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About CorroHealth:
At CorroHealth our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.
We build long-term careers by investing in YOU. We seek to c...

Job Details
Job Location
Remote - Charlotte, NC
Position Type
Full Time
Salary Range
$50,000.00 - $65,000.00 Salary/year
Description
Implementation Specialist - Prior Authorization
How this Role Makes an Impact
The Imagine team is a growing company, and we are inviting a motivated Implementation Specialist - Prior Authorization to join our talented team! This candidate will assist in preparatio...

Description
About Orsini Specialty Pharmacy
Providing patients with comprehensive and compassionate care since 1987, Orsini Specialty Pharmacy is a leader in rare diseases and gene therapies. Orsini partners with biopharma innovators, healthcare providers, and payors to support patients and their families in accessing revolutionary treatments for rare diseases. Through integrated pharmacy distr...

Our client is looking for several Remote Prior Authorization Specialists because of its amazing growth! The ideal prior experience would be working with physicians and clinical staff in a medical or clinical setting and a person who thrives in a fast paced, production-oriented work environment is also preferred!
The Prior Authorization Specialist will be responsible for processing insurance ve...

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.
We are unable to offer remote work to ...

Job Description
Perform duties to assist in all clinical functions of the prior authorization required to access drug benefits. Facilitate efforts in the review of clinical documentation and appropriate drug selection to aid in procurement of drug authorizations, working within the limits of standard or accepted practice. Demonstrate the company's core values of respect, honesty, integrity, div...

Typical pay range: $21.54 - $29.08 hourly, varies on experience.
Surgical Specialist - Remote/Hybrid - Redmond, Oregon
Job Description
ST. CHARLES HEALTH SYSTEM
JOB DESCRIPTION
TITLE: Prior Authorizations and Referral Management Representative
REPORTS TO POSITION: Clinic Manager
DEPARTMENT: St Charles Medical Group
DA...

Why This Role is Important to Us
Commonwealth Care Alliance's (CCA) Clinical Effectiveness (Authorization) Unit is primarily responsible for the evaluation of the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities under the provisions of CCA's benefits plan. The LTSS Service Authorization Specialist is responsible for applying clini...

Why This Role is Important to Us
Commonwealth Care Alliance’s (CCA) Clinical Effectiveness (Authorization) Unit is primarily responsible for the evaluation of the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities under the provisions of CCA’s benefits plan. The LTSS Service Authorization Specialist is responsible for applying clin...

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...

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...

Why This Role is Important to Us
Commonwealth Care Alliance's (CCA) Clinical Effectiveness (Authorization) Unit is primarily responsible for the evaluation of the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities under the provisions of CCA's benefits plan. The Service Authorization Specialist is responsible for providing accurate,...

Network Health's success is rooted in its mission to create healthy and strong Wisconsin communities. It drives the decisions we make, including the people we choose to join our growing team. Network Health is seeking a Population Health Specialist II. This individual will process Network Health (NHIC/NHP/NHAS) authorization requests in accordance with established guidelines and triages authori...

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...

Job Description
This is a remote position.
The Clinical Review Specialist will be responsible for performing prospective, concurrent, or retrospective utilization review/medical management for all services provided by our organization. This role entails evaluating the appropriateness of care based on contract, state, or URAC requirements. They will also analyze and evaluate documentation subm...

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
Job Description
Position Purpose: The Pharmacy Resolution Specialist receives and responds to calls from members, pro...

Company Description
Lingraphica is a mission-driven organization who provides speech-generating devices to help improve communication, speech, and quality of life for people with communication impairments. We look for candidates who enjoy working in a fast-paced, goal-oriented environment, and who share our commitment to helping individuals on their communccation journey.
Job Description
Purpos...

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Under general supervision of the Radiology Financial Clearance Manager, the Insurance Coordinator/Financial Clearance Specialist functions as primary interface between MGB Imaging sites, MGB Patient Service Center, insurance companies, patients, and referring practices. The incumbent performs all tasks related to obtaining insurance authorizations for diagnostic imaging tests - primarily...

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Under general supervision of the Radiology Financial Clearance Manager, the Insurance Coordinator/Financial Clearance Specialist functions as primary interface between MGB Imaging sites, MGB Patient Service Center, insurance companies, patients, and referring practices. The incumbent performs all tasks related to obtaining insurance authorizations for diagnostic imaging tests - primarily...

Overview
Part Time Mon - Fri
20 hours/week
Fully Remote
Reporting to RCM Manager, Revenue Integrity Specialist is primarily responsible for maximizing reimbursement through monitoring and analyzing the charging policies and practices for all clinical departments. The professional in this role is also responsible for communicating the charging policies and practices knowledge to both clinica...