Submit and track prior authorization requests across multiple insurance payers
Gather and review clinical documentation required to support authorization requests
Follow up with payers on pending requests and monitor authorization status through resolution
Raventra Health is a medical services company providing outsourced billing, coding, and claims processing solutions for provider groups and hospitals. The company operates with a fully remote workforce and emphasizes a detail-oriented, collaborative culture.
Serve as a primary contact for medication inquiries, triaging calls and portal messages with empathy and urgency.
Facilitate prior authorizations and coordinate follow-up appointments to ensure continuity of care.
Document all interactions using SBAR standards and educate patients on refill policies and adherence.
Mindpath Health is redefining how mental health care is delivered, operating in more than 100 locations across six states with in-person and telehealth services. The team is deeply committed to compassionate, collaborative care and values diversity and inclusion.
Assist members, providers, and internal teams in navigating prescription coverage and prior authorization requests.
Verify eligibility, drug coverage, and perform claims adjudication based on plan benefit design.
Triage and prioritize multiple requests, coordinate outreach, and make determinations under protocol.
SmithRx is a health-tech company disrupting the pharmacy benefit management industry with a next-generation drug acquisition platform. With hundreds of thousands of members, they have a mission-driven and collaborative culture guided by values of integrity, courage, and together.
Perform clinical review and evaluation of pharmacy prior authorization requests to determine medical necessity and appropriateness.
Coordinate appeals and provide clinical consultation to providers, members, and internal stakeholders.
Support utilization management initiatives, develop clinical criteria, and drive quality improvement across clinical programs.
FairosRx is an innovative company striving to reduce the cost of healthcare. They have a tight-knit culture based on an outward mindset and are growing quickly.
Provide medication prior authorization support for assigned clinics using the Epic In Basket system.
Manage prior authorizations from clinic to pharmacy, including submission, tracking, and follow-up.
Communicate with clinics, pharmacies, and insurance payers to ensure timely approvals and patient access.
UnityPoint Health is a healthcare system delivering medical services across the Midwest. Recognized as a Top 150 Place to Work in Healthcare, it fosters a culture of belonging and supports team members with development and well-being.
Respond to member and provider inquiries about Medicare benefits, claims, and enrollment via phone and email.
Analyze issues, document outcomes, and maintain accurate records in internal systems.
Collaborate across departments to resolve service issues and support contact center documentation.
Curana Health provides value-based primary care services for the senior living industry, including skilled nursing facilities and assisted living communities. With over 1,000 clinicians serving more than 1,500 communities across 34 states, the company has experienced rapid growth since 2021 and participates in innovative CMS programs.
Own the end-to-end prescription experience for a portfolio of newly onboarded practices and escalated cases, from first submission through final determination.
Become an expert in navigating prior authorizations across insurance plans, pharmacies, and affordability programs to get prescriptions processed quickly and correctly.
Operate in a case-management style: investigate the full history of a case, identify where something has stalled, loop in and escalate to the right internal teams, and follow through until it's resolved.
Generator Health exists to ensure administrative friction never stands in the way of a patient getting the medication they need. The company is a remote-first organization that values ownership and operational rigor, though its size is not specified.
Manage end-to-end patient access case activities including benefit verification, prior authorization, appeals, and pharmacy coordination.
Apply pharmacy technician knowledge to review prescriptions, identify barriers, and coordinate with providers, payors, and pharmacies.
Maintain accurate case documentation and communicate effectively with patients, healthcare professionals, and internal teams.
PRO-spectus is a patient services company that strategically navigates the patient access process from prescription intake through treatment initiation. The company fosters a supportive, teamwork-driven culture with a focus on improving patient lives, though its exact size is not specified.
Review prior authorization cases to ensure clinical and operational standards are met.
Audit AI outputs, third-party reviews, and internal decisions for accuracy and compliance.
Collaborate cross-functionally to refine workflows and improve patient access to treatment.
Generator Health operates a platform that streamlines prior authorization processes for patients and providers. They handle tens of thousands of patients weekly and emphasize collaboration and accuracy in a high-autonomy remote environment.
Submit and manage prior authorization requests for surgical and procedural services
Review patient charts and clinical documentation to ensure medical necessity requirements are met
Work directly within payer portals including Availity to process and track authorization requests
Metro Vein Centers is a rapidly growing healthcare practice specializing in state-of-the-art vein treatments. With over 70 clinics across 8 states and a Net Promoter Score of 93, we are building the future of vein care.
