- UpvoteDownvoteShare Job
- Suggest Revision
Manage 1915 Waiver funds ensuring prior authorization and ODM approval is obtained. Expected Starting Salary Range: - REPRESENTATIVE RESPONSIBILITIESThe BH Care Coordination Specialists will utilize high fidelity wrap around model and/or principals to provide community-based care coordination for children and families who are experiencing serious emotional disturbance (SED), trauma, cooccurring behavioral health disorders who are engaged with one or more child-serving systems (, child welfare, intellectual and developmental disabilities, juvenile justice, education) experience.
Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
The associate is responsible for obtaining prior authorization requests and/or pre-determination for these services to ensure maximum reimbursement to the organization. Ensures authorization has been obtained for all scheduled and non-scheduled high dollar outpatient procedures.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Obtaining prior authorization guarantees Atrius Health can bill accurately for services where medication was administered in a timely manner. Reporting to and working under the general direction of the Supervisor(s) and Manager of the department, research patients' individual medical benefits to ensure prior authorization is obtained before patients' medical services are provided.
Full-timeRemoteExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Conducts prior authorization reviews to determine financial responsibility for Molina Healthcare and its members. This role will be doing prior authorization outpatient request for VA Medicaid members.
$51.49 an hourFull-timeExpandUpdated 9 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Review claims for appropriate prior authorization/pre-certification of services, required information, and request additional details as needed. Review claims for appropriate prior authorization/pre-certification of services, required information, and request additional details as needed.
RemoteExpandApply NowActive JobUpdated 10 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Uses prior experience and on-the-job training to solve straightforward tasks. If applicable, final offers will be contingent on ability to obtain authorization for access to U.S. export-controlled information from the U.S. Government.
Full-timeExpandUpdated 13 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Basic understanding of information security and technology terms, concepts, and applications through relevant coursework or projects in network security, access and authorization, security risk management, cloud computing, fundamentals of cryptography, or development coding course (i.e., Python or similar.
$83,710 a yearFull-timeExpandApply NowActive JobUpdated 14 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Conduct prior authorization and utilization management activities including adverse determinations. Requires 3 to 5 years prior experience as a CMO or Associate Medical Director preferably for a Medicare, MMP, or Medicaid plan inclusive of dually eligible enrollees.
Part-timeExpandApply NowActive JobUpdated 14 days ago - UpvoteDownvoteShare Job
- Suggest Revision
The Clinical Review Nurse I is responsible for reviewing and making medical determinations as to whether a prior authorization request meets the benefits the member carries. Prior experience with claim review of Medicare helpful.
$95,880 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Serve as a resource/consultant to customers and staff regarding payer policies and processes (i.e., eligibility and benefit verification, prior-authorization, and appeals/denials) Serve as a resource/consultant to customers and staff regarding payer policies and processes (i.e., eligibility and benefit verification, prior-authorization, and appeals/denials.
$150,000 a yearFull-timeExpandApply NowActive JobUpdated 30 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Maintains subject matter expertise pertaining to all external billing practices including but not limited to third party adjudications, prior authorization, and patient financial assistance programs in order to coach pharmacy technicians and other support staff.
Full-timeExpandUpdated 15 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Review claims for appropriate prior authorization/pre-certification of services. Review claims for appropriate prior authorization/pre-certification of services. Ability to read and interpret contracts, and standard reference materials (PDR, CPT, ICD-9, ICD-10, and HCPCS.
Full-timeRemoteExpandUpdated 1 month ago - UpvoteDownvoteShare Job
- Suggest Revision
About: Utilization review uses managed care techniques such as prior authorization that allow payers, particularly health insurance companies to manage the cost of health care benefits by assessing its appropriateness before it is provided using evidence-based criteria or guidelines.
$24 an hourFull-timeRemoteExpandUpdated 29 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Minimum 7+ years of transport category aircraft maintenance experience (Boeing series aircraft – preferred) 737,777 747-400, 747-800 Gen Fam with RII authorization. Ensure that all aircraft documentation is completed accurately per company and FAA procedures prior to aircraft departure.
$119,000 a yearFull-timeExpandApply NowActive JobUpdated 14 days ago - UpvoteDownvoteShare Job
- Suggest Revision
The prior authorization specialist is responsible for coordinating all aspects of the prior authorization process, including insurance verification, formulary reviews, gathering necessary clinical information from electronic medical record, and timely communication with patients, prescribers and physician office staff.
Full-timeExpandApply NowActive JobUpdated 1 month ago
prior authorization jobs in Cincinnati, OH
FEATURED BLOG POSTS
Internal Hiring Best Practices
Each companies hiring strategy is based on a set of rules that defines the ideal candidate. Many companies utilize internal and external hiring to ensure they have skilled, experienced workers. If you work in recruiting, maximizing your internal hiring strategies could be the key to retaining employees and simplifying your hiring process.
Why is it so Hard to Get a Job After College
For many, it was easy finding a job while in college. But after job hunting for weeks, you may wonder why it is so hard to get a job after college. After all, you’ve put a lot of time and effort into getting your degree. But don’t get discouraged. The University of Washington found that 53% of graduates are either unemployed or working a job that doesn’t require a degree. Other studies also show that landing your first job can take between 3 and 6 months. So, getting your first job takes time.
Why Leadership Is So Important in Your Career
There are plenty of baseball players worldwide, but only a select few will master the sport enough to play in the World Series. Similarly, you’ll meet hundreds of “managers” throughout your professional career. Still, only a few will cement themselves as true leaders in your mind. This is why leadership is important—the most influential leaders leave a mark. They inspire.
Recruiting in a Tight Market
As a recruiter or employer, you know how much the economy affects your recruitment and retention efforts. You aren't just in competition with companies in your industry, but you are also fighting against inflation, recession, unemployment rates, and so much more.
How to Build a Candidate Persona
A candidate persona is a semi-fictional representation of your ideal candidate. Building a candidate persona is one of the best methods employers use to ensure their sourcing, recruiting, and hiring processes are focused. Knowing exactly what you're looking for streamlines everything and helps increase hiring confidence. So here's how to create a candidate persona and how to use it.
How to Get Into The Trades: Step-by-Step Guide
Getting a trade job can be a great career move if you like variety and prefer to learn on the job instead of in an academic setting. A trade job can offer security and be a lucrative career path as the demand for skilled trade workers continues to grow.
How do Good Interviewers Prepare for Interviews?
Just like candidates take the time to research you and your company, you should take the time to prepare for the interview. Preparing for the interview doesn't just reflect well on your employer brand and create a better candidate experience. Preparation also helps prevent bad hiring decisions. Bad hiring decisions are usually a result of poor execution during the hiring process. However, going into an interview fully prepared and ready to evaluate candidates will help avoid bad hires. So, here are 6 interview preparation tips for employers.