Support practices through the prior authorization and appeals process by educating staff on payer ... analysis and conducting regular QBRs with accounts Position Type * Remote Travel * Up to 80%
New
Support practices through the prior authorization and appeals process by educating staff on payer ... analysis and conducting regular QBRs with accounts Position Type * Remote Travel * Up to 80%
New
Client Support Representative (REMOTE-Wisconsin)
Milwaukee, WI · On-site +1
$20/hr
Gather and document prior authorization information and perform related follow-up activities as ... Work Environment This is a remote position based in the United States. Candidates must reside in ...
Client Support Representative (REMOTE-Wisconsin)
Milwaukee, WI · On-site +1
$20/hr
Gather and document prior authorization information and perform related follow-up activities as ... Work Environment This is a remote position based in the United States. Candidates must reside in ...
Pricing & Trade Spend Analyst
Westfield, WI · On-site +1
Flexible remote work schedule Summary: The Pricing and Trade Spend Analyst supports our sales and ... Prior experience with: Blacksmith/Forge Analytics, Business Intelligence, SAP, CRM * Strong team ...
Pricing & Trade Spend Analyst
Westfield, WI · On-site +1
Flexible remote work schedule Summary: The Pricing and Trade Spend Analyst supports our sales and ... Prior experience with: Blacksmith/Forge Analytics, Business Intelligence, SAP, CRM * Strong team ...
Analyze regulatory data against statutory financial statements, prior regulatory filings, and other ... Applicants must have authorization to work indefinitely in the US. Please do not apply for this ...
Analyze regulatory data against statutory financial statements, prior regulatory filings, and other ... Applicants must have authorization to work indefinitely in the US. Please do not apply for this ...
Analyze regulatory data against statutory financial statements, prior regulatory filings, and other ... Applicants must have authorization to work indefinitely in the US. Please do not apply for this ...
Analyze regulatory data against statutory financial statements, prior regulatory filings, and other ... Applicants must have authorization to work indefinitely in the US. Please do not apply for this ...
Analyze regulatory data against statutory financial statements, prior regulatory filings, and other ... Applicants must have authorization to work indefinitely in the US. Please do not apply for this ...
Analyze regulatory data against statutory financial statements, prior regulatory filings, and other ... Applicants must have authorization to work indefinitely in the US. Please do not apply for this ...
Analyze regulatory data against statutory financial statements, prior regulatory filings, and other ... Applicants must have authorization to work indefinitely in the US. Please do not apply for this ...
Analyze regulatory data against statutory financial statements, prior regulatory filings, and other ... Applicants must have authorization to work indefinitely in the US. Please do not apply for this ...
Pricing & Trade Spend Analyst
Westfield, WI · On-site +1
Flexible remote work schedule Summary: The Pricing and Trade Spend Analyst supports our sales and ... Applicants must have the legal authorization to work for any employer in the United States. We are ...
Pricing & Trade Spend Analyst
Westfield, WI · On-site +1
Flexible remote work schedule Summary: The Pricing and Trade Spend Analyst supports our sales and ... Applicants must have the legal authorization to work for any employer in the United States. We are ...
Research Analyst
Milwaukee, WI · On-site +1
... remote days, which can be worked from home or from MCW's ThriveOn King location in Milwaukee, WI ... Candidates must be authorized to work in the United States without the need for current or future ...
Research Analyst
Milwaukee, WI · On-site +1
... remote days, which can be worked from home or from MCW's ThriveOn King location in Milwaukee, WI ... Candidates must be authorized to work in the United States without the need for current or future ...
Research Analyst
Madison, WI · On-site +1
... remote days, which can be worked from home or from MCW's ThriveOn King location in Milwaukee, WI ... Candidates must be authorized to work in the United States without the need for current or future ...
Research Analyst
Madison, WI · On-site +1
... remote days, which can be worked from home or from MCW's ThriveOn King location in Milwaukee, WI ... Candidates must be authorized to work in the United States without the need for current or future ...
HTM Contract Manager
Burlington, WI · Remote
$47.50 - $71.25/hr
This role is primarily remote with possibility of travel as needed for meetings, training, or ... rate summaries, prior authorization requirements and other contract operational documents.
HTM Contract Manager
Burlington, WI · Remote
$47.50 - $71.25/hr
This role is primarily remote with possibility of travel as needed for meetings, training, or ... rate summaries, prior authorization requirements and other contract operational documents.
