Top 81 Prior authorization work from home Jobs in Miami, Fl

Medication Access Specialist - Pharmacy Technician - FT - Days - Memorial Home Infusion
Memorial Healthcare System —Miramar, FL
- Full-time
- Customer service
- Data analysis skills
- Mid-level
Referral & Authorization Care Coordinator
Oshi Health —Miami, FL
- $47,000 - $52,000 a year
- Email
- Remote
- Nursing
- Data analysis skills
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
Medical Office Specialist
HCA FL Weight Mgmt & Metabolic Wellness —Miami, FL
- Full-time
- Surgery
- Mid-level
- Cardiology
- Employee stock purchase plan
- Disability insurance
Quick Apply
RCM Contracts Manager
Integrated Home Care Acquisition —Miramar, FL
- Remote
- 5 years
- Finance
- Analysis skills
- Paid training
- Wellness program
Quick Apply
Construction Sales Representative
Grupo Sineva, INC —Miami, FL
- $55,000 - $60,000 a year
- Weekends as needed
- Spanish
- Clean driving record
- English
- Paid training
- Paid time off
Quick Apply
9d
APP Clinical Manager
LiveWell Choice, LLC —Fort Lauderdale, FL
- Full-time
- Nursing
- Clean driving record
- Microsoft Excel
- Paid time off
Quick Apply
Field Reimbursement Manager, Miami, FL
Amgen —Miami, FL
- $145,470.70 - $196,813.30 a year
- Hybrid work
- Spanish
- Clean driving record
- Doctoral degree
- Disability insurance
- Health insurance
Dermatology Medical Office Receptionist
Dermatology Medical Office —Miami, FL
- $17 an hour
- Full-time
- Spanish
- English
- High school diploma or GED
- Work from home
Quick Apply
7d
Ticket Office Representative
Inter Miami CF LLC —Miami, FL
- Weekends as needed
- Background check
- Spanish
- Sales
Quick Apply
Utilization Review Nurse
FLORIDA PACE CENTERS, INC. —Miami, FL
- Weekends as needed
- Remote
- Acute care
- Background check
- Nursing
- Free parking
- Health insurance
Quick Apply
Office Manager
Premium Eye Centers —Pembroke Pines, FL
- $25 - $33 an hour
- Full-time
- Private practice
- Spanish
- Medical office experience
- Profit sharing
- Paid time off
Quick Apply
1d
Epic Certified Willow Inpatient Analyst 5340180
Accenture —Miami, FL
- $52 - $56 an hour
- Full-time
- Remote
- System design
- HIPAA
- Mid-level
- Disability insurance
- Health insurance
HOUSING SPECIALIST
Care Resource Community Health Centers, Inc. —Miami, FL
- Background check
- Writing skills
- Mid-level
Associate Clinical Specialist, Pain Interventions - Miami, FL
Medtronic —Miami, FL
- $64,000 - $96,000 a year
- Weekends as needed
- Spanish
- RN License
- Mid-level
- Health savings account
- Employee stock purchase plan
11h
Office Associate - College of Arts, Sciences & Education Dean's Office
Florida International University —Miami, FL
- $33,000 - $36,000 a year
- Online Application
- Background check
- Microsoft Excel
- Inventory management
11d
Eastern Air Express - Flight Attendant - Miami, FL
Eastern Airlines LLC —Miami, FL
- Weekends as needed
- 18 years or older
- Pass drug screening
- English
Quick Apply
SOCIAL WORKER
Villa Maria Nursing Ctr & Rehab —North Miami, FL
- CPR Certification
- Master of Social Work
- BLS Certification
Healthcare Consultant
viva —North Miami, FL
- $17 - $22 an hour
- Full-time
- Nursing home
- Mid-level
- Bachelor's degree
- Paid holidays
11d
Technician Production Operations
Beckman Coulter Diagnostics —Hialeah, FL
- Full-time
- High school diploma or GED
- Ability to lift 50 pounds
- Ability to stand for extended periods
- Paid time off
Clinical Business Operations Representative 2 (H)
University of Miami —Miami, FL
- Weekends as needed
- Bilingual
- Mid-level
- Office
- Health insurance
- Dental insurance

