Top 19 Prior authorization specialist Jobs in Taylor, Mi

Prior Authorization Specialist
Cascade Hemophilia Consortium —Ann Arbor, MI
- $41,600 - $70,000 a year
- Full-time
- Background check
- Computer literacy
- HIPAA
- Health insurance
- Dental insurance
Prior Authorization Certified Pharmacy Technician
Shields Health Solutions —Detroit, MI
- $19.45 - $22.21 an hour
- Remote
- Microsoft Excel
- Microsoft Outlook
- Research
Quick Apply
14d
Oncology Prior Authorization Specialist
Triarq Practice Services —Royal Oak, MI
- Full-time
- Remote
- Mid-level
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8d
Infusion Prior Authorization Specialist
M.I.N.D —Farmington Hills, MI
- $19 - $25 an hour
- Full-time
- Mid-level
- High school diploma or GED
- Ability to sit for extended periods
Insurance Verification & Billing Specialist
Eastlake Cardiovascular PC —Saint Clair Shores, MI
- 8 hour shift
- Research
- Mid-level
- Organizational skills
- Paid holidays
- Disability insurance
Quick Apply
Insurance & Claim Encounter Specialist PT
The Children's Center of Wayne County, Inc. —Detroit, MI
- $15,150 - $18,180 a year
- Part-time
- HIPAA
- High school diploma or GED
- Children
- 403(b) matching
- Paid sick time
Front Office Coordinator - Dearborn Heights, MI
Athletico Physical Therapy —Dearborn Heights, MI
- $15.00 - $23.50 an hour
- Overtime
- Microsoft Excel
- Microsoft Outlook
- HIPAA
- Paid parental leave
- Health savings account
Summit Surgery Center - Business Office Specialist
Regent Surgical —Troy, MI
- Full-time
- Surgery
- BLS Certification
- HIPAA
Quick Apply
Front Office Coordinator - Ferndale, MI
Athletico Physical Therapy —Ferndale, MI
- $15.00 - $23.50 an hour
- Overtime
- Microsoft Excel
- Microsoft Outlook
- HIPAA
- Paid parental leave
- Health savings account
Epic Ambulatory Bones Application Engineer Specialist - 6079188
Accenture —Detroit, MI
- $47.85 - $57.85 an hour
- Full-time
- Remote
- 5 years
- High school diploma or GED
- US work authorization
- Disability insurance
- Health insurance
Authorization Specialist -High Tech Radiology
Trinity Health Michigan —Ann Arbor, MI
- Full-time
- Microsoft Excel
- Computer literacy
- Medical office experience
Referral Coordinator
Trinity Health Michigan —Ann Arbor, MI
- Full-time
- Microsoft Word
- Microsoft Excel
- Microsoft Outlook
Patient Reception Specialist - Livonia
Village Medical —Livonia, MI
- Full-time
- Microsoft Outlook
- BLS Certification
- Internal Medicine
- Health insurance
- Dental insurance
Quick Apply
12d
Patient Visit Specialist I
Trinity Health Michigan —Ypsilanti, MI
- Full-time
- Microsoft Word
- Microsoft Excel
- Microsoft Outlook

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Prior Authorization Specialist
Cascade Hemophilia Consortium —Ann Arbor, MI
Supports other teams as needed such as answering telephones when necessary, filing paperwork, etc. Monitors in basket, email, fax, and teams messages, and…
$41,600 - $70,000 a year
Prior Authorization Certified Pharmacy Technician
Shields Health Solutions —Detroit, MI
✈️ Minimal in-state or out-of-state travel may be required. If the candidate's state of residence does not offer Pharmacy Technician registration, national…
$19.45 - $22.21 an hour
Quick Apply
14d

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Must have prior experience with insurances and prior authorizations. Collaborate with clinical staff to ensure timely approvals for patient treatments.
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Associate's Degree required; Bachelor's Degree preferred in Healthcare Administration, Business Administration, Social Work, Public Health, or related field.
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Prior Authorization Specialist

Cascade Hemophilia Consortium -
Ann Arbor, MI

Quick Apply

Job Details

Full-time
$41,600 - $70,000 a year

Benefits

Health insurance
Dental insurance
401(k)
Flexible spending account
Paid time off
Parental leave
Vision insurance
401(k) matching
Life insurance

Qualifications

Health insurance authorizations
Computer operation
Pharmacy Information Systems (PIS)
Insurance prior authorization
Achieving HIPAA compliance
Phone communication
Health insurance information
Pharmacy Technician License
HIPAA
Windows
Pharmacy technician experience
Health insurance
Math
Attention to detail
Desktop applications
Medicaid
Productivity software
Clinical confidentiality policies
Non-profit experience
Medical terminology
Pharmacy Technician Certification

Full Job Description

JOB SUMMARY:

The Prior Authorization and Insurance Specialist is responsible for reviewing, submitting, monitoring, and responding to issues regarding medication prior authorizations for Cascade patients. This position works closely with the Clinical Care and Pharmacy Teams on patient insurance, authorization issues, billing issues, and required forms. Reviews patient history to identify supporting documentation in the patient chart relevant to the medication up to and including medical records, prescriptions, prior authorizations, insurance information and verifications, and management of pertinent forms required for (or involved in) patient care by uploading pertinent documentation to patient charts in the relevant software programs. Works closely with patients, Hemophilia Treatment Centers, and insurance companies to obtain prior authorizations and to resolve problems.

