{ "count" : 19313, "data" : [ { "id" : "6a307eaef292fd229c05160a", "title" : "Prior Authorization Assistant, Oncology", "company" : "Ascertain", "industry" : "Operations", "salary" : { "min" : 45000.0, "max" : 55000.0, "currency" : "USD", "frequency" : "Yearly" }, "location" : "Remote", "locations" : [ "Remote" ], "timestamp" : "2026-06-16T12:45:51.811", "fingerprint" : "53fd3c990fa37f47fc68d5464016a2a6cceb09bf2d7a77f7c2616bf4307e35a0", "source" : "ashby", "language" : "en", "applyUrl" : "https://jobs.ashbyhq.com/ascertain/bfc3b067-a9b1-4495-abac-794894537099/application", "externalId" : "bfc3b067-a9b1-4495-abac-794894537099", "industryFunction" : { }, "structuredLocations" : [ { "country" : "Bulgaria", "continent" : "eu", "workMode" : "remote" } ], "locationText" : "Bulgaria", "employmentType" : "FULL_TIME", "professionalSkills" : [ "Process management", "Cross-functional coordination", "Stakeholder management", "Resource planning", "Continuous improvement" ], "hardSkillsList" : [ "Prior authorization", "Billing", "Insurance verification", "Medical documentation", "Authorization request submission", "Record maintenance" ], "softSkillsList" : [ "Process-Driven" ], "hardSkills" : [ { "name" : "Prior authorization", "level" : "intermediate" }, { "name" : "Billing", "level" : "intermediate" }, { "name" : "Insurance verification", "level" : "intermediate" }, { "name" : "Medical documentation", "level" : "intermediate" }, { "name" : "Authorization request submission", "level" : "intermediate" }, { "name" : "Record maintenance", "level" : "intermediate" } ], "softSkills" : [ { "name" : "Process-Driven" } ], "majorSkills" : "Prior authorization, Oncology billing, Process efficiency", "majorSkillsList" : [ "Prior authorization", "Oncology billing", "Process efficiency" ], "coreResponsibilities" : "Process prior authorizations, Oversee automated submissions, Review insurance information, Verify patient eligibility, Communicate with healthcare providers, Gather medical documentation, Submit authorization requests, Monitor authorization requests, Respond to inquiries, Maintain accurate records, Collaborate with internal teams, Resolve authorization issues, Improve process efficiency, Stay updated on insurance policies, Stay updated on regulations, Stay updated on industry trends", "teamCollaboration" : "Ascertain leadership; Product teams; Healthcare providers; Internal teams; Cross-functional stakeholders", "domainKnowledge" : "Oncology; Prior authorizations; Insurance policies; Healthcare operations", "domainList" : [ "oncology", "prior-authorizations", "insurance-policies", "healthcare-operations" ], "domainSpecificKnowledge" : [ "Oncology", "Prior authorizations", "Insurance policies", "Healthcare operations" ], "toolProficiency" : [ "Athenahealth", "NextGen" ], "documentationSkills" : "Maintain accurate records", "problemSolvingSkills" : "Resolve authorization issues", "qualificationsBasic" : "4+ years prior authorization, 4+ years billing in Oncology, Experience with athenahealth, Experience with NextGen, Familiarity with major payors", "qualificationsPreferred" : "Client experience, Hands-on leadership roles, Engaging with C-suite executives", "remoteFriendly" : true, "workSiteFlexibility" : "Remote", "rawDescription" : "MEET ASCERTAIN Ascertain is building AI agents to automate the administrative work that burdens care teams. We are in major health systems and large specialty groups, saving hundreds of staff hours every week. Our backers include Northwell Health, New York’s largest health system, and Deerfield Management, a leading healthcare investment firm. Together, we’re on a mission to restore time, trust, and focus to the people who keep healthcare running. Our work is urgent — not because of startup timelines, but because our customers rely on us to drive financial resilience and operational clarity in a system under strain. This is a hands-on role for someone who thrives in high-volume operational environments and is comfortable balancing individual contribution with team support. You will continue to process prior authorizations directly—often at high volume—while also serving as a go-to resource for other Ascertain Assistants. Over time, this role will evolve into a hybrid operations + technology position as workflows become increasingly automated and integrated with Ascertain’s platform. This is not a traditional healthcare shift-based, desk role. It is an outcome-driven position that rewards ownership, judgment, and follow-through. WHAT YOU’LL DO: As a Prior Authorization Assistant at Ascertain, you will play a critical role in our new AI-powered prior authorization solution. You’ll collaborate directly with Ascertain leadership and product teams, helping to shape how prior authorization is transformed through recent advances in artificial intelligence. This is a unique opportunity to work at the intersection of healthcare operations and cutting-edge technology. You’ll work closely with healthcare providers to reduce administrative burdens and streamline detailed workflows. Day-to-day, this includes manually processing authorizations and overseeing automated submissions for office visit referrals, procedures, pharmaceuticals, and more. The role offers broad exposure to multiple healthcare specialties, external stakeholders, and departments across Ascertain. - Review and verify insurance information and patient eligibility for prior authorizations. - Communicate with healthcare providers to gather necessary medical documentation and information. - Submit prior authorization requests to insurance companies following established protocols. - Monitor and track authorization requests to ensure timely processing and resolution. - Respond