Top 20 Prior authorization specialist Jobs in Dublin, Oh

Prior Authorization Specialist
Equitas Health, Inc. —Columbus, OH
- $18.13 - $21.78 an hour
- Weekends as needed
- Mid-level
- Driver's License
- Driving
- Dental insurance
- 401(k)
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BH Insurance/Precert Specialist
Nationwide Children's Hospital —Columbus, OH
- Full-time
- CPR Certification
- BLS Certification
- High school diploma or GED
Procedure Denial & Authorization Follow‑Up Specialist
Pain Zero LLC —Grove City, OH
- $18.50 - $20.00 an hour
- Full-time
- Background check
- Clinic experience
- In-person
- Paid time off
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8d
Patient Financial Specialist III
Mount Carmel —Columbus, OH
- Full-time
- Surgery
- Hospital
- Customer service
- Relocation assistance
- Health insurance
Utilization Management Specialist
ST VINCENT FAMILY SERVICES —Columbus, OH
- Weekends as needed
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- HIPAA
- Paid time off
- 401(k) matching
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Client Insurance Specialist
Integrated Services for Behavioral Health —Columbus, OH
- $20.97 - $24.56 an hour
- Hybrid work
- Mid-level
- Organizational skills
- 2 years
- Disability insurance
- Health insurance
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Referral Specialist
PrimaryOne Health —Columbus, OH
- High school diploma or GED
- Entry level
- Paid holidays
- Disability insurance
Medical Billing and Accounts Receivable Specialist
I Am Boundless, Inc. —Worthington, OH
- Full-time
- Remote
- Computer literacy
- Mid-level
- Microsoft Office
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Patient Representative| Registration | Full Time | Memorial Health
Memorial Health Ohio —Marysville, OH
- Full-time
- Microsoft Word
- Microsoft Excel
- Microsoft Outlook
- Free parking
- Paid holidays
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Patient Representative | Registration |Part-Time | City Gate Urgent Care | Every 3rd Weekend Rotation
Memorial Health Ohio —Marysville, OH
- Part-time
- Microsoft Word
- Microsoft Excel
- Microsoft Outlook
- Free parking
- Paid holidays
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Pharmacy Support Specialist
HEART OF OHIO FAMILY HEALTH CENTERS —Columbus, OH
- $22 - $25 an hour
- Full-time
- 18 years or older
- Mid-level
- Office
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Billing Specialist I
Ohio Gastro —Columbus, OH
- Microsoft Excel
- HIPAA
- English
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Central Pharmacy Liaison
AndHealth —Columbus, OH
- Full-time
- Current TB test
- BLS Certification
- Mid-level
- Disability insurance
- Health insurance
Quick Apply
6d
Customer Support Specialist
Kinetics Noise Control —Dublin, OH
- $42,000 - $45,000 a year
- Microsoft Excel
- Microsoft Outlook
- ERP systems
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9d
Remote Processing Specialist
CLEAResult Consulting Inc. —Columbus, OH
- $16 an hour
- Full-time
- Remote
- US work authorization
- Organizational skills
- Entry level
- Health insurance
- Dental insurance
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2d
Remote Energy Efficiency Customer Support Specialist
CLEAResult Consulting Inc. —Columbus, OH
- $17 an hour
- Full-time
- Remote
- Sales
- High school diploma or GED
- US work authorization
- Health insurance
- Dental insurance
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2d

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Prior Authorization Specialist
Equitas Health, Inc. —Columbus, OH
Reliable transportation, driver’s license and proof of auto insurance required. Essential job functions include, but are not limited to, driving or having…
$18.13 - $21.78 an hour
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BH Insurance/Precert Specialist
Nationwide Children's Hospital —Columbus, OH
CPR certification (based on position and as determined by manager). Obtains insurance prior authorization as needed and documents the verification of benefits…

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prior authorization specialist jobs near dublin, oh

Prior Authorization Specialist

Equitas Health, Inc. -
Columbus, OH

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Job Details

$18.13 - $21.78 an hour

Benefits

Dental insurance
401(k)
Paid time off
Vision insurance

Qualifications

Care documentation
Driver's License
Cultural competency
Driving
Working with individuals from diverse cultural backgrounds
Documentation Handling

Full Job Description

ORGANIZATION INFORMATION:

Established in 1984, Equitas Health is a regional not-for-profit community-based healthcare system and federally qualified community health center look-alike. Its expanded mission has made it one of the nation’s largest HIV/AIDS, lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) healthcare organizations. With 22 offices in 12 cities, it serves more than 67,000 individuals in Ohio, Kentucky, and West Virginia each year through its diverse healthcare and social service delivery system focused around: primary and specialized medical care, retail pharmacy, dental, behavioral health, HIV/STI prevention, advocacy, and community health initiatives.

