Review and process prior authorization requests for various medications.
Communicate prior authorization criteria to providers and act as a help desk.
Process requests via phone, fax, and web submission while maintaining HIPAA compliance.
Lumicera Health Services is a specialty pharmacy focused on optimizing patient well-being through transparency and stewardship. It fosters a diverse and creative work environment as part of the Navitus organization.
Handle inbound calls, chats, emails, and faxes from healthcare providers, resolving questions on authorizations, claims, and provider services.
Document each interaction, research issues, and ensure accurate, timely follow-up with providers.
Guide providers through processes like checking authorization status, submitting claims, and navigating the provider portal.
Curana Health is a national leader in value-based care, offering senior living and skilled nursing facilities solutions such as on-site primary care, ACOs, and Medicare Advantage plans. Founded in 2021, it serves 200,000+ seniors in 1,500+ communities across 32 states with 1,000+ clinicians.
Verify insurance, obtain benefits, calculate estimates, and secure prior authorizations for outpatient services.
Act as liaison between payers and clinic staff; follow up on denied or delayed authorizations.
Maintain detailed documentation and resolve issues with physicians, nurses, and financial advocates.
University of Utah Health is a patient-focused organization enhancing health through care, research, and education. It operates five hospitals and eleven clinics with a culture of collaboration, excellence, leadership, and respect.
Coordinates utilization review and prior authorization requests, ensuring accurate entry into the UM platform.
Provides customer service to providers and members, confirming benefits and answering authorization questions.
Facilitates communication between reviewers, hospitals, and physicians to ensure timely decisions.
University of Utah Health Plans is a patient-focused organization that enhances health through patient care, research, and education. It is part of a nationally ranked academic medical center with five hospitals and eleven clinics, fostering a culture of collaboration and excellence.
Serve as primary point of contact for clients, managing inbound and outbound communications to resolve inquiries via phone, email, chat, or social media.
Calmly de-escalate issues, escalate when necessary, and track call information for auditing and reporting purposes.
Provide feedback on call issues and upsell when appropriate to ensure a positive customer experience.
TP is a leading global provider of digital business services, partnering with prominent brands to optimize operations through advanced technology and sustainable business practices. With a global workforce of 500,000 across 300 languages, TP prioritizes a culture of inclusion and diversity with limitless career advancement.
Serve as primary point of contact for clients, managing inbound/outbound communications with professional excellence.
Resolve inquiries via phone, email, chat, or social media, de-escalating issues and escalating when necessary.
Track call information for auditing and reporting, and upsell if required.
TP is a leading global provider of digital business services, partnering with prominent brands to optimize operations through advanced technology and sustainable practices. With a global workforce of 500,000 across 300 languages, TP fosters a culture of inclusion, diversity, and career growth.
Handle inbound and outbound customer inquiries related to third-party liability and subrogation matters.
Conduct professional interviews to collect, verify, and document insurance and claims information.
Navigate multiple computer systems while maintaining accurate records and meeting productivity targets.
This company focuses on improving healthcare payment accuracy and helping individuals navigate complex insurance-related inquiries. It operates with a customer-focused team in a fast-paced, technology-driven environment.
Serve as first point of contact for members and providers via phone and email, resolving health insurance inquiries.
Use active listening and empathy to understand issues, explain benefits, claims, and coverage, and document interactions.
Maintain a structured schedule, with availability during peak season, and uphold the Gravie CARE service model and core values.
Gravie creates innovative health benefits for small and midsize businesses, focusing on solutions that genuinely benefit employees. The company is well-funded, non-hierarchical, and merit-driven, with a culture that values authenticity, curiosity, and creativity.
Supervises representatives, manages performance, and provides feedback through side-by-side and recorded call reviews.
Handles escalated calls, partners with business units, and coordinates team schedules to maximize efficiency.
Monitors volumes for pending queues and ensures timely processing of prior authorization forms.
PharMerica is a long-term care pharmacy services provider that supplies medications, clinical support, and pharmacy management to healthcare organizations across the United States. It operates as part of BrightSpring Health Services, combining personalized care with the resources of a national network.
Provide world-class customer service to members and providers by phone in a call center environment.
Resolve claims, benefits, eligibility, and provider network inquiries with one-call resolution.
Document calls, follow up on issues, and support team accountability for service performance.
University of Utah Health is an integrated academic healthcare system with five hospitals, eleven community health centers, and a health plan serving over 200,000 members. It is nationally ranked for research and quality, with over 2 million patient visits annually and a culture of collaboration, excellence, and respect.