To support successful onboarding, full attendance during remote classroom training is required ... Prior disability insurance claims experience is a plus but not required. * Strong analytical ...
To support successful onboarding, full attendance during remote classroom training is required ... Prior disability insurance claims experience is a plus but not required. * Strong analytical ...
To support successful onboarding, full attendance during remote classroom training is required ... Prior disability insurance claims experience is a plus but not required. * Strong analytical ...
To support successful onboarding, full attendance during remote classroom training is required ... Prior disability insurance claims experience is a plus but not required. * Strong analytical ...
Research Analyst- Advanced
Green Bay, WI · On-site +1
$81K - $89K/yr
High speed internet access is required to meet the needs of remote work. Come see why DCF is such a ... S., a lawful permanent resident, an alien authorized to work in the U.S. without DCF sponsorship ...
Research Analyst- Advanced
Green Bay, WI · On-site +1
$81K - $89K/yr
High speed internet access is required to meet the needs of remote work. Come see why DCF is such a ... S., a lawful permanent resident, an alien authorized to work in the U.S. without DCF sponsorship ...
Business Data Analyst
Milwaukee, WI · On-site +1
$55K - $120K/yr
... fully remote arrangements for the ideal candidate. Responsibilities: * Elicit, analyze, and ... To qualify, all applicants must be authorized to work in the United States and must not require ...
Business Data Analyst
Milwaukee, WI · On-site +1
$55K - $120K/yr
... fully remote arrangements for the ideal candidate. Responsibilities: * Elicit, analyze, and ... To qualify, all applicants must be authorized to work in the United States and must not require ...
Remote Member Support Advisor
Milwaukee, WI · On-site +1
... prior industry experience is required. We provide structured onboarding, virtual training, and ... Be legally authorized to work in the United States * Have access to a computer or laptop * Maintain ...
Remote Member Support Advisor
Milwaukee, WI · On-site +1
... prior industry experience is required. We provide structured onboarding, virtual training, and ... Be legally authorized to work in the United States * Have access to a computer or laptop * Maintain ...
LTE - Agricultural Impact Statement Program Analyst
Madison, WI · On-site +1
$21.70/hr
Approval of the employee's remote work agreement and work schedule will vary based on the ... A criminal background check will be performed on the selected applicant prior to an offer of ...
LTE - Agricultural Impact Statement Program Analyst
Madison, WI · On-site +1
$21.70/hr
Approval of the employee's remote work agreement and work schedule will vary based on the ... A criminal background check will be performed on the selected applicant prior to an offer of ...
Compliance Analyst I
Milwaukee, WI · On-site +1
This position is open to remote. What You'll Do: As the Compliance Analyst , you will: * Research ... Prior pharmacy benefit management (PBM) or health insurance experience preferred. Competencies:
Compliance Analyst I
Milwaukee, WI · On-site +1
This position is open to remote. What You'll Do: As the Compliance Analyst , you will: * Research ... Prior pharmacy benefit management (PBM) or health insurance experience preferred. Competencies:
Data Scientist Analyst
Waukesha, WI · On-site +1
... and authorization data to identify emerging cost drivers. * Apply machine learning and AI ... Prior experience in healthcare analytics or trend analysis is a strong advantage highly preferred.
Data Scientist Analyst
Waukesha, WI · On-site +1
... and authorization data to identify emerging cost drivers. * Apply machine learning and AI ... Prior experience in healthcare analytics or trend analysis is a strong advantage highly preferred.
$55K - $65K/yr
Ability to manage priorities, meet deadlines, and work independently in a remote team environment ... Experience with public safety or law enforcement software is a plus; prior SmartCOP software ...
$55K - $65K/yr
Ability to manage priorities, meet deadlines, and work independently in a remote team environment ... Experience with public safety or law enforcement software is a plus; prior SmartCOP software ...
Remote Prior Authorization Analyst information
What is the difference between Remote Prior Authorization Analyst vs Remote Claims Processor?
| Aspect | Remote Prior Authorization Analyst | Remote Claims Processor |
|---|---|---|
| Required Credentials | Healthcare certifications, knowledge of insurance policies | Basic insurance knowledge, data entry skills |
| Work Environment | Home office, healthcare or insurance companies | Home office, insurance companies or third-party administrators |
| Employer & Industry | Hospitals, insurance providers, healthcare organizations | Insurance companies, third-party claims firms |
| Common Search/Comparison | Yes | Yes |
The Remote Prior Authorization Analyst and Remote Claims Processor roles both operate in the healthcare insurance industry and often require knowledge of insurance policies. However, the analyst focuses on obtaining prior approvals for treatments, while the claims processor handles the processing of insurance claims after services are rendered. Both roles are typically remote, involve working within healthcare or insurance organizations, and are frequently compared by job seekers seeking similar positions in the industry.