HOURLY RATE: $18.13-$21.78

BENEFITS:

PTO
Vision
Dental
Health
401k
Sick time

POSITION SUMMARY:
The Prior Authorization Specialist handles all prior authorizations, third party appeals, and pending third party payer issues across all Equitas Health medical centers. This individual will work with internal and external pharmacies, CoverMyMeds, the EHR, and all Equitas Health health center providers to facilitate prior authorization completion. This individual must be able to work in conjunction with the pharmacy department and health center staff to facilitate the prior authorization process.

ESSENTIAL JOB FUNCTIONS:
The Prior Authorization Specialist is responsible for handling all prior authorizations, appeals, and third party medication disputes for providers at Equitas Health. The Prior Authorization Specialist will be required to communicate with prescribers, pend medication changes, and maintain exceptional documentation in the patient health record. The staff member will also be in constant communication with internal pharmacies, external pharmacies, and patients waiting on prior authorizations. Essential job functions include, but are not limited to, driving or having reliable transportation, written and verbal communication, utilizing a computer for typing, multi-system use/maintenance, and attending meetings.

MAJOR AREAS OF RESPONSIBILITIES:

Complete prior authorizations submission within established time frame.
Collaborate with providers to manage appeals and/or peer-to-peer discussion with third party representatives.
Ensure proper documentation is maintained in the EHR.
Work with clinical pharmacist team to provide potential therapeutic substitutions to prescribers
Communicate with the clinical team on the status of prior authorizations or changes that must be made for therapy to continue for the patient.
Maintain constant communication with the internal and external pharmacy teams for medication processing.
Inform patients when prior authorizations are approved.
Provide data on prior authorizations as needed to Senior Leadership.
Other duties as assigned by the Prior Authorization Supervisor, Director of Nursing, and Leadership.
Comply with the Equitas Health Care Corporate Compliance Standards of Conduct and related policies and procedures.
Demonstrate unconditional positive regard to clients and conduct all aspects of job responsibilities.
Continuously grow and develop cultural competency, exhibiting an understanding, awareness, and respect for diversity.
Contribute to a positive work environment by demonstrating unconditional positive regard to all Equitas Health employees, interns, etc. with an understanding, awareness, and respect for diversity.

EDUCATION/LICENSURE:

Medical Assistant, Certified Pharmacy Technician or Registered Pharmacy Technician (must be registered with State of Ohio Board of Pharmacy).

Knowledge, Skills, Abilities and other Qualifications:

Experience working in medical records preferred.
Must be able to accurately and effectively meet established deadlines
Experience with prior authorizations preferred.
Strong attention to detail.
Ability to be flexible in working hours.
Must ensure detailed and thorough documentation.
Exemplary written and verbal communication skills.
Knowledge of healthcare terminology.
Must have sensitivity to, interest in and competence in cultural differences, HIV/AIDS, minority health, sexual practices, chemical dependency and a demonstrated competence in working with persons of color, and gay/lesbian/bisexual/transgender community.
Proficiency in all Microsoft Office applications, computers, email, web-based systems and electronic health records.
Reliable transportation, driver’s license and proof of auto insurance required.

OTHER INFORMATION:

Background and reference checks will be conducted. In accordance with Equitas Health’s Drug-Free Workplace Policy, pre-employment drug testing will be administered. Hours may vary, including working some evenings and weekends based on workload. Individuals are not considered applicants until they have been asked to visit for an interview and at that time complete an application for employment. Completing the application does not guarantee employment. EOE/AA

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.

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Refine Your Search

prior authorization specialist jobs in dublin, oh

Prior Authorization Specialist

BH Insurance/Precert Specialist

Procedure Denial & Authorization Follow‑Up Specialist

Patient Financial Specialist III

Utilization Management Specialist

Client Insurance Specialist

Referral Specialist

Medical Billing and Accounts Receivable Specialist

Patient Representative| Registration | Full Time | Memorial Health

Patient Representative | Registration |Part-Time | City Gate Urgent Care | Every 3rd Weekend Rotation

Pharmacy Support Specialist

Billing Specialist I

Central Pharmacy Liaison

Customer Support Specialist

Remote Processing Specialist

Remote Energy Efficiency Customer Support Specialist

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