Hire Authority Jobs in Usa

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House Cleaners Wanted!! - The Cleaning Authority - Now hiring
✦ New
Salary not disclosed
Garden grove, CA 10 hours ago
Full Time Positions Available

The Cleaning Authority is hiring for full time positions. We offer the highest pay for cleaning in the area!

Are you tired of retail and fast food hours? Want your nights and weekends back? Would you like to be home during the holidays? You can have them! We clean Monday-Friday from 8 am - 5 pm and we are closed on the major holidays!

No experience? No problem. We have a computer based learning system as well as a 2-week training program which includes hands on training with one of our experienced and professional trainers.

We offer paid holidays and paid vacations too!

Requirements
  • Must be 18 years of age or older
  • Be able to pass a background check
  • Have a great attitude, be a team player, and take pride in your work!
  • A willingness to learn -- everybody can clean, but not everyone cleans like we do!
  • Be able to be on your feet all day with light lifting (less than 15 pounds) -- we won't lie, it's a physically demanding job!
  • Driver's license preferred.

EOE

Are you looking for a career that is both rewarding and fulfilling? Look no further than the housecleaning industry! At The Cleaning Authority, we offer professional housecleaning services backed by more than 25 years of excellence. When you join the team, you'll be trained on our Detail-Clean Rotation System, which has proven effective in more than 20 million cleans across North America.

The Cleaning Authority is renowned for providing quality cleans at affordable prices. Founded in Maryland in 1977, The Cleaning Authority was one of the first whole house cleaning services in the region. Our goal is to make our customers' lives better, and we know that starts with our Professional Housecleaners. It's the employees that make The Cleaning Authority great! Each location is committed to hiring only the best and empowering them to become leaders who bring out the best in the people around them.

Become a part of a legacy of success and integrity. The Cleaning Authority is looking to hire enthusiastic Professional Housecleaners for full-time and part-time positions. If you enjoy cleaning, giving back to others, and gaining contentment from a job well done, we're waiting for you!

Not Specified
Prior Authorization Specialist - Pharmacy
Salary not disclosed

Description

:The role of the Prior Authorization Specialist is to centrally coordinate, obtain, review, and track prior authorizations for medications and other home care needs.

The goal of the Prior Authorization Specialist is to work with other departments in order to complete prior authorizations through the various methods that are required by insurers.Education: Required: High School Diploma or Equivalent Experience: Required: One year customer service or pharmacy experience Preferred: At least one year experience as a Pharmacy Technician Skills: Strong customer service skills when working with various staff members.

Have professional verbal and written communication skills.

Ability to work independently and be self-directed to complete prior authorizations in a timely manner.

Possess excellent time management skills.

Proficient using computers, including all Microsoft programs and promote the mission and values of CoxHealth Licensure/Certification/Registration: Preferred: Registered with Missouri State Board of Pharmacy Technician OR application completed upon hire and obtained within 90 days of hire.
Not Specified
Authorization Specialist
✦ New
Salary not disclosed
Pittsburgh, PA 1 day ago

A closed door pharmacy is looking to hire a Prior Authorization Specialist. This role will include assisting in the initiation of new prior auth requests, identifying correct forms required for patients insurance, coordinating information for forms, and following up with medical offices. These individuals must have experience working in a previous pharmacy setting and must have a strong ability to multitask.


Responsibilities:

  • Process pharmacy claims accurately and timely to meet client expectations
  • Triage rejected pharmacy insurance claims to ascertain patient pharmacy benefits coverage
  • Maintain compliance with patient assistance program guidelines
  • Document all information and data discovery according to operating procedures
  • Research required information using available resources
  • Maintain confidentiality of patient and proprietary information
  • Perform all tasks in a safe and compliant manner that is consistent with corporate policies as well as State and Federal laws
  • Work collaboratively and cross-functionally between management, the Missouri-based pharmacy, compliance and engineering


Must Haves:

  • 1+ year(s) working with prior authorizations or insurance verification in a pharmacy
  • High school diploma or GED required, Bachelor’s degree strongly preferred
  • Customer service or inbound call center experience required
  • Sound technical skills, analytical ability, attention to detail, good judgment, and strong operational focus
  • Must be flexible to work shifts ranging from 8am - 8pm.

