Schedule: M-F (Day Shift) On-site during probation period until cleared to work remote. Summary ... Obtains insurance prior authorization as needed and documents the verification of benefits and ...
Schedule: M-F (Day Shift) On-site during probation period until cleared to work remote. Summary ... Obtains insurance prior authorization as needed and documents the verification of benefits and ...
Lead Reimbursement Analyst
Columbus, OH · On-site
$31.47 - $39.34/hr
... prior authorizations, appeals, and patient assistance programs; manage and resolve escalated cases ... Remote; desk-based role with frequent phone and computer use and minimal physical requirements
New
Quick apply
Lead Reimbursement Analyst
Columbus, OH · On-site
$31.47 - $39.34/hr
... prior authorizations, appeals, and patient assistance programs; manage and resolve escalated cases ... Remote; desk-based role with frequent phone and computer use and minimal physical requirements
New
Lead Reimbursement Analyst
Columbus, OH · Remote
$31.47 - $39.34/hr
... prior authorizations, appeals, and patient assistance programs; manage and resolve escalated cases ... Remote; desk-based role with frequent phone and computer use and minimal physical requirements
New
Lead Reimbursement Analyst
Columbus, OH · Remote
$31.47 - $39.34/hr
... prior authorizations, appeals, and patient assistance programs; manage and resolve escalated cases ... Remote; desk-based role with frequent phone and computer use and minimal physical requirements
New
Field Reimbursement Manager
Columbus, OH · On-site +1
... remote interaction and on-site training. This position is client-facing and customer-facing and ... Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare ...
Field Reimbursement Manager
Columbus, OH · On-site +1
... remote interaction and on-site training. This position is client-facing and customer-facing and ... Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare ...
Field Reimbursement Manager
Springfield, OH · On-site +1
... remote interaction and on-site training. This position is client-facing and customer-facing and ... Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare ...
Field Reimbursement Manager
Springfield, OH · On-site +1
... remote interaction and on-site training. This position is client-facing and customer-facing and ... Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare ...
Senior FHIR Mapping & Integration Analyst
Columbus, OH · On-site +1
$108K - $181K/yr
Apply HL7 Da Vinci Implementation Guides (PAS, CRD, DTR) to support prior authorization and ... Resumes or CVs submitted to this email box will not be accepted. Join us at McKesson!
Senior FHIR Mapping & Integration Analyst
Columbus, OH · On-site +1
$108K - $181K/yr
Apply HL7 Da Vinci Implementation Guides (PAS, CRD, DTR) to support prior authorization and ... Resumes or CVs submitted to this email box will not be accepted. Join us at McKesson!
Senior FHIR Mapping & Integration Analyst
Columbus, OH · On-site +1
$108K - $181K/yr
Apply HL7 DaVinci Implementation Guides (PAS, CRD, DTR) to support prior authorization and coverage ... Resumes or CVs submitted to this email box will not be accepted. Join us at McKesson!
Senior FHIR Mapping & Integration Analyst
Columbus, OH · On-site +1
$108K - $181K/yr
Apply HL7 DaVinci Implementation Guides (PAS, CRD, DTR) to support prior authorization and coverage ... Resumes or CVs submitted to this email box will not be accepted. Join us at McKesson!
Senior FHIR Mapping & Integration Analyst
Columbus, OH · On-site +1
$108K - $181K/yr
Apply HL7 DaVinci Implementation Guides (PAS, CRD, DTR) to support prior authorization and coverage ... Resumes or CVs submitted to this email box will not be accepted. Join us at McKesson!
Senior FHIR Mapping & Integration Analyst
Columbus, OH · On-site +1
$108K - $181K/yr
Apply HL7 DaVinci Implementation Guides (PAS, CRD, DTR) to support prior authorization and coverage ... Resumes or CVs submitted to this email box will not be accepted. Join us at McKesson!
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... prior authorizations. * Ensures clinical communications are managed, tasks are completed and ...
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... prior authorizations. * Ensures clinical communications are managed, tasks are completed and ...
Registered Nurse RN
Columbus, OH · On-site
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... prior authorizations. * Ensures clinical communications are managed, tasks are completed and ...
Registered Nurse RN
Columbus, OH · On-site
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... prior authorizations. * Ensures clinical communications are managed, tasks are completed and ...
