Prior authorization jobs in North Bergen, NJCreate job alerts

Implement security best practices, including authentication and authorization mechanisms like OAuth ... Bachelor's degree in computer science or related field. * 10+ years of prior experience as a ...

Process medication requests and prior authorization requests * Obtain outside medical records from outside providers * Conduct telephone triage (during office hours) Qualifications - * A Nurse ...

Required-on call shifts monitoring Critical Lab Phone Line - (24/7) * Prepare prior authorizations requests * Efficiently process and send EMR Requests * Additional clinical and administrative duties ...

Implement security best practices, including authentication and authorization mechanisms like OAuth ... Bachelor's degree in computer science or related field. * 10+ years of prior experience as a ...

Facilitates and administers Health Plan clinical operations functions--prior authorization, Part A and B services, medication reviews, HEDIS and STARs quality gap closure, and promotes membership ...

... signing off after authorization and plotting start of care (SOC) visits. * Coordinates ... Receives report from field clinicians prior to scheduled days off on patient status and ongoing ...

Assess appropriate site of care utilization and continued medical necessity reviews for prior authorization to vendors. * Ensure communication with MD offices in relation to Site of Care program

Completes prior authorization for medications and equipment as indicated * Maintain accuracy and completeness of all patient records * Actively participates in departmental/facility/network in ...

Coordinates consumers' medication management needs with the YA ACT nurse, including ordering blood work and/or toxicology testing when indicated, managing prior authorizations for medications ...

FRM Manhattan, NY Expert in Retail Pharmacy and Specialty pharmacy drug Prior Authorizations, Appeals, and working denials, with experience of FRM territory management experience, training and ...

Experience in Coverage Determinations (prior authorization) * Experience using online clinical references and accessing professional (clinical and regulatory) internet sites * Experience working with ...

Prior Authorization Department, In-House Lab, In-House Pathology, In-House Plastics, Research Center, Call Center, Billing, Medical and Facility Operations, Provider Relations and Patient Liaison

Prior Authorization Department, In-House Lab, In-House Pathology, In-House Plastics, Research Center, Call Center, Billing, Medical and Facility Operations, Provider Relations and Patient Liaison ...

Support tasks like prior authorization for treatments, participation in health outcome reporting, and quality improvement initiatives. Qualifications for the Staff Nurse (RN/LPN): * Education

... about prior authorization & appeals process, how to access related forms, and high-level information about submission procedures and • reauthorization requirements. This may require travel to ...

... any prior compensation history, until such time as the applicant is extended a conditional offer of employment with compensation. If such information has been requested from you before such time ...

Other tasks as assigned. * Assist with Prior Authorization for medications * Act as liaison with pharmacies Requirements KNOWLEDGE, EDUCATION, SKILLS AND ABILITIES REQUIRED: * NYS Licensed Registered ...

... prior authorizations, responding to emails, school paperwork, scheduling, finding services ... authorization is granted to work outside of the location listed in this posting.

Ensure all City and State project authorizations and budget approvals are in place prior to bidding of the projects * On a weekly basis update PMWeb-based CUNY Project Management System on the status ...

... and Excel · Prior experience working with children strongly preferred · Bachelor's degree is ... ESSA; · Current authorization to work in the United States - A candidate must have such ...

... authorizations. * Assist with budget management, track expenses, and process invoices. May involve ... prior arrest.

Prior Community Health experience ideally with this population * Open to hospital experience but must know the population * Prefer BSN but open to ASN * Bilingual is Spanish or French is preferred ...

Candidates must be authorized to work in the United States; our client cannot provide sponsorship ... Prepare all food & beverage prep prior to opening * Partner with management on seasonal menu roll ...

Manage submission of prior authorization requests for prescription medications via ePA, fax, and phone. Document and escalate any issues related to prior authorization requests (e. Medix's NYC-based client is looking for Prior Authorization Representative! Apply if qualified and interested!.