Preferred Skills:

  • 1+ year(s) working with prior authorizations or insurance verification in a pharmacy
  • Knowledge of pharmacy benefits and pharmacy claims


  • Shift: 40hours/week (rotational shifts between 9am-8pm EST)
  • Weekly rotating schedules from 11:00 am - 7:00pm EST , 12:00pm - 8:00pm EST and once a month 9:00am - 5:00pm EST
  • Possible rotational Saturday's shift 9:00AM - 5:00 PM EST


This position is a 6 month contract to hire.

Not Specified
Technical Author
✦ New
🏢 Akkodis
Salary not disclosed
Allen Park, MI 1 day ago

Akkodis is seeking a Technical Author for a position with a client located in Allen Park, MI.

We are seeking an experienced Automotive Technical Author to support documentation for Ford Motor Company vehicle service and repair procedures. This role is ideal for dealership technicians or automotive professionals who want to transition into technical documentation while applying their diagnostic and mechanical expertise.


Pay Range: $32/hr. - $36/hr. (The pay may be negotiable based on experience, education, geographic location, and other factors.)


Work Schedule

  • Hybrid: 2 days onsite / 3 days remote
  • Core hours: 9 AM – 3 PM (flexible)
  • Additional onsite days during initial training



Technical Author – Automotive


Key Responsibilities

  • Create and maintain service, repair, and diagnostic documentation for vehicle systems
  • Translate complex engineering data, wiring diagrams, and technical specifications into clear instructions for technicians
  • Collaborate with engineering and product teams to ensure technical accuracy
  • Support labor time studies and documentation for vehicle service procedures
  • Maintain documentation using content management and authoring tools


Required Qualifications

  • 2+ years of dealership diagnostic repair experience (bumper-to-bumper)
  • Hands-on experience with collision repair, spot welding, panel installation, body measurements, and paint
  • Strong automotive diagnostic and mechanical skills
  • Ability to interpret service manuals, wiring diagrams, and repair procedures
  • Strong written communication and documentation skills
  • Proficiency with Microsoft Office (Word, Excel) and Adobe Acrobat


Preferred

  • Prior technical authoring or documentation experience
  • Experience with XML authoring tools such as Oxygen XML Editor, Arbortext Editor, or XMetaL
  • National Institute for Automotive Service Excellence (ASE) certifications
  • Experience working in a Ford dealership environment



If you are interested in this Technical Author job in Allen Park, MI then please click APPLY NOW. For other opportunities available at Akkodis go to you have questions about the position, please contact Nandakini Sajwanat


Equal Opportunity Employer/Veterans/Disabled

Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, an EAP program, commuter benefits, and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable. Disclaimer: These benefit offerings do not apply to client-recruited jobs and jobs that are direct hires to a client. To read our Candidate Privacy Information Statement, which explains how we will use your information, please visit Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:

· The California Fair Chance Act

· Los Angeles City Fair Chance Ordinance

· Los Angeles County Fair Chance Ordinance for Employers

· San Francisco Fair Chance Ordinance

Not Specified
Remote PBM Prior Authorization Pharmacist (Looking for PBM experience)
✦ New
Salary not disclosed
Atlanta, Remote 1 day ago
Clinical Pharmacist Advisor – Medicare (Remote, Contract to hire) Job Type: Contract to hire Pay Rate: $53/hour Location: Fully Remote (U.S.) Schedule: Business hours between 7:00 AM – 8:00 PM EST Monday–Friday and 7:00 AM – 4:30 PM EST Saturday & Sunday (rotating schedule) Training Schedule: Monday–Friday, 9:00 AM – 5:30 PM EST for the first 8 weeks Position Overview We are seeking a Licensed Registered Pharmacist to join our team as a Clinical Pharmacist Advisor – Medicare .

In this role, you will support Medicare Part D members and healthcare providers by reviewing pharmacy benefit requests, evaluating clinical documentation, and ensuring decisions comply with Medicare guidelines and timelines.

This is an excellent opportunity for pharmacists interested in managed care, pharmacy benefit management, and clinical review operations .

High-performing contractors may have the opportunity for full-time employment based on performance .