Pre-Certification Coordinator 2
Columbus, OH · On-site +1
$18 - $22.75/hr
... prior authorization for visits, procedures and hospitalizations, pre-approval, PCP referrals ... Location: Remote Location Position Type: Regular Scheduled Hours: 40 Shift: First Shift Final ...
Pre-Certification Coordinator 2
Columbus, OH · On-site +1
$18 - $22.75/hr
... prior authorization for visits, procedures and hospitalizations, pre-approval, PCP referrals ... Location: Remote Location Position Type: Regular Scheduled Hours: 40 Shift: First Shift Final ...
Medical Scribe
Columbus, OH · On-site
$15.25 - $20.50/hr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... Prior clinical experience, including shadowing and/or volunteering [strongly preferred] * Prior ...
Medical Scribe
Columbus, OH · On-site
$15.25 - $20.50/hr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... Prior clinical experience, including shadowing and/or volunteering [strongly preferred] * Prior ...
Medical Scribe
Columbus, OH · On-site
$17 - $28.46/hr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... Prior clinical experience, including shadowing and/or volunteering [strongly preferred] * Prior ...
Medical Scribe
Columbus, OH · On-site
$17 - $28.46/hr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... Prior clinical experience, including shadowing and/or volunteering [strongly preferred] * Prior ...
Field Reimbursement Manager Ohio Upper PA
Columbus, OH · On-site
$46.92 - $58.17/hr
... investigations, prior authorizations, claims escalations, and appeals, ensuring timely patient ... Remote in the field, M-F; 8 AM - 5 PM * Weekly paycheck * Dedicated Onboarding Specialist ...
Quick apply
Field Reimbursement Manager Ohio Upper PA
Columbus, OH · On-site
$46.92 - $58.17/hr
... investigations, prior authorizations, claims escalations, and appeals, ensuring timely patient ... Remote in the field, M-F; 8 AM - 5 PM * Weekly paycheck * Dedicated Onboarding Specialist ...
Field Reimbursement Manager (FRM), Endocrinology - Ohio/Pennsylvania
Columbus, OH · Remote
$154K - $200K/yr
... benefits verifications, prior authorizations, and reimbursement and access logistics ... Remote Applicants must be currently authorized to work in the United States on a full-time basis.
Field Reimbursement Manager (FRM), Endocrinology - Ohio/Pennsylvania
Columbus, OH · Remote
$154K - $200K/yr
... benefits verifications, prior authorizations, and reimbursement and access logistics ... Remote Applicants must be currently authorized to work in the United States on a full-time basis.
Licensed Behavioral Health Counselor
Columbus, OH · Remote
$85K - $105K/yr
This is a fully remote position , offering telehealth opportunities based on client and program ... Prior authorizations * Patient relations support * Established referral base * In-house prescribers ...
Quick apply
Licensed Behavioral Health Counselor
Columbus, OH · Remote
$85K - $105K/yr
This is a fully remote position , offering telehealth opportunities based on client and program ... Prior authorizations * Patient relations support * Established referral base * In-house prescribers ...
Pharmaceutical Sales - Neuroscience Long Term Care (LTC) Specialist - Columbus, OH
Columbus, OH · On-site
$116 - $166.75/hr
Remote-Sales: Columbus, OHtime type: Full timeposted on: Posted Todayjob requisition id ... prior authorization requirements, formulary placement, and availability expectations. This ...
Pharmaceutical Sales - Neuroscience Long Term Care (LTC) Specialist - Columbus, OH
Columbus, OH · On-site
$116 - $166.75/hr
Remote-Sales: Columbus, OHtime type: Full timeposted on: Posted Todayjob requisition id ... prior authorization requirements, formulary placement, and availability expectations. This ...
Registered Nurse RN
Homer, OH · On-site
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... prior authorizations. * Ensures clinical communications are managed, tasks are completed and ...
Registered Nurse RN
Homer, OH · On-site
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... prior authorizations. * Ensures clinical communications are managed, tasks are completed and ...
Registered Nurse RN
Columbus, OH · On-site
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... prior authorizations. * Ensures clinical communications are managed, tasks are completed and ...
Registered Nurse RN
Columbus, OH · On-site
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... prior authorizations. * Ensures clinical communications are managed, tasks are completed and ...
Registered Nurse RN
Columbus, OH · On-site
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... prior authorizations. * Ensures clinical communications are managed, tasks are completed and ...
