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Global

  • Obtain and manage insurance authorizations for residents receiving skilled nursing and rehabilitation services.
  • Monitor authorization status, track expiration dates, and submit timely extension requests to prevent coverage gaps.
  • Collaborate with clinical, admissions, and payer representatives to ensure timely approvals and accurate documentation.

Utilization Review Managed Care Microsoft Office

10 jobs similar to Authorization Specialist - Managed Care

Jobs ranked by similarity.

US

  • Verify patient insurance coverage, eligibility, and benefits prior to services.
  • Obtain required prior authorizations from payers for services, procedures, or medications.
  • Monitor and track pending authorizations; follow up to prevent delays.

Prompt is revolutionizing healthcare with modern software for rehab therapy businesses. As the fastest-growing company in the therapy EMR space, Prompt is setting a new standard in healthcare technology with a team of exceptionally talented individuals.

  • Manage insurance verification, authorization processes, and referral coordination to ensure patients receive timely access to covered medical services.
  • Work closely with insurance providers, clinical documentation, and internal systems to ensure accuracy and compliance across all steps.
  • Verify active insurance coverage and review patient benefits in detail.

Jobgether uses an AI-powered matching process to ensure applications are reviewed quickly, objectively, and fairly against core role requirements. The system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company.

US

  • Oversee prior authorization technicians and administrative PA functions.
  • Analyze data and provide staffing, workflow, and system enhancement recommendations.
  • Investigate/resolve escalated issues from clients and providers.

Judi Health is an enterprise health technology company providing a suite of solutions for employers and health plans. They have a comprehensive Enterprise Health Platform that consolidates all claim administration-related workflows in one scalable, secure platform.

US

  • Manage day-to-day credentialing and re-credentialing workflows for Tia’s provider network.
  • Support medical licensing workflows for MDs, DOs, NPs, PAs, and RNs across multiple states, including tracking requirements, deadlines and renewals.
  • Track onboarding progress and help ensure providers are licensed, credentialed, enrolled, and compliant before go-live.

Tia is building a new model for women’s healthcare, one that treats women as whole people. They are a Series D, venture-backed company trusted by more than 120,000 women across four markets, building a culture of excellence in people, process, and product.

US

  • Communicate and provide education to members and providers on insurance plan benefits and digital health solutions.
  • Employ active listening & motivational interviewing skills, and can handle difficult calls tactfully, courteously, professionally and document accordingly that can build patient trust and engagement.
  • Accurately track and document work on a variety of internal software tools and platforms.

Evry Health is on a mission to bring humanity to health insurance. They are a high-technology health plan that expands benefits, increases access and transparency, and features a personalized, human approach. Evry Health is the major medical division of Globe Life (NYSE:GL) with more than 3,000 corporate employees and 15,000 agents.

US

  • Responsible to secure outpatient accounts by performing insurance verification and obtaining benefit information.
  • Calculates patient estimates and obtains prior authorization before services are rendered.
  • Works with physicians, nurses, clinic managers, and financial advocates to resolve issues that arise during the prior authorizations process.

University of Utah Health is a patient-focused organization that enhances the health and well-being of people through patient care, research, and education. They have five hospitals and eleven clinics which provide excellence in comprehensive services, medical advancement, and overall patient outcomes.

$23–$26/hr
US

  • Deliver an outstanding customer experience by supporting inquiries across phone, email, text, and chat.
  • Manage high-complexity insurance workflows and inbound support requests to collect documentation.
  • Partner with clinical, scheduling, and operations teams to ensure accurate treatment plan alignment and continuity of care.

Expressable is a virtual speech therapy practice that aims to transform care delivery and expand access to high-quality services. Since 2019, they serve thousands of clients with a focus on parent-focused intervention and an e-learning platform with home-based learning modules.

$55,000–$60,000/yr
US

  • Responsible for the review and processing of claims within the claims transactional system, according to plan benefits and contractual reimbursement terms.
  • Follows established policies and procedures to pay, pend for additional information, or deny claims.
  • Accountable to meet and maintain established department production and quality standards.

Evry Health is on a mission to bring humanity to health insurance by expanding benefits, increasing access and transparency, and featuring a personalized, human approach. Evry Health is the major medical division of Globe Life (NYSE:GL) with more than 3,000 corporate employees and 15,000 agents.

US

  • Coordinate medical record retrieval, ensuring complete and timely submission of patient documentation for provider review
  • Prepare and process referrals to specialists and manage prior authorization requests in coordination with insurance payors
  • Virtually greet and room patients prior to telehealth appointments, confirming patient information and visit readiness

Synapticure is a patient and caregiver-founded company that provides instant access to expert neurologists, cutting-edge treatments and trials, and wraparound care coordination and behavioral health support in all 50 states through a virtual care platform. They are dedicated to transforming the lives of millions of individuals and their families living with neurodegenerative diseases like Alzheimer’s, Parkinson’s, and ALS.

$78,000–$83,000/yr
US

  • Pulling, sorting, and analyzing data to determine member eligibility for the Population Health management Program.
  • Coordinating and providing care that is timely, effective, equitable, safe, and member-centric while following HMO processes.
  • Managing case assignments which includes outreach, documentation, monitoring for case progression, and case closure.

Guidehealth is a data-powered healthcare company dedicated to operational excellence. They aim to make healthcare affordable, improve patient health, and restore fulfillment in practicing medicine. Guidehealth is a growing and innovative organization and employees are expected to adapt to evolving business needs.