Place outbound calls to Medicare eligible customers from qualified leads and assist in transferring to licensed sales agents.
Ask required scripted questions, overcome objections, and explain benefits during open enrollment.
Meet transfer targets, disposition each call, and work weekends as required.
TP is a leading global provider of digital business services, partnering with top brands to optimize operations through technology and sustainable practices. With 500,000 employees across 300 languages, we foster inclusion, diversity, and limitless career advancement.
Serve as a primary point of contact for clients, managing inbound and outbound communications with professional excellence.
Handle and carefully respond to all customer inquiries, resolving issues on the first call through active listening.
Track and document call information for auditing, escalate interactions when necessary, and upsell if required.
TP is a leading global provider of digital business services, partnering with brands to optimize operations through technology and sustainable practices. With 500,000 employees across 300 languages, TP fosters an inclusive culture focused on growth and well-being.
Provide warm client interactions, manage phone triage, and schedule/reschedule appointments.
Collect insurance information, verify benefits, and manage copays and payment balances.
Answer client questions and stay organized in a fast-paced, collaborative environment.
Diana Health is a network of modern women's health practices partnering with hospitals to reimagine maternity and women's healthcare. Our interdisciplinary team shares a commitment to transform women's health and fosters a collaborative, growth-oriented culture.
Handle inbound calls efficiently, schedule/reschedule appointments, and complete daily administrative tasks for the Call Center support team.
Provide excellent customer service with a professional, confidential work ethic and knowledge of HIPAA regulations.
Work remotely from approved states (PA, MD, VA, DC, FL, GA) with reliable internet and a quiet dedicated space.
Vision Innovation Partners exists to protect and restore vision. The company offers a culture centered on its Shared Values – PATIENTS, with opportunities for growth and development.
Receive medical claims from healthcare providers or patients and verify supporting documentation to ensure completeness.
Interpret Explanation of Benefits (EOB) and CMS-1500 forms, then evaluate claims against program-specific business rules for approval or rejection.
Provide support to customer inquiries via phone, email, or fax while maintaining HIPAA compliance and meeting daily productivity goals.
IQVIA is a leading global provider of clinical research services, commercial insights, and healthcare intelligence to the life sciences and healthcare industries. With operations in over 100 countries, they cultivate a diverse, collaborative culture focused on improving patient outcomes.
Serve as the first point of contact, greeting patients and handling inbound calls.
Verify insurance, update demographics, and register patients in EMR (EPIC).
Document patient concerns, triage messages, and escalate emergent issues promptly.
U.S. Urology Partners provides urology and specialty services, including surgery and cancer treatment. It has over 50 offices across the East Coast and Midwest, with values of compassion, collaboration, respect, and accountability.
Assist patients with enrolling in our Prescription Payment Plan and verifying eligibility.
Coordinate with pharmacies to apply benefits and reduce out-of-pocket costs.
Guide patients through renewals and updates to ensure continued access.
We are a team dedicated to improving access to affordable prescription medications for patients. We partner with insurance companies, healthcare providers, and pharmacies to reduce the financial burden of medications, ensuring patients can access treatments without excessive costs.
Manage patient intake processes by scheduling, rescheduling, and canceling appointments.
Verify and update patient demographics, insurance eligibility, and collect payments.
Process referrals and authorizations while responding to patient inquiries with professional communication.
A comprehensive healthcare network serving the Puget Sound region with a full spectrum of health care services, from routine wellness to complex disease management. It includes 10 hospitals and nearly 300 care sites, fostering a culture of compassionate care and shared purpose.
Triage incoming phone calls from members and pharmacies with professional etiquette.
Identify, document, and escalate member and pharmacy concerns to appropriate teams.
Ensure first-call resolution and exceptional customer care with genuine compassion.
Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. We are an intelligence platform powering benefits plans for millions of Americans, delivering the healthcare we all deserve.
Manage end-to-end drug prior authorization and claims cases, assessing requests against clinical guidelines and plan provisions.
Communicate authorization outcomes clearly to members, providers, and internal stakeholders while resolving escalated and complex scenarios.
Serve as a subject matter expert to support teams, training, and continuous improvement initiatives.
The hiring company operates in the insurance and benefits sector, managing complex drug prior authorization and claims cases. It is a global organization with a collaborative culture that values flexibility, continuous improvement, and employee well-being.