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prior authorization work from home jobs near miami, fl

Medication Access Specialist - Pharmacy Technician - FT - Days - Memorial Home Infusion

Memorial Healthcare System -
Miramar, FL

Apply Now

Job Details

Full-time

Qualifications

Pharmacy Technician License
PTCB Certification
High school diploma or GED
Registered Pharmacy Technician

Full Job Description

Location:

Miramar, Florida

At Memorial Healthcare System (MHS), our ever-growing pharmacy career options present unlimited opportunities to individuals passionate about advancing pharmacy practice. As a nationally recognized and respected leader for providing “A-rated” patient care and safety, MHS prides itself on being able to grow and adapt to the rapidly evolving needs of our community and healthcare industry.

Summary:

Responsible for performing benefit coverage investigations, initiating, processing, resolving prior authorizations (including denials), helping patients obtain financial assistance from pharmacy related services. Coordinates enrollment, utilization, and ongoing eligibility for manufacturer patient assistance programs to ensure access to medications and compliance with program requirements. Responsible preparing monthly pharmaceutical savings reports and responding to patient assistance program audits.

Responsibilities:

Assesses, assists and enrolls patients that require financial assistance for pharmacy services. Contacts pharmaceutical companies to obtain information and enrolls patients into pharmaceutical patient assistance programs. Monitors and coordinates re-enrollment or transition into additional pharmacy service lines.Participates in pharmacy reimbursement initiatives that increase patient access to pharmaceutical services and promotes cost savings to the health system.Performs pharmacy benefit investigation and applies knowledge and understanding of the coverage rules by third party payers, including Medicare and Medicaid. Identifies therapies that require certification of medical necessity. Works with providers and payers to obtain approval. Initiates support for appeals to denied authorizations for pharmacy services.Processes patient financial documentation for pharmacy financial assistance eligibility. Develops reimbursement payments schedules for patients with special needs. Tracks status of expiring reimbursements and processes renewals for patients as appropriate.Tracks, trends and reports financial data related to drug reimbursement and replacement transactions.Improves access to pharmaceutical therapy by performing pharmacy benefit investigation, prior authorizations, copay assistance, enrollment in manufacturer free drug programs, including medication replacement and appeals as appropriate.Coordinates receipt, delivery and distribution of free drug, drug replacements and bulk pharmaceuticals.Ensures compliance with financial and regulatory requirements. Coordinates and ensures appropriates credit to patient accounts when applicable.

Competencies:

ACCOUNTABILITY, ANALYSIS AND DECISION MAKING - PHAP, CUSTOMER SERVICE, FINANCIAL COUNSELING - PATIENT SERVICES, PATIENT AND FAMILY CENTERED CARE, PROBLEM SOLVING, RESPONDING TO CHANGE, STANDARDS OF BEHAVIOR, VERIFY INSURANCE

Education and Certification Requirements:

High School Diploma or Equivalent (Required)Certified Pharmacy Technician (CPHT) - Pharmacy Technician Certification Board (PTCB), Certified Pharmacy Technician Exam (EXCPT) - National Healthcareer Association (NHA), Registered Pharmacy Technician (RPT LICENSE) - State of Florida (FL)

Additional Job Information:

Complexity of Work: Requires critical thinking skills, effective communication skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.Required Work Experience: Three (3) years of pharmacy experience. Proficient understanding of the delivery of healthcare across multiple service lines.Other Information: Certified pharmacy technician through a nationally accredited organization.