to inquiries from healthcare providers, patients, and insurance companies regarding authorization status. - Maintain accurate records of authorization requests, approvals, and denials. - Collaborate with internal teams to resolve authorization issues and improve process efficiency. - Stay updated on insurance policies, regulations, and industry trends related to prior authorizations. WHAT YOU'LL NEED: - 4+ years of experience with prior authorization and billing in Oncology - Experience with athenahealth and or NextGen - Familiarity with major payors including UnitedHealthcare, Aetna, Blue Cross Blue Shield, etc. - Bonus if you have experience in… - client relationships; - hands-on leadership roles (e.g., Team Lead, Supervisor, or informal leadership), paired with a roll-up-your-sleeves approach; - engaging with C-suite executives. WHAT YOU'LL BRING TO THE TABLE: - Detail-Oriented. You are meticulous in your work, catching errors and ensuring every authorization is processed accurately the first time. - Collaborative. You are energized by working with others, building trust and communicating clearly with providers, teammates, and cross-functional stakeholders. - Adaptable. You are comfortable shifting between manual workflows and leveraging new AI-powered tools, adjusting quickly as processes evolve. - Empathetic. You are attuned to the needs of healthcare providers and patients, approaching each interaction with patience, professionalism, and understanding. - Process-Driven. You are motivated by structure and consistency, following established workflows while identifying opportunities for improvement. BENEFITS & PERKS - Cutting-edge technology: Work directly with the latest advancements in generative AI and automation, tackling challenging problems that meaningfully impact healthcare. - Ownership & growth: You’ll join Ascertain at a pivotal early stage, shaping our products, technical direction, and culture, with significant opportunities for career advancement. - Collaborative team: Join a talented, passionate, and supportive team with backgrounds from top tech companies and clinical institutions. - Competitive compensation: We offer competitive salary, meaningful equity, comprehensive health insurance, and more. Why Ascertain? Make a real difference: Your work will directly impact healthcare organizations and improve patient care. Join Ascertain in transforming healthcare with AI!", "summaryDescription" : "Prior Authorization Assistant, Oncology at Ascertain. Skills: Prior authorization, Oncology billing, Process efficiency. Process prior authorizations. Oversee automated submissions", "createdAt" : "2026-06-16T01:59:43.890", "lastUpdated" : "2026-06-16T12:45:51.811", "ingestTimestamp" : "2026-06-16T01:59:43.890", "mongoId" : "6a307eaef292fd229c05160a", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "salaryAnnualMin" : 45000, "salaryAnnualMax" : 55000, "salaryBand" : "30k-50k", "hasSalary" : true, "allSkills" : [ "Prior authorization", "Billing", "Insurance verification", "Medical documentation", "Authorization request submission", "Record maintenance", "Process-Driven", "Oncology billing", "Process efficiency", "Process management", "Cross-functional coordination", "Stakeholder management", "Resource planning", "Continuous improvement", "Oncology", "Prior authorizations", "Insurance policies", "Healthcare operations", "Athenahealth", "NextGen" ], "skillCount" : 20, "jobCategory" : "operations", "jobSubcategory" : "general", "seniorityLevel" : "Mid", "dataQualityScore" : 0.7777778, "_score" : 515.9436, "hasLocation" : true, "hasGeo" : false, "llmIndustry" : "Healthcare", "llmIndustryConfidence" : 0.95 }, { "id" : "6a307eaef292fd229c051609", "title" : "Prior Authorization Assistant, Cardiology", "company" : "Ascertain", "industry" : "Operations", "salary" : { "min" : 45000.0, "max" : 55000.0, "currency" : "USD", "frequency" : "Yearly" }, "location" : "Remote", "locations" : [ "Remote" ], "timestamp" : "2026-06-16T11:10:43.201", "fingerprint" : "e82dd88a352e12238e6b0734d88ab82ee83098906142bcf845e4c0621c997013", "source" : "ashby", "language" : "en", "applyUrl" : "https://jobs.ashbyhq.com/ascertain/da3f512f-3f55-42a6-85b7-c1e9664a0553/application", "externalId" : "da3f512f-3f55-42a6-85b7-c1e9664a0553", "industryFunction" : { }, "structuredLocations" : [ { "country" : "Bulgaria", "continent" : "eu", "workMode" : "remote" } ], "locationText" : "Bulgaria", "employmentType" : "FULL_TIME", "professionalSkills" : [ "Prior authorization", "Billing", "Process efficiency" ], "hardSkillsList" : [ "Insurance verification", "Eligibility verification", "Medical documentation gathering", "Authorization request submission", "Authorization status tracking", "Record maintenance" ], "hardSkills" : [ { "name" : "Insurance verification", "level" : "intermediate" }, { "name" : "Eligibility verification", "level" : "intermediate" }, { "name" : "Medical documentation gathering", "level" : "intermediate" }, { "name" : "Authorization request submission", "level" : "intermediate" }, { "name" : "Authorization status tracking", "level" : "intermediate" }, { "name" : "Record maintenance", "level" : "intermediate" } ], "majorSkills" : "Prior authorization, Cardiology billing, AI-powered solutions", "majorSkillsList" : [ "Prior authorization", "Cardiology billing", "AI-powered solutions" ], "coreResponsibilities" : "Process prior authorizations, Oversee automated submissions, Review insurance information, Verify patient eligibility, Communicate with healthcare providers, Gather medical documentation, Submit authorization requests, Monitor authorization requests, Track authorization requests, Respond to inquiries, Maintain accurate records, Collaborate