Registered Nurse RN
Columbus, OH · On-site
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... prior authorizations. * Ensures clinical communications are managed, tasks are completed and ...
Cvs Prior Authorization Remote information
See salary details
$13.70 - $15.38
6% of jobs
$15.38 - $17.07
14% of jobs
$17.49 is the 25th percentile. Wages below this are outliers.
$17.07 - $18.75
20% of jobs
The median wage is $19.69 / hr.
$18.75 - $20.43
18% of jobs
$20.43 - $22.12
16% of jobs
$22.31 is the 75th percentile. Wages above this are outliers.
$22.12 - $23.80
12% of jobs
$23.80 - $25.48
7% of jobs
$25.48 - $27.16
5% of jobs
$27.16 - $28.85
2% of jobs
$28.85 - $30.53
0% of jobs
$30.53 - $32.21
0% of jobs
$13
$20
$32
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Full-time
Re-posted 13 days ago
Nationwide Children's Hospital rating
6.9
Based on 131 frontline employees who took The Breakroom Quiz
554th of 1,059 rated hospitals
Job description
Schedule: M-F (Day Shift)
On-site during probation period until cleared to work remote.
Job Description Summary:
Verifies and documents benefit information. Requests initial authorization and meets provider's referral requirements to ensure that optimum payment is made to the hospital and providers.
Job Description:
Essential Functions:
- Contacts insurance companies to obtain and verify benefit information, documents all benefit information, and meets payer's referral requirements to ensure that optimum payment to the hospital and providers will be satisfied.
- Obtains insurance prior authorization as needed and documents the verification of benefits and prior authorizations in Epic. Maintains record of pending prior authorizations and documents timely follow-up.
- Assists with the retrospective review of records for patients who have insurance changes that impact the authorization.
- Communicates authorization denials and appeal options to referral sources/Providers. Assists with coverage resources as appropriate.
- Contacts schedulers if insurance cannot be verified and refers self-pay patients to financial assistance resources.
- Participates in department and interdepartmental meetings to promote knowledge, troubleshoot, and resolve issues related to benefits or authorizations.
- Maintains knowledge of The Joint Commission, Medicaid, Medicare, and other third-party payer standards and requirements.
Education Requirement:
High school graduate, required.
Associate's Degree, preferred.
Licensure Requirement:
(not specified)
Certifications:
CPR certification (based on position and as determined by manager).
Skills:
Strong computer skills required with the ability to navigate most current technology systems.
Excellent written, communication, and organizational skills required.
Experience:
One year previous health care or insurance experience preferred.
Physical Requirements:
OCCASIONALLY: Bend/twist, Biohazard waste, Blood and/or Bodily Fluids, Chemicals/Medications, Communicable Diseases and/or Pathogens, Driving motor vehicles (work required) *additional testing may be required, Lifting / Carrying: 0-10 lbs, Lifting / Carrying: 11-20 lbs, Loud Noises, Patient Equipment, Pushing / Pulling: 0-25 lbs, Reaching above shoulder, Squat/kneel, Standing, Walking
FREQUENTLY: Flexing/extending of neck, Hand use: grasping, gripping, turning
CONTINUOUSLY: Audible speech, Color vision, Computer skills, Decision Making, Depth perception, Hearing acuity, Interpreting Data, Peripheral vision, Problem solving, Repetitive hand/arm use, Seeing - Far/near, Sitting
Additional Physical Requirements performed but not listed above:
Able to multi-task within in a stressful environment.
"The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet"
What Nationwide Children's Hospital employees say
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Get the full story on Breakroom
About Nationwide Children's Hospital
Sourced by ZipRecruiter
Nationwide Children's Hospital, established in 1894, is a leading pediatric healthcare system based in Columbus, Ohio, United States. They serve as a primary pediatric network, providing wellness, preventive, diagnostic, treatment, and rehabilitative care for infants, children, adolescents, and adults with congenital disease. Being the third-largest pediatric hospital in the nation, Nationwide Children's Hospital prides itself on its relentless commitment to children and their families, driven by their core values of respect, integrity, determination, empathy, and solidarity. The institution's comprehensive mission is to enhance the health of children by providing high-quality, family-centered care, conducting groundbreaking research, advocating for pediatric health, and training top healthcare professionals.
Industry
Hospitals
Company size
10,000+ Employees
Headquarters location
Columbus, OH, US
Year founded
1892