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Job Location: C9990 - Sugar Land, TX Salary Range: Undisclosed
Description
Healix Infusion Therapy is seeking a full-time, remote Prior Authorization Specialist to join our Corporate Clinical Review Team.
As a Prior Authorization Specialist with Healix, you will have the opportunity to work as a key member of the Clinical Review Team to review referrals for payor criteri...

Job Title: Prior Authorization Specialist
Location: Fully remote
Duration: 12 months contract
Job Description:
* Prior Authorization Specialist 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 documenta...

About DrFirst
Here is a remarkable chance for you to join a thriving Healthcare IT company with established products, prestigious clients, substantial revenue, blue-chip institutional investors, and continuous growth. At DrFirst, you will collaborate with brilliant minds, tackling unique healthcare challenges on an unprecedented scale. Our culture is entrepreneurial, collaborative, and fast-pac...

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....

What We Do
LucyRx is an independent, next-generation pharmacy benefits manager (PBM) transforming how healthcare works. We're fixing what's broken in the PBM industry by putting people first and challenging outdated norms. For too long, traditional PBMs have prioritized profit over patients, and we believe that's just plain wrong.
LucyRx offers bold, innovative solutions powered by LucyIQ, our ...

Overview
Employment Type: Full Time
REMOTE
Benefits: M/D/V, Life Ins., 401(k)
Evansville, IN
SCOPE: With minimal supervision, is responsible for payer and patient account balances being paid timely and remaining current. Performs collection activities such as monitoring delinquent accounts, contacting patients for account payment, resolving billing problems, and answering routine to complex ac...

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 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 te...

Job Description:
* Prior Authorization Specialist 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 phar...

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themse...

Company Description
Guardant Health is a leading precision oncology company focused on helping conquer cancer globally through use of its proprietary tests, vast data sets and advanced analytics. The Guardant Health oncology platform leverages capabilities to drive commercial adoption, improve patient clinical outcomes and lower healthcare costs across all stages of the cancer care continuum. ...

Company Description
Guardant Health is a leading precision oncology company focused on helping conquer cancer globally through use of its proprietary tests, vast data sets and advanced analytics. The Guardant Health oncology platform leverages capabilities to drive commercial adoption, improve patient clinical outcomes and lower healthcare costs across all stages of the cancer care continuum. G...

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...

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...

At GenesisCare we want to hear from people who are as passionate as we are about innovation and working together to drive better life outcomes for patients around the world.
Patient Access Specialist
Role Summary:
* This roles primary responsibility is to facilitate a seamless and efficient patient experience by ensuring accurate patient eligibility, obtaining prior authorizations, and m...

REMOTE
Schedule: M-F, 8am-4:30pm EST
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...

Position: Insurance Verification Specialist
Department: Insurance Verification
Schedule: Per Diem, Part Time
POSITION SUMMARY:
The Insurance Verification Specialist role is part of the Revenue Cycle Patient Access team and is responsible for coordinating all financial clearance activities by navigating all referral, precertification, and/or authorization requirements as outlined in payer-specif...