What are popular job titles related to Remote Prior Authorization Analyst jobs in Wisconsin?
For Remote Prior Authorization Analyst jobs in Wisconsin, the most frequently searched job titles are:
What job categories do people searching Remote Prior Authorization Analyst jobs in Wisconsin look for?
The top searched job categories for Remote Prior Authorization Analyst jobs in Wisconsin are:
What cities in Wisconsin are hiring for Remote Prior Authorization Analyst jobs?
Cities in Wisconsin with the most Remote Prior Authorization Analyst job openings:
Full-time
Posted 3 days ago
New
Job description
Territory: NM, CO, WY, NE, SD, and NDPosition Summary
Harrow is seeking a Field Reimbursement Manager (FRM) to serve as the trusted, in-market reimbursement expert for physician practices utilizing Harrow's buy-and-bill drug portfolio across the Retina and Surgical franchises. This individual will provide non-promotional, compliant education on coverage, coding, billing, and claims processes - giving customers the confidence and technical know-how to appropriately access and be reimbursed for Harrow brands.
The ideal candidate is a proactive problem-solver who thrives in the field, builds strong relationships with practice staff, and brings sharp analytical skills to identify and resolve access barriers at the account level. This role is part of a hard-charging, high-accountability team focused on one outcome: expanding appropriate patient access to Harrow therapies.
Core ResponsibilitiesCustomer Education & Reimbursement Support
- Serve as the primary field point of contact for practice administrators, billing/coding staff, and clinical staff on reimbursement matters related to Harrow buy-and-bill brands
- Provide non-promotional education on payer coverage policy, medical benefit billing/coding (HCPCS/CPT/J-codes, ICD-10, modifiers), prior authorization requirements, and claims submission best practices
- Support practices through the prior authorization and appeals process by educating staff on payer-specific requirements and documentation needs
- Educate practices on available support programs, including patient assistance, product replacement, and sample programs, and coordinate warm handoffs to the HUB as needed
Account Management & Business Reviews
- Build and maintain trusted relationships with key accounts within an assigned territory
- Conduct regular, structured business reviews with accounts to assess reimbursement performance, identify denial trends, and develop action plans to resolve barriers
- Proactively identify at-risk accounts (e.g., high denial rates, low utilization due to access friction) and develop targeted intervention plans
- Partner with Sales to align on account priorities and ensure a coordinated, compliant approach to customer support
Claims & Payer Analysis
- Conduct account-level claims analysis to identify denial patterns, coding errors, or payer-specific barriers, and translate findings into clear, actionable guidance for the practice
- Maintain current, deep knowledge of payer policies (commercial, Medicare, Medicare Advantage, Medicaid) relevant to assigned brands and territory
- Escalate systemic or complex payer issues to the National Sr. Director and Market Access leadership with supporting data and recommendations
Collaboration & Reporting
- Partner closely with the HUB and Patient Services team to ensure seamless coordination on benefit verification, PA/appeals support, and patient assistance
- Provide regular field intelligence and account-level insights to leadership to inform national strategy and payer engagement
- Maintain accurate, timely documentation of account activity, business reviews, and issue resolution in CRM/reporting systems
- Represent Harrow professionally and compliantly at all times, strictly adhering to all applicable laws, regulations, and company policies
- 7+ years of proven success in the healthcare-related field, reimbursement, brand management, and/or sales experience.
- Bachelor's degree preferred, or equivalent work experience.
- Buy-and-bill experience required.
- Minimum 2 years of Field Reimbursement experience required.
- Healthcare credentialing and/or certification preferred.
- Eye care experience preferred.
- Private equity experience preferred.
- HCPCS Level II (J-code) and Transitional Pass-Through reimbursement experience preferred.
- Experience with benefit verifications, prior authorizations, claim assistance, and appeals.
- Payer coverage experience with Medicare (MACs), Medicare Advantage, Commercial, and Medicaid plans.
- Experience in conducting claims analysis and conducting regular QBRs with accounts
- Remote
- Up to 80%
About Harrow
Sourced by ZipRecruiter
Industry
Pharmaceutical and medicine manufacturing
Company size
201 - 500 Employees
Headquarters location
Nashville, TN, US
Year founded
1998