with internal teams, Resolve authorization issues, Improve process efficiency, Stay updated on insurance policies, Stay updated on regulations, Stay updated on industry trends", "teamCollaboration" : "Ascertain leadership; Product teams; Healthcare providers; External stakeholders; Ascertain departments", "domainKnowledge" : "Prior authorizations; Cardiology; Healthcare operations; Insurance policies; Insurance regulations; Healthcare AI", "domainList" : [ "prior-authorizations", "cardiology", "healthcare-operations", "insurance-policies", "insurance-regulations", "healthcare-ai" ], "domainSpecificKnowledge" : [ "Prior authorizations", "Cardiology", "Healthcare operations", "Insurance policies", "Insurance regulations", "Healthcare AI" ], "toolProficiency" : [ "Athenahealth", "NextGen" ], "documentationSkills" : "Medical documentation", "innovationCreativity" : "AI-powered solutions", "problemSolvingSkills" : "Resolve authorization issues", "outcomesObjectives" : "Save staff hours; Drive financial resilience; Provide operational clarity", "qualificationsBasic" : "4+ years prior authorization, 4+ years billing in Cardiology, Experience with athenahealth, Experience with NextGen, Familiarity with major payors", "qualificationsPreferred" : "Client experience, Hands-on leadership roles, Engaging with C-suite executives", "remoteFriendly" : true, "workSiteFlexibility" : "Remote", "rawDescription" : "MEET ASCERTAIN Ascertain is building AI agents to automate the administrative work that burdens care teams. We are in major health systems and large specialty groups, saving hundreds of staff hours every week. Our backers include Northwell Health, New York’s largest health system, and Deerfield Management, a leading healthcare investment firm. Together, we’re on a mission to restore time, trust, and focus to the people who keep healthcare running. Our work is urgent — not because of startup timelines, but because our customers rely on us to drive financial resilience and operational clarity in a system under strain. This is a hands-on role for someone who thrives in high-volume operational environments and is comfortable balancing individual contribution with team support. You will continue to process prior authorizations directly—often at high volume—while also serving as a go-to resource for other Ascertain Assistants. Over time, this role will evolve into a hybrid operations + technology position as workflows become increasingly automated and integrated with Ascertain’s platform. This is not a traditional healthcare shift-based, desk role. It is an outcome-driven position that rewards ownership, judgment, and follow-through. WHAT YOU’LL DO: As a Prior Authorization Assistant at Ascertain, you will play a critical role in our new AI-powered prior authorization solution. You’ll collaborate directly with Ascertain leadership and product teams, helping to shape how prior authorization is transformed through recent advances in artificial intelligence. This is a unique opportunity to work at the intersection of healthcare operations and cutting-edge technology. You’ll work closely with healthcare providers to reduce administrative burdens and streamline detailed workflows. Day-to-day, this includes manually processing authorizations and overseeing automated submissions for office visit referrals, procedures, pharmaceuticals, and more. The role offers broad exposure to multiple healthcare specialties, external stakeholders, and departments across Ascertain. - Review and verify insurance information and patient eligibility for prior authorizations. - Communicate with healthcare providers to gather necessary medical documentation and information. - Submit prior authorization requests to insurance companies following established protocols. - Monitor and track authorization requests to ensure timely processing and resolution. - Respond to inquiries from healthcare providers, patients, and insurance companies regarding authorization status. - Maintain accurate records of authorization requests, approvals, and denials. - Collaborate with internal teams to resolve authorization issues and improve process efficiency. - Stay updated on insurance policies, regulations, and industry trends related to prior authorizations. WHAT YOU'LL NEED: - 4+ years of experience with prior authorization and billing in Cardiology - Experience with athenahealth and or NextGen - Familiarity with major payors including UnitedHealthcare, Aetna, Blue Cross Blue Shield, etc. - Bonus if you have experience in… - client relationships; - hands-on leadership roles (e.g., Team Lead, Supervisor, or informal leadership), paired with a roll-up-your-sleeves approach; - engaging with C-suite executives. WHAT YOU'LL BRING TO THE TABLE: - Detail-Oriented. You are meticulous in your work, catching errors and ensuring every authorization is processed accurately the first time. - Collaborative. You are energized by working with others, building trust and communicating clearly with providers, teammates, and cross-functional stakeholders. - Adaptable. You are comfortable shifting between manual workflows and leveraging new AI-powered tools, adjusting quickly as processes evolve. - Empathetic. You are attuned to the needs of healthcare providers and patients, approaching each interaction with patience, professionalism, and understanding. - Process-Driven. You are motivated by structure and consistency, following established workflows while identifying opportunities for improvement. BENEFITS & PERKS - Cutting-edge technology: Work directly with the latest advancements in generative AI and automation, tackling challenging problems that meaningfully impact healthcare. - Ownership & growth: You’ll