Top 32 Authorization specialist Jobs in Southaven Ms

Pharmacy Mail Order Prior Authorization Specialist (PTCB Required)
Methodist Le Bonheur Healthcare —Memphis, TN
- Full-time
- Microsoft Word
- Research
- Mid-level
3h
Specialist-Authorization Denial
Baptist Memorial Health Care —Memphis, TN
- Surgery
- Clinic experience
- Research
- Health insurance
Medical Authorization Specialist II
bioventus —Memphis, TN
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Mid-level
Customer Service Specialist
Highline Warren —Memphis, TN
- Full-time
- Hybrid work
- Mid-level
Quick Apply
EXOGEN Order Specialist
bioventus —Memphis, TN
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Research
Health Information Specialist I - Memphis, TN
Datavant —Memphis, TN
- Overtime
- Hybrid work
- Microsoft Excel
- Computer literacy
- HIPAA
- Health insurance
- Dental insurance
Coordinator - Quality - Southaven, Mississippi
Mayo Clinic —Southaven, MS
- $85,467 - $128,252 a year
- Full-time
- Master's degree
- Bachelor's degree
- US work authorization
- Health savings account
- Health insurance
Medical Assistant - Urology
The Specialty Alliance —Southaven, MS
- Full-time
- Vital signs
- Medication administration
- Computer literacy
Quick Apply
Billing Specialist
Eye Specialty Group —Memphis, TN
- Full-time
- Ability to walk for extended periods
- Writing skills
- HIPAA
Quick Apply
7d
Senior Patient Access Specialist
Ensemble RCM LLC —Memphis, TN
- $18.65 - $19.90 an hour
- Full-time
- Management
- Customer service
- Mid-level
- Tuition reimbursement
Operations Specialist
AdaptHealth, LLC —Cordova, TN
- Background check
- HIPAA
- Administrative experience
- Paid parental leave
- Health savings account
Quick Apply
14d
Field Reimbursement Specialist
Syneos Health Commercial Solutions —Memphis, TN
- Up to 50% travel
- Mid-level
- 3 years
- Health insurance
- Dental insurance
1d
Medical Scribe Float
Oak Street Health —Memphis, TN
- $17.00 - $25.65 an hour
- Full-time
- Computer literacy
- HIPAA
- Clinic
- Health insurance
- Dental insurance
4d
Clinical Tech. (Medical Assistant)
Fast Pace Health —Memphis, TN
- Full-time
- CPR Certification
- Vital signs
- BLS Certification
- Paid holidays
- Health insurance
14d
Field Reimbursement Specialist
サイネオス・ヘルス —Memphis, TN
- Up to 50% travel
- Mid-level
- 3 years
- Health insurance
- Dental insurance
1d
Medical Assistant - PRN
Concentra —Memphis, TN
- PRN
- Microsoft Excel
- Vital signs
- Microsoft Outlook
Billing & Collections Supervisor
Anovorx Group LLC —Memphis, TN
- Customer service
- Supervising experience
- Bachelor's degree
Quick Apply
Provider Revenue Integrity Manager
Methodist Le Bonheur Healthcare —Memphis, TN
- Full-time
- Office
- Master's degree
- High school diploma or GED
Quick Apply
Clinical Tech. (Medical Assistant) - FT Float to Bartlett, Arlington, Germantown, and Millington
Fast Pace Health —Bartlett, TN
- Full-time
- CPR Certification
- Vital signs
- BLS Certification
- Paid holidays
- Health insurance
Specialty Pharmacy Prior Authorization Specialist Medical Authorizations
Methodist Le Bonheur Healthcare —Memphis, TN
- Full-time
- Microsoft Word
- Research
- Mid-level
Quick Apply

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Pharmacy Mail Order Prior Authorization Specialist (PTCB Required)

Methodist Le Bonheur Healthcare -
Memphis, TN

Apply Now

Job Details

Full-time
3 hours ago

Qualifications

Pharmacy Technician License
PTCB Certification
High school diploma or GED
Clinical information systems
Registered Pharmacy Technician

Full Job Description

If you are looking to make an impact on a meaningful scale, come join us as we embrace the Power of One!

We strive to be an employer of choice and establish a reputation for being a talent rich organization where Associates can grow their career caring for others. For over a century, we’ve served the health care needs of the people of Memphis and the Mid-South.

Responsible for precertification of eligible prescriptions. Ensures complete documentation is obtained that meets insurer guidelines for medical necessity and payment for services. Models appropriate behavior as exemplified in MLH Mission, Vision and Values.

Working at MLH means carrying the mission forward of caring for our community and impacting the lives of patients in every way through compassion, a deliberate focus on service expectations and a consistent thriving for excellence.