Guide new patients through the sales and healthcare reimbursement process.
Investigate insurance benefits, review clinical records, and secure prior authorizations.
Partner with field sales representatives and maintain CRM documentation.
Cala creates non-invasive prescription therapies for chronic diseases, starting with hand tremor treatment. They are a mission-driven company with products used by thousands, focusing on neurology and cardiology, and offer stock options and benefits.
Provide on-site and on-demand education on reimbursement challenges and support services for physician offices.
Educate on benefit investigation, prior authorization, Medicare and Commercial coverage, and patient communication streams.
Collaborate with internal hub support and case managers to ensure customer needs are met and track activities in CRM.
McKesson is a Fortune 10 healthcare company that delivers insights, products, and services to make quality care more accessible and affordable. It fosters a culture where employees can grow, make an impact, and thrive as they shape the future of health.
Processes electronic medication refill requests and communicates with providers and patients.
Ensures compliance with all HIPAA regulations and maintains patient confidentiality.
Provides excellent customer service and assists with prior authorization and medication assistance guidance.
St. Elizabeth Healthcare provides medical services as one of the largest healthcare providers in the Northern Kentucky region. The organization emphasizes a culture of caring for patients and each other, with a focus on innovation and community.
Lead a team of pharmacy technicians in the end-to-end prior authorization and financial assistance processes.
Drive team performance by monitoring service levels, conducting audits, and providing ongoing feedback.
Oversee daily operations, including scheduling, workload distribution, and collaboration with hospital stakeholders.
Shields Health Solutions is a patient support center specializing in specialty pharmacy services. The company culture emphasizes leadership, performance, and patient outcomes, with a team-oriented environment.
Provides high-quality customer service to patients and providers, managing high-volume phone calls, scheduling, and managed care authorizations.
Processes referrals, verifies insurance, and prepares materials for clinic visits and ancillary procedures.
Triages and documents patient calls in EPIC, communicates with providers, and handles administrative tasks to support the Pediatric Neurology practice.
OHSU is Oregon's only public academic health center, providing patient care, leading research, and training health care professionals. As Portland's largest employer, it offers opportunities to learn and advance across a system of hospitals and clinics.
Provide support to participants and clients regarding eligibility, benefits, claims, and general plan inquiries via phone and email.
Document all customer interactions accurately in the call tracking system and navigate multiple systems to assist customers.
Maintain confidentiality in accordance with HIPAA standards and contribute to a positive, team-oriented environment.
Point C is a National third-party administrator that delivers customized self-funded benefit programs. They are a mission-driven company focused on innovative cost containment strategies.
Answer new referral intake and refill calls in a timely and professional manner, accurately updating patient information in the computer system.
Contact patients to collect information for medical chart establishment and schedule delivery or shipping arrangements for refills.
Maintain accurate patient records, assist with copay collections, and participate in performance improvement and quality management processes.
VytlOne is a specialty pharmacy company transforming the pharmacy industry through purposeful engagement across Pharmacy Benefit Management, Pharmacy Management, Specialty Pharmacy, and more. They foster a diverse and progressive culture with a remote work model and a team-oriented environment that encourages collaboration and innovation.
Determine patient qualification for financial assistance programs and payment arrangements using confidential financial information.
Verify insurance coverage, obtain authorizations, and provide price estimates for scheduled procedures.
Serve as a liaison between patients, providers, and internal departments to coordinate benefits and collect patient portions.
CommonSpirit Health is a large healthcare system with over 700 care sites across the U.S., serving nearly one in four Americans. The culture emphasizes compassion, community health, and employee commitment to a greater cause.
Coordinate with providers, insurance companies, and hospital staff to secure pre-authorizations and address denials.
Review daily schedules, obtain authorizations via phone/fax/portals, and verify CPT/ICD-10 code alignment.
Communicate with patients about approvals, reschedules, or cancellations while maintaining HIPAA compliance.
Cardiac Study Center is a dedicated team at the forefront of cardiovascular medicine, empowering patients with the knowledge and treatment they need to lead heart-healthy lives. As a growing organization with deep roots in the Pacific Northwest, we foster continuous learning and collaboration among passionate professionals.
Support pharmacy benefit operations by coordinating clinical and administrative workflows.
Review documentation and communicate with members, providers, and internal stakeholders.
Ensure accurate and compliant processing of pharmacy benefit requests.
We are an innovative company striving to reduce the cost of healthcare. We have a tight-knit culture based on an outward mindset and are growing quickly.