Working Conditions and Physical Requirements:

Bending and Stooping = 80%
Climbing = 40%
Keyboard Entry = 80%
Kneeling = 40%
Lifting/Carrying Patients 35 Pounds or Greater = 0%
Lifting or Carrying 0 - 25 lbs Non-Patient = 80%
Lifting or Carrying 2501 lbs - 75 lbs Non-Patient = 60%
Lifting or Carrying > 75 lbs Non-Patient = 0%
Pushing or Pulling 0 - 25 lbs Non-Patient = 80%
Pushing or Pulling 26 - 75 lbs Non-Patient = 60%
Pushing or Pulling > 75 lbs Non-Patient = 40%
Reaching = 80%
Repetitive Movement Foot/Leg = 0%
Repetitive Movement Hand/Arm = 80%
Running = 60%
Sitting = 80%
Squatting = 80%
Standing = 80%
Walking = 80%
Audible Speech = 80%
Hearing Acuity = 80%
Smelling Acuity = 60%
Taste Discrimination = 0%
Depth Perception = 80%
Distinguish Color = 80%
Seeing - Far = 80%
Seeing - Near = 80%
Bio hazardous Waste = 40%
Biological Hazards - Respiratory = 40%
Biological Hazards - Skin or Ingestion = 40%
Blood and/or Bodily Fluids = 60%
Communicable Diseases and/or Pathogens = 40%
Asbestos = 0%
Cytotoxic Chemicals = 80%
Dust = 80%
Gas/Vapors/Fumes = 60%
Hazardous Chemicals = 80%
Hazardous Medication = 80%
Latex = 80%
Computer Monitor = 80%
Domestic Animals = 40%
Extreme Heat/Cold = 0%
Fire Risk = 40%
Hazardous Noise = 0%
Heating Devices = 60%
Hypoxia = 0%
Laser/High Intensity Lights = 0%
Magnetic Fields = 60%
Moving Mechanical Parts = 80%
Needles/Sharp Objects = 80%
Potential Electric Shock = 40%
Potential for Physical Assault = 0%
Radiation = 0%
Sudden Decompression During Flights = 0%
Unprotected Heights = 0%
Wet or Slippery Surfaces = 60%

Shift:

Disclaimer: This job description is not intended, nor should it be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to indicate the general nature and level of work performed by employees within this classification.

Wages shown on independent job boards reflect market averages, not specific to any employer. We encourage candidates to talk to their Memorial Healthcare System recruiter to discuss actual pay rates, during the hiring process.

Memorial Healthcare System is proud to be an equal opportunity employer committed to workplace diversity.

Memorial Healthcare System recruits, hires and promotes qualified candidates for employment opportunities without regard to race, color, age, religion, gender, sexual orientation, national origin, veteran status, disability, genetic information, or any factor prohibited by law.

We are proud to offer Veteran’s Preference to former military, reservists and military spouses (including widows and widowers). You must indicate your status on your application to take advantage of this program.

Employment is subject to post offer, pre-placement assessment, including drug testing.

If you need reasonable accommodation during the application process, please call 954-276-8340 (M-F, 8am-5pm) or email [email protected]

Apply Now

Refine Your Search

prior authorization work from home jobs in miami, fl

Medication Access Specialist - Pharmacy Technician - FT - Days - Memorial Home Infusion

Referral & Authorization Care Coordinator

Medical Office Specialist

RCM Contracts Manager

Construction Sales Representative

APP Clinical Manager

Field Reimbursement Manager, Miami, FL

Dermatology Medical Office Receptionist

Ticket Office Representative

Utilization Review Nurse

Office Manager

Epic Certified Willow Inpatient Analyst 5340180

HOUSING SPECIALIST

Associate Clinical Specialist, Pain Interventions - Miami, FL

Office Associate - College of Arts, Sciences & Education Dean's Office

Eastern Air Express - Flight Attendant - Miami, FL

SOCIAL WORKER

Healthcare Consultant

Technician Production Operations

Clinical Business Operations Representative 2 (H)

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