Collaborate with clinic teams to deliver hands-on patient care.
Process prior authorizations, resolve insurance issues, and support financial assistance.
Educate patients on pharmacy services and assist with specialty and retail prescriptions.
Shields Health Solutions is redefining patient care through specialty pharmacy. They are hiring motivated people and seem to have a good employee culture.
Initiate communication to communities regarding expensive and non-formulary medication orders.
Keep detailed records of all orders that require communication to the community.
Review Medicare D rejections and prior authorizations, and coordinate with pharmacists or physicians.
Symbria Rx Services delivers patient-centered care to the geriatric population in senior-living and post-acute settings. As one of the few 100% employee-owned companies in healthcare, our business practices are guided strictly by the values to which our employee owners are committed to.
Conduct insurance verification for new referrals and ongoing patients.
Initiate and obtain prior authorizations for home health services.
Maintain insurance, authorization, and eligibility information in real-time.
VitalCaring is a leading provider of home health and hospice services. Founded in 2021, they have over 65 locations across the country and are committed to fostering a culture of support, growth, and excellence for their team, ensuring exceptional patient care.
Answer inbound calls and return voicemails from members, delivering exemplary customer service and support.
Troubleshoot and resolve prescription-related issues for members whose plans utilize CVS or Carelon as the PBM.
Coordinate with providers’ offices and retail/mail-order pharmacies as needed to resolve claims processing, prior authorization, and medication access issues.
Point C is a National third-party administrator (TPA) with local market presence that delivers customized self-funded benefit programs. They focus on cost containment strategies and driving down the cost of plans with innovative solutions. Point C provides equal opportunity in all employment practices.
Secures outpatient accounts by performing insurance verification and obtaining prior authorization before services are rendered.
Works with physicians, nurses, clinic managers, and financial advocates to resolve issues during the prior authorizations process.
Ensures accurate ICD, CPT codes and related medical records are submitted in the authorization request.
University of Utah Health enhances the health and well-being of people through patient care, research, and education. They are a Level 1 Trauma Center and is nationally ranked with five hospitals and eleven clinics providing excellent comprehensive services.
Review patient care notes for clinical data needed for prior authorization approvals.
Monitor patient adherence across all sites and disease categories, focusing on oncology and specialty-specific disease states.
Recommend alternative therapeutic drug regimens and disease-specific treatments according to guidelines.
Shields Health Solutions provides integrated pharmacy solutions to health systems. They focus on improving patient care and outcomes through specialized pharmacy programs and services. The company values innovation, collaboration, and a patient-centered approach.