Key Responsibilities Review and process Medicare Part D pharmacy benefit requests and appeals Ensure accurate case setup by reviewing internal notes, documentation, and fax requests Evaluate clinical information and apply professional clinical judgment for decision-making Conduct provider outreach to obtain additional clinical details when necessary Document case activities clearly and accurately within internal systems Ensure compliance with CMS Medicare guidelines and timelines Meet departmental productivity and quality standards Utilize drug compendia resources and clinical references for appropriate decision-making Participate in feedback sessions and development discussions with supervisors Required Qualifications Bachelor’s Degree in Pharmacy or PharmD Active Pharmacist License in good standing in the state of residence Strong computer literacy including: Microsoft Excel Microsoft Word Data entry and multi-system navigation Ability to work independently in a productivity-driven environment Ability to sit and focus for extended periods during scheduled shifts Reliable wired internet connection Minimum 25 Mbps download / 5 Mbps upload Dedicated quiet workspace for remote work Verifiable High School Diploma or GED Preferred Qualifications Experience in Managed Care or PBM (Pharmacy Benefit Management) environments Knowledge of: Microsoft Access Microsoft PowerPoint Microsoft Visio Experience handling high-volume data entry and multi-screen workflows Work Environment Fully remote position Camera use required during training and meetings Data entry and navigating multiple systems across dual monitors Possible outbound provider calls for clinical information Important Training & Scheduling Requirements Attendance is critical during the first 8–10 weeks of training Training schedule is Monday–Friday, 9:00 AM – 5:30 PM EST After training, shifts may include one weekend day or rotating weekend coverage Assigned shifts will fall within 7 AM – 8 PM EST Hiring Process Requirements Candidates must provide the following with their resume: Internet speed test screenshot showing both download and upload speeds ( ) Must have 25 download and 5 upload.

MUST SHOW BOTH Screenshot of active pharmacist license showing: Name License number State Status Valid dates Interview Process Virtual interview via Microsoft Teams
Remote working/work at home options are available for this role.
Not Specified
IMMEDIATE HIRE FOR REGISTERED NURSE / RN SHIFT CARE
✦ New
Salary not disclosed
Arkansas 1 day ago
Department: 7A
Shift: Day
Working Hours: 7:00 AM - 7:00 PM
Summary:
A registered nurse at Baptist Health is accountable for utilizing the nursing process and the training provided by Baptist Health to provide safe, therapeutic, and compassionate patient care. The nurse is expected to demonstrate clinical competence and critical thinking. The RN is responsible to know and understand the policies and processes of the department and the requirements of the organization and use them in a unified workflow with the rest of the healthcare team to create an exceptional patient experience with the best possible outcomes.
Other information:
A new RN graduate from an accredited nursing program or Registered Nurse in good standing, and licensed to practice in the state of Arkansas. BSN preferred. Applies basic knowledge and skills to meet standard of care. Is able to practice as a full partner of an interdisciplinary team. RN that is not actively participating in the Clinical Nurse Advancement Program. Healthcare CPR required, some areas may require ACLS, PALS and/or NALS - training is provided. Specialty units require and will provide specific specialty education.
This job will be authorized 72.00 hours bi-weekly.
temporary
Executive Chef-Immediate Hire
✦ New
Salary not disclosed
Minerva, OH 10 hours ago
At Danbury, you don’t just clock in at a job. You walk in the door to a work family who wants to make the day count. We truly believe our employees and residents are a family that comes together to enjoy the good things in life, including one another. When our employees feel special, so do our residents. That’s the Danbury Difference
We are currently seeking applicants for an Executive Chef position.
Responsibilities include but are not limited to:
The executive chef will plan, organize, develop, inspire and direct the overall operation of Dining Services to assure that delicious quality nutritional services are provided.
It is the responsibility of this director to ensure that the department is maintained in a clean, safe and sanitary manner.
Determine how food should be presented and create decorative food displays. Standardize methods in which work will be accomplished.
Assist in planning regular and special diet menus as prescribed by the attending physician. Assure that food is available for preparation.
Perform administrative requirements such as completing necessary forms, reports, evaluations, studies, etc., and submit as required.
Coordinate dining services with other departments as necessary.
Develop and maintain a good working rapport with all community staff to assure that dining service can be properly maintained to meet the needs of the residents.
Ensure that department staff, residents, visitors, etc., follow established policies and procedures at all times.
Delegate authority, responsibility, and accountability to other responsible department staff.
Establish dining service production lines, etc., to assure that meals are prepared on time.
Requirements:
This department director has should extensive experience in providing fine dining in a variety of venues.
The ideal candidate will have a culinary degree from an accredited institution and 5 years of dietary/dining service experience in a supervisory capacity in a restaurant, hospital, health care/senior living facility.
Training/education in cost control, food management, and/or diet therapy for healthcare residents is a must.
Benefits for full time employees:
~ Company paid Short Term Disability, Long Term Disability, Life and AD&D
~ Medical, Dental, Vision, Additional Voluntary Life, Additional Voluntary AD&D
~401(k)
~ Paid Time Off
~ Paid Holidays
~ Tuition Reimbursement