join Ascertain at a pivotal early stage, shaping our products, technical direction, and culture, with significant opportunities for career advancement. - Collaborative team: Join a talented, passionate, and supportive team with backgrounds from top tech companies and clinical institutions. - Competitive compensation: We offer competitive salary, meaningful equity, comprehensive health insurance, and more. Why Ascertain? Make a real difference: Your work will directly impact healthcare organizations and improve patient care. Join Ascertain in transforming healthcare with AI!", "summaryDescription" : "Prior Authorization Assistant, Cardiology at Ascertain. Skills: Prior authorization, Cardiology billing, AI-powered solutions. Process prior authorizations. Oversee automated submissions", "createdAt" : "2026-06-16T01:59:41.602", "lastUpdated" : "2026-06-16T11:10:43.201", "ingestTimestamp" : "2026-06-16T01:59:41.602", "mongoId" : "6a307eaef292fd229c051609", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "salaryAnnualMin" : 45000, "salaryAnnualMax" : 55000, "salaryBand" : "30k-50k", "hasSalary" : true, "allSkills" : [ "Insurance verification", "Eligibility verification", "Medical documentation gathering", "Authorization request submission", "Authorization status tracking", "Record maintenance", "Prior authorization", "Cardiology billing", "AI-powered solutions", "Billing", "Process efficiency", "Prior authorizations", "Cardiology", "Healthcare operations", "Insurance policies", "Insurance regulations", "Healthcare AI", "Athenahealth", "NextGen" ], "skillCount" : 19, "jobCategory" : "operations", "jobSubcategory" : "general", "seniorityLevel" : "Mid", "dataQualityScore" : 0.7777778, "_score" : 515.2759, "hasLocation" : true, "hasGeo" : false, "llmIndustry" : "Healthcare", "llmIndustryConfidence" : 0.95 }, { "id" : "6a307eaef292fd229c05160b", "title" : "Prior Authorization Assistant, Sleep Medicine", "company" : "Ascertain", "industry" : "Operations", "salary" : { "min" : 45000.0, "max" : 55000.0, "currency" : "USD", "frequency" : "Yearly" }, "location" : "Remote", "locations" : [ "Remote" ], "timestamp" : "2026-06-16T13:12:55.902", "fingerprint" : "f8426698b647255cca1cc9697f551c8c723f176b7443a7a0ea5c1001917748ca", "source" : "ashby", "language" : "en", "applyUrl" : "https://jobs.ashbyhq.com/ascertain/9247a806-ba64-4bdf-af98-939a414c671f/application", "externalId" : "9247a806-ba64-4bdf-af98-939a414c671f", "industryFunction" : { }, "structuredLocations" : [ { "country" : "Bulgaria", "continent" : "eu", "workMode" : "remote" } ], "locationText" : "Bulgaria", "employmentType" : "FULL_TIME", "professionalSkills" : [ "Prior authorization", "Billing", "Medical documentation" ], "hardSkillsList" : [ "Insurance verification", "Eligibility verification", "Authorization submission", "Record maintenance" ], "hardSkills" : [ { "name" : "Insurance verification", "level" : "intermediate" }, { "name" : "Eligibility verification", "level" : "intermediate" }, { "name" : "Authorization submission", "level" : "intermediate" }, { "name" : "Record maintenance", "level" : "intermediate" } ], "majorSkills" : "Prior authorization, Sleep Medicine, Healthcare operations", "majorSkillsList" : [ "Prior authorization", "Sleep Medicine", "Healthcare operations" ], "coreResponsibilities" : "Process prior authorizations, Review insurance information, Verify patient eligibility, Communicate with providers, Gather medical documentation, Submit authorization requests, Monitor authorization requests, Track authorization requests, Respond to inquiries, Maintain accurate records, Resolve authorization issues, Improve process efficiency, Stay updated on policies, Stay updated on regulations, Stay updated on trends", "teamCollaboration" : "Internal teams; Healthcare providers; Ascertain leadership; Product teams; External stakeholders; Ascertain Assistants", "domainKnowledge" : "Sleep Medicine; Prior authorizations; Insurance policies; Healthcare operations", "domainList" : [ "sleep-medicine", "prior-authorizations", "insurance-policies", "healthcare-operations" ], "domainSpecificKnowledge" : [ "Sleep Medicine", "Prior authorizations", "Insurance policies", "Healthcare operations" ], "toolProficiency" : [ "Athenahealth", "NextGen" ], "documentationSkills" : "Maintain accurate records", "problemSolvingSkills" : "Resolve authorization issues", "qualificationsBasic" : "4+ years prior authorization, 4+ years billing, Experience with athenahealth, Experience with NextGen, Familiarity with UnitedHealthcare, Familiarity with Aetna, Familiarity with Blue Cross Blue Shield", "qualificationsPreferred" : "Client experience, Hands-on leadership roles, Engaging with C-suite executives", "remoteFriendly" : true, "workSiteFlexibility" : "Remote", "rawDescription" : "MEET ASCERTAIN Ascertain is building AI agents to automate the administrative work that burdens care teams. We are in major health systems and large specialty groups, saving hundreds of staff hours every week. Our backers include Northwell Health, New York’s largest health system, and Deerfield Management, a leading healthcare investment firm. Together, we’re on a mission to restore time, trust, and focus to the people who keep healthcare running. Our work is urgent — not because of startup timelines, but because our customers rely on us to drive financial resilience and operational clarity in a system under strain. ABOUT THE JOB This is a hands-on role for someone who thrives in high-volume operational environments and is comfortable balancing individual contribution with team support. You will continue to process prior authorizations directly—often at high volume—while also serving as a go-to resource for other Ascertain