Salary Range:

$40,020-$71,340

MINIMUM COMPETENCIES:

Education: Licensed and certified Pharmacy Technician

Experience:

a. Minimum of three years of experience in a medical or non-profit setting working with insurance companies

b. Excellent written and oral communication skills

c. Proficiency in Microsoft Office Suite

POSITION REQUIREMENTS:

Knowledgeable in medical terminology.
Proficient knowledge of major health plans and insurance processes.
Proficiency in operating a standard desktop and Windows-based computer system.
Excellent communications skills in both written and verbal forms, including proper phone etiquette. Ability to read, understand and respond to detailed written and oral instructions.
Excellent attention to detail
Ability to work collaboratively in a team-oriented environment; displays courteous and friendly demeanor.
Good organizational and time management skills to effectively juggle multiple priorities, time constraints and ever-changing situations.
Ability to exercise sound judgement and problem-solving skills.
Ability to perform mathematical calculations needed during the course of performing basic job duties.
Knowledge of the compliance aspects of clinical care and patient privacy.
Ability to handle patient and organizational information in a confidential manner.
Knowledge of or willingness to learn various software programs required by insurance companies to submit prior authorizations and check eligibility (CoverMyMeds, Availity, etc).

JOB RESPONSIBILITIES:

Coordinate with appropriate parties when necessary such as Hemophilia Treatment Center and insurance, to complete prior authorizations. Advocate for the patient to the best of our ability on the prior authorizations and when communicating with insurance companies. Professionally communicates with the ordering provider, HTC staff and representatives of insurance companies, including both oral and written communication.

Updates information in patient medical record in Cascade pharmacy software and Epic EHR with prior authorization approval or denial information; follows up with HTC as to status and/or issues with prior authorizations. Advises the HTC with potential next steps, such as appeals.

Monitors in basket, email, fax, and teams messages, and follows up on correspondence timely and accurately.

Assists in all aspects of new patient intake

Supports team with annual patient mailings and forms, coordinate with Forms Committee and Compliance about new forms, adjustments to current forms, and changes in processes.

Monitor the schedule for daily orders and coordinate with team members to dispense workload.

Complete insurance verifications for daily pharmacy orders and upcoming orders.

Assist the Pharmacy Technicians when billing issues arise, by calling insurance companies, requesting overrides (high cost overrides, Pillar and SaveOn overrides) when necessary, updating insurance processing information in the internal system, or provide general help getting a claim to process.

Develops, implements and revises electronic forms via HIPAA compliant software, working in conjunction with the Forms Committee

Monitors and manages electronic form responses and files into EMR accordingly

Keep up to date with insurance changes and requirements.

Advise the Pharmacists and Clinical Care team when questions come up regarding insurance coverage for a new medication, dose change, out of pocket costs, or other prior authorization/insurance questions.

Inform the HTC when new insurance is discovered for a patient of theirs and advise them of next steps to get medication covered. Discuss whose program the patient will be on with the HTC.

Monitor monthly PA expirations, verify active insurance, and create referrals in current software. Assign the PA referrals to the appropriate team member to ensure PA’s are submitted in a timely manner to avoid interruptions in patient care.

Monitor necessary letters of medical necessity. Coordinate with the HTC’s to facilitate renewals and new letters of medical necessity as applicable.

Be able to identify underinsured new or current patients, and coordinate with Patient Access team for support.

Supports other teams as needed such as answering telephones when necessary, filing paperwork, etc.

Participates in 340B trainings.

Participate in weekend on-call schedule, covering holidays in equal fairness with other staff members.

Special projects when needed and other duties as assigned.

Job Type: Full-time

Pay: $41,600.00 - $70,000.00 per year

Benefits:

401(k)
401(k) matching
Dental insurance
Flexible spending account
Health insurance
Life insurance
Paid time off
Parental leave
Vision insurance

Application Question(s):

This position is full-time and requires regular, in person attendance at our Ann Arbor, MI office. Please confirm your current location. Only candidates in close geographical proximity to Ann Arbor will be eligible for consideration.

Experience:

Prior Authorization: 2 years (Required)

License/Certification:

Pharmacy Technician License (Required)

Work Location: In person

Quick Apply

Refine Your Search

prior authorization specialist jobs in taylor, mi

Prior Authorization Specialist

Prior Authorization Certified Pharmacy Technician

Oncology Prior Authorization Specialist

Infusion Prior Authorization Specialist

Insurance Verification & Billing Specialist

Insurance & Claim Encounter Specialist PT

Front Office Coordinator - Dearborn Heights, MI

Summit Surgery Center - Business Office Specialist

Front Office Coordinator - Ferndale, MI

Epic Ambulatory Bones Application Engineer Specialist - 6079188

Authorization Specialist -High Tech Radiology

Referral Coordinator

Patient Reception Specialist - Livonia

Patient Visit Specialist I

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