If you are outstanding in your profession, have a positive outlook, and would like to work on a great team then we want to hear from you!
Danbury Senior Living provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
 
IND789
 
 
 
Not Specified
FULL TIME Lead Platform Engineer with Python Programming & AWS Cloud - HYBRID ONSITE (DIRECT HIRE)
✦ New
Salary not disclosed
Boston, MA, Hybrid 1 day ago
Please send current resumes directly to
Bhagyashree Yewle, Principal Lead Recruiter - YOH SPG
TIME Lead Platform Engineer with Python Programming & AWS Cloud - HYBRID ONSITE 

Location Flexibility: This role is based 4 days per week in either Boston MA or Needham MA, with occasional travel between offices as needed.

Candidates requiring visa sponsorship are welcome to apply!

FROM THE HIRING MANAGER - for our Platform Engineering team what we’re looking for are people who have experience building technology to be used by other development teams (not business users).

THE POSITION We are currently seeking qualified candidates for a Lead Software Engineer position for our Platform Engineering team which is responsible for designing and building tools and workflows for our internal software engineering teams. These systems will allow them to build and deploy applications effortlessly, allowing them to focus on building business functionality for their users. Your work will directly support enterprise-wide initiatives, helping teams across the organization streamline operations, improve reliability, and accelerate delivery. This role is ideal for someone who enjoys solving complex technical problems and collaborating with other engineers to create highimpact internal platforms. The ideal candidate should have experience enabling IT organizations to work more efficiently, standardize best practices, and reduce friction across the development lifecycle. This includes creating reusable components, automation frameworks, and platform capabilities that empower our engineering teams.

KEYS TO THE POSITION
  • 10+ years of experience in software engineering
  • Proficient in Python with experience building tools using widely adopted libraries such as Pandas, NumPy, Requests, BeautifulSoup, FastAPI, and SQLAlchemy
  • Skilled in packaging, testing, and deploying Python applications using tools like pytest, setuptools, and Docker
  • Hands-on experience designing, deploying, and managing cloud-native applications using AWS services (e.g., EC2, Lambda, S3, RDS, CloudFormation), with a strong grasp of scalable and secure architecture principles.
  • Experience designing and operating DevOps platforms including CI/CD pipelines, infrastructure as code (e.g., Terraform, Jenkins), and container orchestration using ECS or EKS - Experience designing and operating monitoring, logging, and performance optimization tools (e.g., OpenSearch, Open Telemetry, CloudWatch, X-Ray)
  • Excellent written and verbal communication
  • Attention to detail, self-discipline, and passion to drive and innovate
  • Must be comfortable with test-driven development, continuous integration, and agile development methodologies using tools like GIT, Artifactory, and Jenkins
  • Experience working with offshore development teams is a plus
  • Bachelor’s degree in computer science, engineering, math, or related field, or equivalent experience is preferred

Estimated Min Rate: $140,000.00

Estimated Max Rate: $165,000.00

What’s In It for You?
We welcome you to be a part of the largest and legendary global staffing companies to meet your career aspirations. Yoh’s network of client companies has been employing professionals like you for over 65 years in the U.S., UK and Canada. Join Yoh’s extensive talent community that will provide you with access to Yoh’s vast network of opportunities and gain access to this exclusive opportunity available to you. Benefit eligibility is in accordance with applicable laws and client requirements. Benefits include:

  • Medical, Prescription, Dental & Vision Benefits (for employees working 20+ hours per week)
  • Health Savings Account (HSA) (for employees working 20+ hours per week)
  • Life & Disability Insurance (for employees working 20+ hours per week)
  • MetLife Voluntary Benefits
  • Employee Assistance Program (EAP)
  • 401K Retirement Savings Plan
  • Direct Deposit & weekly epayroll
  • Referral Bonus Programs
  • Certification and training opportunities

Note: Any pay ranges displayed are estimations. Actual pay is determined by an applicant's experience, technical expertise, and other qualifications as listed in the job description. All qualified applicants are welcome to apply.

