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About DrFirst
This is a great opportunity to be a part of a successful Healthcare IT company experiencing significant growth. We have proven products that address the leading causes of gaps in patient care, brand-name customers, significant growth opportunities and are backed by leading investors. Here you'll get to work with some of the smartest and most interesting people around; solving uniq...

Job Description:
The Rep I, Clinical Services takes in-bound calls from providers, pharmacies, members, etc providing professional and courteous phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of reviews. Transfers all clinical questions, escalations and judgement calls to the pharmacist team.
The Re...

Company Description
Guardant Health is a leading precision oncology company focused on guarding wellness and giving every person more time free from cancer. Founded in 2012, Guardant is transforming patient care and accelerating new cancer therapies by providing critical insights into what drives disease through its advanced blood and tissue tests, real-world data and AI analytics. Guardant tes...

Company
Lumicera
About Us
Lumicera - Lumicera Health Services Powered by Navitus - Innovative Specialty Pharmacy Solutions- Lumicera Health Services is defining the "new norm" in specialty pharmacy to optimize patient well-being through our core principles of transparency and stewardship. Here at Lumicera, our team members work in an environment that celebrates creativity and fosters diversity....

ABOUT NATERA:
Natera is a global leader in cell-free DNA (cfDNA) testing, dedicated to helping families and healthcare providers make more informed decisions. Through cutting-edge technology and a commitment to innovation, Natera offers genetic testing solutions that span reproductive health, oncology, and organ health. We are passionate about delivering accurate, actionable insights that impro...

Company
Lumicera
About Us
Lumicera - Lumicera Health Services Powered by Navitus - Innovative Specialty Pharmacy Solutions- Lumicera Health Services is defining the "new norm" in specialty pharmacy to optimize patient well-being through our core principles of transparency and stewardship. Here at Lumicera, our team members work in an environment that celebrates creativity and fosters diversity....

POSITION SUMMARY:
Responsible for screening prior-authorization and coordination of specialized services requests in the medical care management program, including a broad range of requests for inpatient, outpatient and ancillary services. Adheres to policies and procedures in order to comply with performance and compliance standards and to ensure cost effective and appropriate healthcare deli...

ABOUT VISANTE
We are a specialized consulting firm focused on helping hospitals and health systems accelerate strong clinical, operational, and financial performance through pharmacy. Our team of professionals brings deep, contemporary expertise and innovation to optimizing all aspects of a fully integrated health system pharmacy program, driving significant value quickly.
Our mission is to tra...

Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!
Job Title:
Authorization Specialist (Remote in Wisconsin/Michigan)
Cost Center:
101651135 Insurance Verification
Scheduled Weekly Hours:
40
Employee Type:
Regular
Work Shift:
Mon-Fri; day shifts (United States of America)
Job Description:
**Wisconsin and Michigan residents only e...

Top Healthcare Provider Network
The 61st Street Service Corporation, provides administrative and clinical support staff for ColumbiaDoctors. This position will support ColumbiaDoctors, one of the largest multi-specialty practices in the Northeast. ColumbiaDoctors' practices comprise an experienced group of more than 2,800 physicians, surgeons, dentists, and nurses, offering more than 240 specia...

Job Description Reimbursement Specialist Description POSITION SUMMARY: Under the general supervision of the operational program leadership, the Reimbursement Specialist is responsible for various reimbursement functions, including but not limited to benefit investigations, prior authorization support, and call triage. The Reimbursement Specialist responds to all provider acco...

About Children’s Minnesota Children’s Minnesota is one of the largest pediatric health systems in the United States and the only health system in Minnesota to provide care exclusively to children, from before birth through young adulthood. An independent and not-for-profit system since 1924, Children’s Minnesota is one system serving kids throughout the Upper Midwest at two free-standing hospit...

Description
Soleo Health is seeking a Full-time Clearance Specialist to work Remotely (USA) and support our infusion patients. Join us in Simplifying Complex Care!
Must be able to work 8:30am-5pm Central Standard Time Zone
Soleo Health Perks:
* Competitive Wages
* 401(k) with a Match
* Referral Bonus
* Paid Time Off
* Great Company Culture
* Annual Merit B...

Description
Soleo Health is seeking a Full-time Clearance Specialist to work Remotely (USA). Join us in Simplifying Complex Care!
Must be located in Mountain Standard Time Zone
Soleo Health Perks:
* Competitive Wages
* 401(k) with a Match
* Referral Bonus
* Paid Time Off
* Great Company Culture
* No Weekends or Holidays
* Paid Parental Leave Options
* Affordab...

From Intake to Outcomes, CareMetx is dedicated to supporting the patient journey by providing hub services, innovative technology, and decision-making data to pharmaceutical, biotechnology, and medical device innovators.
Job Title: Reimbursement Specialist
POSITION SUMMARY:
Under the general supervision of the operational program leadership, the Reimbursement Specialist is responsible for vario...

The Reimbursement Specialist improves revenue collection pertaining to high cost medications that require prior authorization. This job will initiate, follow-up, and proceed with approval and/or denials of prior authorizations efficiently via phone, fax, or electronically.
The Reimbursement Specialist carries out benefit investigation and coordinates Patient Assistance Programs and/or copay car...

Utilization Review Specialist/Behavioral Health Substance Abuse
FLSA Status: Exempt
Classification: Full-Time
Reports To: The UR Specialist will report to UR Manager.
Job Overview: The Utilization Review Specialist is responsible for all aspects of the authorization of treatment via insurance and managed care companies. The Utilization Review Specialist provides appropriate client information t...

Top Healthcare Provider Network
The 61st Street Service Corporation, provides administrative and clinical support staff for ColumbiaDoctors. This position will support ColumbiaDoctors, one of the largest multi-specialty practices in the Northeast. ColumbiaDoctors' practices comprise an experienced group of more than 2,800 physicians, surgeons, dentists, and nurses, offering more than 240 specia...

REMOTE
GENERAL SUMMARY:
The goal of the Clinical Denial Specialist is to successfully manage claim denials related to referral, authorizations, notifications, non-coverage, medical necessity, and other clinically related denials, as assigned. The specialist will review claims and make recommendations for claim resubmission, retro authorization, written appeal or if no action is needed.
The Clin...

The Coding Denials Specialist performs advanced level work related to coding denials management. The individual is responsible for resolving coding claim edits, coding-related claim denials & coding correspondence, monitoring for trends and assist in the analysis, development, and implementation of solutions to minimize avoidable denials and adjustments.
This role is 100% remote for the follow...