medical Review involves detailed clinical evaluation of patient records to determine medical necessity. Both require healthcare credentials and are integral to healthcare quality and cost management.
For Prior Authorization Utilization Review jobs in Ohio, the most frequently searched job titles are:
The top searched job categories for Prior Authorization Utilization Review jobs in Ohio are:
Cities in Ohio with the most Prior Authorization Utilization Review job openings:
$18 - $22/hr
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Re-posted 21 days ago
About Us:
For over two decades, Riverhills Neuroscience has been a pioneer in delivering exceptional neuroscience care. Our commitment to excellence extends across diagnosis, education, and treatment for those facing nervous system diseases and injuries.
Position: Prior Authorization Specialist
Location: Norwood Office
Department: Billing
Schedule: Monday-Friday, 8am-4:30pm, Hybrid, 2 days in office, 3 days remote after full in office training.
Pay: $18-22 per hour
Key Benefits for Full-Time Employees:
Responsibilities:
As a Prior Authorization Specialist at Riverhills Neuroscience, you will play a vital role in ensuring the efficiency and accuracy of our billing processes. Your responsibilities include:
Background and Experience:
If you're eager to contribute to a world-class healthcare team, apply today. We look forward to welcoming dedicated professionals to contribute to the growth of our practice.
Equal Opportunity/Drug-Free Workplace:
Riverhills Neuroscience is an equal opportunity employer and maintains a drug-free workplace.