Yoh, a Day & Zimmermann company, is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Visit to contact us if you are an individual with a disability and require accommodation in the application process.

For California applicants, qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. All of the material job duties described in this posting are job duties for which a criminal history may have a direct, adverse, and negative relationship potentially resulting in the withdrawal of a conditional offer of employment.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

By applying and submitting your resume, you authorize Yoh to review and reformat your resume to meet Yoh’s hiring clients’ preferences. To learn more about Yoh’s privacy practices, please see our Candidate Privacy Notice:  working/work at home options are available for this role.

permanent
Prior Authorization and FHIR Integration Specialist
Salary not disclosed
Plano, TX 2 days ago


About the Role



What you will do





  • Own the process for building payer relationships, identifying payer requirements for connection, translating requirements into user stories for the development team, coordinating implementation and testing, and ensuring the payer connection is successful in production.

  • Fill the role of subject matter expert in relation to prior authorizations and notice of admission both in terms of payer requirements and overall business requirements to successfully manage prior authorizations between providers and payers.

  • Identify and document the correct method of submission and status for prior authorizations to payers based on the payer requirement for specific service or CPT code including EDI 278 215/217, UMO payer portal, or Fax.

  • Document payer portal prior authorization workflows for robotic process automation and work with the RPA development team to build and test new payer portal prior auth automations.

  • Define and monitor key metrics for prior authorization connectivity, including transaction turnaround time, error rates, and customer satisfaction

  • Maintain up-to-date knowledge of regulatory requirements impacting prior authorization processes and ensure compliance in all payer connections

  • Become an expert in the upcoming Da Vinci FHIR prior authorization standards and work with development and business teams to ensure successful transition to FHIR

  • Work with payers and providers to establish FHIR connections for Prior Auth

  • Collaborate with the development team and clearinghouse team to establish EDI connections to payers

  • Collaborate closely with development, QA, UX, and other cross-functional teams to ensure deliverables meet customer and business expectations.

  • Engage directly with customers and internal stakeholders to elicit and understand business needs, pain points, and desired outcomes.

  • Triage errors and issues that arise and work and collaborate with other teams to resolve as needed to resolve the issues.

  • Prioritize the payer connection backlog based on business value, customer impact, and development capacity, ensuring alignment with strategic goals.

  • Apply critical thinking to streamline processes and work towards continual improvement and efficiency

  • Maintain and prioritize the user story backlog and work with development and stakeholder teams to refine user stories to meet the Definition of Ready for development

  • Work with the scrum team to ensure all tasks are completed and the committed objectives are achieved



What you will bring





  • Subject matter expert knowledge of healthcare prior authorizations and notice of admission processes on the provider, payer, and UMO sides.

  • 2+ years of experience working with prior authorization submissions and status to payers and UMOs

  • Knowledge of Da Vinci FHIR and ability to become a Da Vinci FHIR subject matter expert

  • Strong skills in creating detailed requirements, user stories, and acceptance criteria.

  • Strong analytical and critical thinking skills to solve complex business problems.

  • Provide guidance and direction to the technology teams during the development cycle and participate in all scrum ceremonies. Be available and ready to make quick, well-informed team-level decisions on behalf of stakeholders and the business

  • Ability to train others and share knowledge across teams

  • Excellent written and verbal communication skills, excellent inter-personal skills with the ability to bridge business and technical environments, and ability to build professional relationships

  • Ability to quickly learn complex systems and understand product architecture and development frameworks.



What we would like to see





  • Bachelor's degree in a related field

  • Experience working directly with healthcare providers, payers, or RCM vendors.

  • Experience in Agile Scrum and SAFe development methodologies

  • Healthcare revenue cycle management knowledge specifically related to prior authorizations

  • Knowledge of healthcare EDI transactions including 278 215/216/217, 837, 835, 276/277, 270/271, and 275 EDI transactions



About FinThrive



FinThrive is advancing the healthcare economy.
For the most recent information on FinThrive's vision for healthcare revenue management visit /why-finthrive.




Award-winning Culture of Customer-centricity and Reliability



At FinThrive we're proud of our agile and committed culture, which makes FinThrive an exceptional place to work. Explore our latest workplace recognitions at careers#culture.




Our Perks and Benefits



FinThrive is committed to continually enhancing the colleague experience by actively seeking new perks and benefits. For the most up-to-date offerings visit /careers-benefits.