Assistants. Over time, this role will evolve into a hybrid operations + technology position as workflows become increasingly automated and integrated with Ascertain’s platform. This is not a traditional healthcare shift-based, desk role. It is an outcome-driven position that rewards ownership, judgment, and follow-through. WHAT YOU’LL DO: As a Prior Authorization Assistant at Ascertain, you will play a critical role in our new AI-powered prior authorization solution. You’ll collaborate directly with Ascertain leadership and product teams, helping to shape how prior authorization is transformed through recent advances in artificial intelligence. This is a unique opportunity to work at the intersection of healthcare operations and cutting-edge technology. You’ll work closely with healthcare providers to reduce administrative burdens and streamline detailed workflows. Day-to-day, this includes manually processing authorizations and overseeing automated submissions for office visit referrals, procedures, pharmaceuticals, and more. The role offers broad exposure to multiple healthcare specialties, external stakeholders, and departments across Ascertain. - Review and verify insurance information and patient eligibility for prior authorizations. - Communicate with healthcare providers to gather necessary medical documentation and information. - Submit prior authorization requests to insurance companies following established protocols. - Monitor and track authorization requests to ensure timely processing and resolution. - Respond to inquiries from healthcare providers, patients, and insurance companies regarding authorization status. - Maintain accurate records of authorization requests, approvals, and denials. - Collaborate with internal teams to resolve authorization issues and improve process efficiency. - Stay updated on insurance policies, regulations, and industry trends related to prior authorizations. WHAT YOU'LL NEED: - 4+ years of experience with prior authorization and billing in Sleep Medicine - Experience with athenahealth and or NextGen - Familiarity with major payors including UnitedHealthcare, Aetna, Blue Cross Blue Shield, etc. - Bonus if you have experience in… - client relationships; - hands-on leadership roles (e.g., Team Lead, Supervisor, or informal leadership), paired with a roll-up-your-sleeves approach; - engaging with C-suite executives. WHAT YOU'LL BRING TO THE TABLE: - Detail-Oriented. You are meticulous in your work, catching errors and ensuring every authorization is processed accurately the first time. - Collaborative. You are energized by working with others, building trust and communicating clearly with providers, teammates, and cross-functional stakeholders. - Adaptable. You are comfortable shifting between manual workflows and leveraging new AI-powered tools, adjusting quickly as processes evolve. - Empathetic. You are attuned to the needs of healthcare providers and patients, approaching each interaction with patience, professionalism, and understanding. - Process-Driven. You are motivated by structure and consistency, following established workflows while identifying opportunities for improvement. BENEFITS & PERKS - Cutting-edge technology: Work directly with the latest advancements in generative AI and automation, tackling challenging problems that meaningfully impact healthcare. - Ownership & growth: You’ll join Ascertain at a pivotal early stage, shaping our products, technical direction, and culture, with significant opportunities for career advancement. - Collaborative team: Join a talented, passionate, and supportive team with backgrounds from top tech companies and clinical institutions. - Competitive compensation: We offer competitive salary, meaningful equity, comprehensive health insurance, and more. Why Ascertain? Make a real difference: Your work will directly impact healthcare organizations and improve patient care. Join Ascertain in transforming healthcare with AI!", "summaryDescription" : "Prior Authorization Assistant, Sleep Medicine at Ascertain. Skills: Prior authorization, Sleep Medicine, Healthcare operations. Process prior authorizations. Review insurance information", "createdAt" : "2026-06-16T01:59:46.031", "lastUpdated" : "2026-06-16T13:12:55.902", "ingestTimestamp" : "2026-06-16T01:59:46.031", "mongoId" : "6a307eaef292fd229c05160b", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "salaryAnnualMin" : 45000, "salaryAnnualMax" : 55000, "salaryBand" : "30k-50k", "hasSalary" : true, "allSkills" : [ "Insurance verification", "Eligibility verification", "Authorization submission", "Record maintenance", "Prior authorization", "Sleep Medicine", "Healthcare operations", "Billing", "Medical documentation", "Prior authorizations", "Insurance policies", "Athenahealth", "NextGen" ], "skillCount" : 13, "jobCategory" : "operations", "jobSubcategory" : "general", "seniorityLevel" : "Mid", "dataQualityScore" : 0.7777778, "_score" : 474.20477, "hasLocation" : true, "hasGeo" : false, "llmIndustry" : "Healthcare", "llmIndustryConfidence" : 0.95 }, { "id" : "6a2c913974d8ee00a098254d", "title" : "Patient Services Representative, Authorizations", "company" : "AOTI", "industry" : "Healthcare", "salary" : { "min" : 22.0, "max" : 24.0, "currency" : "USD", "frequency" : "yearly", "is_estimated" : false }, "location" : "US Remote", "locations" : [ "US Remote" ], "timestamp" : "2026-06-15T08:23:22.065", "fingerprint" : "2ae1056479be642ee2e2cfe18f95f639a3017d0782997645a8aa642a291acfef", "source" : "greenhouse", "language" : "en", "applyUrl" : "https://job-boards.greenhouse.io/aoti/jobs/4247828009", "externalId" : "4247828009", "industryFunction" : { }, "structuredLocations" : [ { "city" : "Exton", "state" : "Pennsylvania", "country" : "United States", "continent" : "na", "source" : "llm", "workMode" : "hybrid", "geo" : "40.0299755,-75.6290436" }, { "city" : "Oceanside", "state" : "California", "country" : "United States", "continent" : "na", "source" : "llm", "workMode" : "hybrid", "geo" : "33.1958696,-117.3794830" } ], "locationText" : "Exton, Pennsylvania, United States; Oceanside, California, United States", "employmentType" : "FULL_TIME", "professionalSkills" : [ "Customer Success", "Customer relationships", "Customer retention", "Value realization" ], "hardSkillsList" : [ "Payer authorization" ], "hardSkills" : [ { "name" : "Payer authorization", "level" : "intermediate" } ], "majorSkills" : "Prior authorizations, Patient services", "majorSkillsList" : [ "Prior authorizations", "Patient services" ], "coreResponsibilities" : "Obtain prior authorizations for procedural orders, Complete authorization process with payers", "teamCollaboration" : "Cross-functional teams", "domainKnowledge" : "Wound care; Topical wound oxygen therapy; Negative pressure wound therapy", "domainList" : [ "wound-care", "topical-wound-oxygen-therapy", "negative-pressure-wound-therapy" ], "domainSpecificKnowledge" : [ "Wound care", "Topical wound oxygen therapy", "Negative pressure wound therapy" ], "specialRequirements" : "Lift up to 50 pounds", "qualificationsBasic" : "Prior authorization process completion", "remoteFriendly" : true, "workSiteFlexibility" : "Hybrid", "rawDescription" : "About AOTI Advanced Oxygen Therapy, Inc. (AOTI) is transforming the future of wound care through breakthrough technologies that improve the lives of patients with chronic non-healing and acute complex wounds. At the heart of our mission is our patented, multimodality Topical Wound Oxygen (TWO2) therapy, the only device of its kind proven effective in both Randomized Controlled Trials (RCTs) and Real-World Evidence (RWE) studies. TWO2 has delivered exceptional clinical outcomes, including an 88% reduction in hospitalizations and a 71% reduction in amputations among patients with Diabetic Foot Ulcers (DFUs) over 12 months. In addition to TWO2, we offer the NEXA™ NPWT System, an innovative, multi-week, multi-patient Negative Pressure Wound Therapy (NPWT) device designed to deliver the clinical benefits of traditional durable systems with the convenience and simplicity of disposable solutions. The NEXA System is portable, easy to operate, and cost-effective—making advanced wound care more accessible across diverse care settings, from hospitals to the home. Backed by a world-class international leadership team and a robust global infrastructure, AOTI offers a unique opportunity to make a meaningful impact in healthcare. If you're driven by purpose and want to be part of a company that’s transforming wound care, we’d love to hear from you. Why We’re Hiring As demand for our TWO2 therapy continues to grow, we are expanding our team to ensure we maintain the highest standards of patient care. We are looking for compassionate and motivated individuals to join us in delivering life-changing therapy to more patients across the country. Position Summary The Patient Services Representative, Authorizations is responsible for obtaining prior authorizations for all procedural orders by successfully completing the authorization process with all payers. Location: Hybrid (Exton, PA or Oceanside, CA) Employment Type: Full-Time (Remote) Compensation Salary Range: $22.00 - $24.00 Benefits In addition to competitive pay, we offer a comprehensive benefits package that includes: Full benefits with a company-sponsored stipend 401(k) with company match Company-paid Basic Life, AD Gathers and analyzes information; Develops solutions; Uses reason Physical Demands Occasionally required to sit. Occasionally required to walk. Occasionally required to use hands to finger, handle, or feel. Occasionally required to reach with hands and arms. Occasionally required to talk or hear. Occasionally required to bend, lift or climb. Occasionally required to lift up to (50 pounds or greater). Finger dexterity required. Hand coordination required. Specific vision abilities required for this job include close vision, distance vision, ability to adjust or focus. Work Environment Exposure to adverse conditions. Exposure to moving mechanical parts. Exposure to high, precarious places. Exposure to outside weather conditions. Exposure to fumes or airborne particles. Possible risk of electrical shock. Protective clothing or equipment is required including gloves, covered shoes, protective eyewear. Equal Opportunity Employer Advanced Oxygen Therapy, Inc. is an Equal Employment Opportunity Employer and does not discriminate against applicants or employees on the basis of race, color, religion, creed, national origin, ancestry, disability that can be reasonably accommodated without undue hardship, sex, sexual orientation, gender identity, age, citizenship, marital or veteran status, or any other legally protected status. Data Privacy Notice We collect and use personal information you provide in your application, such as your name, contact details, and professional experience, to evaluate your qualifications and manage our recruiting process. We may also obtain information from publicly available sources or referrals in connection with recruiting activities. We retain this information for a limited period in accordance with applicable laws and our internal policies. You may request access to, correction of, or deletion of your personal information at any time by contacting us at talentaquisition@aotinc.net. Join Us Join AOTI and help us grow our impact—one patient at a time", "summaryDescription" : "Patient Services