A Brief Overview
Responsible for precertification of eligible prescriptions. Ensures complete documentation is obtained that meets insurer guidelines for medical necessity and payment for services. Models appropriate behavior as exemplified in MLH Mission, Vision and Values.

What you will do

Responsible for precertification of eligible prescription medications for inpatient and outpatient services based on medical plan documents and medical necessity. Ensures medical documentation is sufficient to meet insurer guidelines for medical necessity documentation and procedure payment.
Reviews clinical information submitted by medical providers to evaluate the necessity, appropriateness and efficiency of the use of prescription medications.
Assists with patient assistance and grant coordination for Patients for outpatient pharmacies from designated areas.
Proactively analyzes information submitted by providers to make timely medical necessity review determinations based on appropriate criteria and standards guidelines. Verifies physician orders are accurate. Determines CPT, HCPCS and ICD-10 codes for proper Prior Authorization.
Contacts insurance companies and third party administrators to gather information and organize work-flow based on the requested procedure.
Collects, reads and interprets medical documentation to determine if the appropriate clinical information has been provided for insurance reimbursement and proper charge capture.
Serves as primary contact with physicians/physician offices to collect clinical documentation consistent with insurer reimbursement guidelines. Establishes and maintains rapport with providers as well as ongoing education of providers concerning protocols for pre-certification.
Communicates information and acts as a resource to Patient Access, Case Management, and others in regard to contract guidelines and pre-certification requirements.
Performs research regarding denials or problematic accounts as necessary. Works to identify trends and root cause of issues and recommend resolutions for future processes.

Education/Formal Training Requirements

Required - High School Diploma or Equivalent

Work Experience Requirements

Required - Pharmacy (clinical, hospital, outpatient, or specialty) 3-5 years

Licenses and Certifications Requirements

Required - Pharmacy Technician - Tennessee - Tennessee Board of Pharmacy
Required - Certified Pharmacy Technician - Pharmacy Technician Certification Board
Preferred - Certified Pharmacy Technician- ExCPT - National Healthcareer Association
Preferred - Pharmacy Technician - Mississippi - Mississippi Board of Pharmacy

Knowledge, Skills and Abilities

Basic understanding of prescription processing flow. Expertise in utiliizing EMRs to document clinical critieria required for third party approval.
Knowledgeable of medical terminology, drug nomenclature, symbols and abbreviations associated with pharmacy practice.
Strong attention to detail and critical thinking skills.
Ability to speak and communicate effectively with patients, associates, and other health professionals.
Ability to diagnose a situation and make recommendations on how to resolve problems.
Experience with a computerized healthcare information system required. Familiarity with fundamental Microsoft Word software.
Excellent verbal and written communication skills.

Supervision Provided by this Position

There are no lead or supervisory responsibilities assigned to this position.

Physical Demands

The physical activities of this position may include climbing, pushing, standing, hearing, walking, reaching, grasping, kneeling, stooping, and repetitive motion.
Must have good balance and coordination.
The physical requirements of this position are: light work - exerting up to 25 lbs. of force occasionally and/or up to 10 lbs. of force frequently.
The Associate is required to have close visual acuity to perform an activity, such as preparing and analyzing data and figures; transcribing; viewing a computer terminal; or extensive reading.
The conditions to which the Associate will be subject in this position: The Associate is not substantially exposed to adverse environmental conditions; job functions are typically performed under conditions such as those found in general office or administrative.

Our Associates are passionate about what they do, the service they provide and the patients they serve. We value family, team and a Power of One culture that requires commitment to the highest standards of care and unity.

Boasting one of the South's largest medical centers, Memphis blends a friendly community, a thriving and growing downtown, and a low cost of living. We see each day as a new opportunity to make a difference in the lives of the people in our community.

Apply Now

Refine Your Search

authorization specialist jobs in southaven ms

Pharmacy Mail Order Prior Authorization Specialist (PTCB Required)

Specialist-Authorization Denial

Medical Authorization Specialist II

Customer Service Specialist

EXOGEN Order Specialist

Health Information Specialist I - Memphis, TN

Coordinator - Quality - Southaven, Mississippi

Medical Assistant - Urology

Billing Specialist

Senior Patient Access Specialist

Operations Specialist

Field Reimbursement Specialist

Medical Scribe Float

Clinical Tech. (Medical Assistant)

Field Reimbursement Specialist

Medical Assistant - PRN

Billing & Collections Supervisor

Provider Revenue Integrity Manager

Clinical Tech. (Medical Assistant) - FT Float to Bartlett, Arlington, Germantown, and Millington

Specialty Pharmacy Prior Authorization Specialist Medical Authorizations

I want to receive the latest job alert for authorization specialist in southaven ms

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