FinThrive's Core Values and Expectations





  • Demonstrate integrity and ethics in day-to-day tasks and decision making, adhere to FinThrive's core values of being Customer-Centric, Agile, Reliable and Engaged, operate effectively in the FinThrive environment and the environment of the work group, maintain a focus on self-development and seek out continuous feedback and learning opportunities

  • Support FinThrive's Compliance Program by adhering to policies and procedures pertaining to HIPAA, FCRA, GLBA and other laws applicable to FinThrive's business practices; this includes becoming familiar with FinThrive's Code of Ethics, attending training as required, notifying management or FinThrive's Helpline when there is a compliance concern or incident, HIPAA-compliant handling of patient information, and demonstrable awareness of confidentiality obligations



Physical Demands

The physical demands and work environment characteristics described here are representative of those that a colleague must meet to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.



Statement of EEO
FinThrive values diversity and belonging and is proud to be an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We're committed to providing reasonable accommodation for qualified applicants with disabilities in our job application and recruitment process.

FinThrive Privacy Notice for California Resident Job Candidates

Know Your Rights
Pay Transparency Notice




FinThrive is an Equal Opportunity Employer and ensures its employment decisions comply with principles embodied in Title VII, the Age Discrimination in Employment Act, the Rehabilitation Act of 1973, the Vietnam Veterans Readjustment Assistance Act of 1974, Executive Order 11246, Revised Order Number 4, and applicable state regulations.
2024 FinThrive. All rights reserved. The FinThrive name, products, associated trademarks and logos are owned by FinThrive or related entities. RV092724TJO

| FinThrive Careers | FinThrive Benefits & Perks | Physical Demands



Not Specified
Prior Authorization Specialist - 250193
✦ New
Salary not disclosed
Plano, TX 1 day ago

Pharmacy Prior Authorization Specialist

Plano, TX (Fully Onsite)

$21 – $28 per hour

Monday – Friday | 8:30 AM – 5:00 PM


About the Role


We are seeking a Pharmacy Prior Authorization Specialist to support complex specialty medication workflows and ensure timely access to therapy for patients. This role plays a critical part in managing prior authorization processes, coordinating with insurance payers, and collaborating with clinical and pharmacy teams.

The ideal candidate is detail-oriented, proactive, and comfortable navigating insurance systems while communicating with payers, patients, and healthcare professionals. Candidates with pharmacy or healthcare insurance experience who enjoy problem-solving and working in a fast-paced environment will thrive in this role.


Key Responsibilities

Prior Authorization & Benefits Coordination

  • Contact insurance companies to obtain real-time status updates on prior authorization requests
  • Run benefit investigations and gather documentation needed for commercial insurance authorizations
  • Check status daily on pending authorizations and ensure timely follow-up
  • Assist with continuation authorizations for existing patients

Documentation & Data Management

  • Accurately enter approval letters, authorization numbers, and related documentation into internal systems such as CareTend
  • Enter patient demographics, diagnosis information, and payor data into the electronic medical record
  • Maintain detailed records of payer interactions including reference numbers and next steps

Denial Review & Workflow Management

  • Review denial letters and ensure documentation is complete before routing cases to clinical teams for review and appeals
  • Monitor authorization queues to prevent delays in patient therapy initiation or continuation
  • Conduct patient chart audits and maintain current documentation files

Collaboration & Communication

  • Coordinate with pharmacy operations, intake teams, clinical staff, and revenue cycle teams
  • Communicate authorization outcomes and documentation needs to internal teams
  • Maintain professional communication with insurance representatives, patients, and referral sources


Required Qualifications

  • High School Diploma or GED
  • 1+ year of experience in a pharmacy, healthcare, or medical insurance environment
  • Experience with prior authorizations, benefits verification, or insurance coordination
  • Strong attention to detail and data entry accuracy
  • Ability to manage multiple tasks and changing priorities in a fast-paced environment
  • Experience with Microsoft Office (Excel, Outlook, Word, Teams)


Preferred Qualifications

  • Pharmacy Technician Certification (preferred but not required)
  • Experience with CareTend or similar pharmacy/authorization platforms
  • Knowledge of Medicare, Medicaid, and commercial insurance plans
  • Experience in pharmacy billing, specialty pharmacy, or medical insurance verification
Not Specified
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