Representative, Authorizations at AOTI. Skills: Prior authorizations, Patient services. Obtain prior authorizations for procedural orders. Complete authorization process with payers", "postedDate" : "2026-06-13T21:22:45.631", "createdAt" : "2026-06-13T21:22:45.631", "lastUpdated" : "2026-06-15T08:23:22.065", "ingestTimestamp" : "2026-06-13T21:22:45.631", "mongoId" : "6a2c913974d8ee00a098254d", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "salaryAnnualMin" : 45760, "salaryAnnualMax" : 49920, "salaryBand" : "30k-50k", "hasSalary" : true, "allSkills" : [ "Payer authorization", "Prior authorizations", "Patient services", "Customer Success", "Customer relationships", "Customer retention", "Value realization", "Wound care", "Topical wound oxygen therapy", "Negative pressure wound therapy" ], "skillCount" : 10, "jobCategory" : "sales", "jobSubcategory" : "customer_success", "seniorityLevel" : "Mid", "dataQualityScore" : 0.8888889, "_score" : 384.31555, "daysOld" : 1, "hasLocation" : true, "hasGeo" : true, "llmIndustry" : "Healthcare", "llmIndustryConfidence" : 0.95 }, { "id" : "6a2c98e274d8ee00a0994e55", "title" : "Prior Authorization Specialist", "industry" : "Healthcare", "salary" : { "min" : 38000.0, "max" : 52000.0, "currency" : "USD", "frequency" : "yearly", "is_estimated" : true, "estimation_basis" : "Market baseline for an Entry-level Prior Authorization Specialist in New Orleans, United States, adjusted for the healthcare industry." }, "location" : "New Orleans, LA", "locations" : [ "New Orleans, LA" ], "timestamp" : "2026-06-16T06:03:01.406", "fingerprint" : "5e87c98839ad00a525772c1af8df9b330dbc87d25191b65c1ef522ae7f86eb9d", "source" : "jazzhr", "language" : "en", "externalId" : "qWwrIiR4Bt", "industryFunction" : { }, "structuredLocations" : [ { "city" : "New Orleans", "state" : "Louisiana", "country" : "United States", "continent" : "na", "source" : "llm", "workMode" : "onsite", "geo" : "29.9561422,-90.0733934" } ], "locationText" : "New Orleans, Louisiana, United States", "coreResponsibilities" : "Process prior authorization requests, Verify insurance eligibility, Communicate with providers, Document all interactions, Follow up on pending authorizations", "domainKnowledge" : "Prior authorization process; Medical insurance", "domainList" : [ "prior-authorization-process", "medical-insurance" ], "domainSpecificKnowledge" : [ "Prior authorization process", "Medical insurance" ], "documentationSkills" : "Document interactions", "remoteFriendly" : false, "workSiteFlexibility" : "Onsite", "summaryDescription" : "Prior Authorization Specialist. 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Verify insurance eligibility", "createdAt" : "2026-06-14T18:47:41.142", "lastUpdated" : "2026-06-16T06:03:01.406", "ingestTimestamp" : "2026-06-14T18:47:41.142", "mongoId" : "6a2c98e274d8ee00a0994e55", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "salaryAnnualMin" : 38000, "salaryAnnualMax" : 52000, "salaryBand" : "30k-50k", "hasSalary" : true, "allSkills" : [ "Prior authorization process", "Medical insurance" ], "skillCount" : 2, "jobCategory" : "operations", "jobSubcategory" : "general", "seniorityLevel" : "Entry", "dataQualityScore" : 0.44444445, "_score" : 376.76987, "hasLocation" : true, "hasGeo" : true, "llmIndustry" : "Healthcare", "llmIndustryConfidence" : 0.95 }, { "id" : "6a2c964374d8ee00a098f0c3", "title" : "Authorization Specialist", "company" : "OOS Management Corp.", "industry" : "Healthcare", "salary" : { "min" : 54000.0, "max" : 75000.0, "currency" : "USD", "frequency" : "yearly", "is_estimated" : true, "estimation_basis" : "Market baseline for Authorization Specialist in Brooklyn, NY, adjusted for mid-seniority in the healthcare industry." }, "location" : "Brooklyn, New York, United States", "locations" : [ "Brooklyn", "New York", "United States" ], "timestamp" : "2026-06-16T06:26:14.660", "fingerprint" : "0a54714c65d78668a1fd14b5b90c6eef5957d2b75b718f34d8209aa60ab570b3", "source" : "greenhouse", "language" : "en", "applyUrl" : "https://job-boards.greenhouse.io/oosmanagementcorp/jobs/4261372009", "externalId" : "4261372009", "industryFunction" : { }, "structuredLocations" : [ { "city" : "Brooklyn", "state" : "New York", "country" : "United States", "continent" : "na", "source" : "llm", "workMode" : "onsite", "geo" : "40.6526006,-73.9497211" } ], "locationText" : "Brooklyn, New York, United States", "employmentType" : "FULL_TIME", "professionalSkills" : [ "Benefit verification", "Authorization management" ], "majorSkills" : "Insurance authorizations, Benefit verification", "majorSkillsList" : [ "Insurance authorizations", "Benefit verification" ], "coreResponsibilities" : "Submit insurance authorization requests, Manage insurance authorization requests, Submit insurance authorization renewals, Manage insurance authorization renewals, Verify insurance benefits, Verify coverage details, Track approvals, Track denials, Track authorization timelines, Coordinate with intake departments, Coordinate with billing departments, Coordinate with clinical departments, Ensure timely processing, Maintain accurate records, Maintain documentation related to authorizations, Follow up with insurance providers, Resolve authorization issues, Resolve eligibility issues", "teamCollaboration" : "Coordination between departments", "domainKnowledge" : "Healthcare authorizations; Insurance verification; Medical billing", "domainList" : [ "healthcare-authorizations", "insurance-verification", "medical-billing" ], "domainSpecificKnowledge" : [ "Healthcare authorizations", "Insurance verification", "Medical billing" ], "documentationSkills" : "Documentation skills", "qualificationsBasic" : "Experience with healthcare authorizations, Experience with insurance verification, Experience with medical billing, Organizational skills, Follow-up skills, Manage multiple deadlines, Manage priorities efficiently, Documentation skills", "qualificationsPreferred" : "Related administrative work preferred, Communication skills, Detail-oriented, Experience with insurance portals, Experience with healthcare systems", "remoteFriendly" : false, "workSiteFlexibility" : "Onsite", "rawDescription" : "Authorization Specialist - Brooklyn, NY \uD83D\uDCCD Brooklyn, NY | Full-Time | On-Site Join a Growing Healthcare Team Supporting Families and Clinical Care Licensed Behavior Analyst Professional Services (LBAPS) is seeking a highly organized and detail-oriented Authorization Specialist to join our growing operations team. This role is essential in helping clients access services efficiently by managing insurance authorizations, benefit verification, and coordination between intake, billing, and clinical departments. The ideal candidate is proactive, dependable, and able to manage multiple tasks in a fast-paced healthcare environment while maintaining strong attention to detail and follow-through. Key Responsibilities: Submit and manage insurance authorization requests and renewals Verify insurance benefits and coverage details Track approvals, denials, and authorization timelines Coordinate with intake, billing, and clinical teams to ensure timely processing Maintain accurate records and documentation related to authorizations Follow up with insurance providers regarding pending requests and updates Assist in resolving authorization and eligibility issues as needed Qualifications: Experience with healthcare authorizations, insurance verification, medical billing, or related administrative work preferred Strong organizational, communication, and follow-up skills Ability to manage multiple deadlines and priorities efficiently Detail-oriented with strong documentation skills Experience working with insurance portals and healthcare systems is a plus What We Offer: Competitive compensation based on experience Supportive and collaborative team environment Opportunity for professional growth within a rapidly expanding organization Meaningful work helping families access essential services \uD83D\uDCE9 Apply today: resumes@lbaps.com", "summaryDescription" : "Authorization Specialist at OOS Management Corp.. Skills: Insurance authorizations, Benefit verification. Submit insurance authorization requests. Manage insurance authorization requests", "postedDate" : "2026-06-14T20:06:16.819", "createdAt" : "2026-06-14T20:06:16.819", "lastUpdated" : "2026-06-16T06:26:14.660", "ingestTimestamp" : "2026-06-14T20:06:16.819", "mongoId" : "6a2c964374d8ee00a098f0c3", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "salaryAnnualMin" : 54000, "salaryAnnualMax" : 75000, "salaryBand" : "50k-75k", "hasSalary" : true, "allSkills" : [ "Insurance authorizations", "Benefit verification", "Authorization management", "Healthcare authorizations", "Insurance verification", "Medical billing" ], "skillCount" : 6, "jobCategory" : "operations", "jobSubcategory" : "general", "seniorityLevel" : "Mid", "dataQualityScore" : 0.8888889, "_score" : 302.19034, "daysOld" : 1, "hasLocation" : true, "hasGeo" : true, "llmIndustry" : "Healthcare", "llmIndustryConfidence" : 0.95 }, { "id" : "6a1b5a9658b93c861ea24a7b", "title" : "Senior Coordinator, Prior Authorization", "company" : "Cardinal Health", "industry" : "Healthcare", "salary" : { "min" : 16.75, "max" : 16.75, "currency" : "USD", "frequency" : "yearly" }, "location" : "US-Nationwide-FIELD", "locations" : [ "US-Nationwide-FIELD", "United States of America" ], "timestamp" : "2026-06-01T02:20:25.499", "fingerprint" : "6f9448cd9b1abfa3d026496618974092f8962d173ff190c04010fad1842343d5", "source" : "workday", "language" : "en", "applyUrl" : "https://cardinalhealth.wd1.myworkdayjobs.com/EXT/job/US-Nationwide-FIELD/Senior-Coordinator--Prior-Authorization_20179036", "externalId" : "20179036", "industryFunction" : { }, "locationPoint" : "49.1,1.96667", "structuredLocations" : [ { "country" : "United States", "continent" : "na", "workMode" : "remote" } ], "locationText" : "United States", "employmentType" : "FULL_TIME", "experienceMinYears" : 3, "experienceMaxYears" : 6, "experienceLevel" : "Mid", "professionalSkills" : [ "Prior authorization", "Insurance verification", "Medical documentation", "Revenue cycle", "Claims processing", "HIPAA compliance", "PHI handling" ], "hardSkillsList" : [ "Prior authorization submission", "Documentation compilation", "Payer follow-up", "Order release", "Re-authorization initiation", "Data capture", "Compliance adherence", "Productivity target achievement", "Quality metric adherence", "Payer knowledge sharing" ], "hardSkills" : [ { "name" : "Prior authorization submission", "level" : "intermediate" }, { "name" : "Documentation compilation", "level" : "intermediate" }, { "name" : "Payer follow-up", "level" : "intermediate" }, { "name" : "Order release", "level" : "intermediate" }, { "name" : "Re-authorization initiation", "level" : "intermediate" }, { "name" : "Data capture", "level" : "intermediate" }, { "name" : "Compliance adherence", "level" : "intermediate" }, { "name" : "Productivity target achievement", "level" : "intermediate" }, { "name" : "Quality metric adherence", "level" : "intermediate" }, { "name" : "Payer knowledge sharing", "level" : "intermediate" } ], "majorSkills" : "Prior Authorization, Payer Portals, Documentation, Compliance", "majorSkillsList" : [ "Prior Authorization", "Payer Portals", "Documentation", "Compliance" ], "coreResponsibilities" : "Obtain, document, and track payer approvals, Submit prior authorization requests, Conduct phone-based follow-ups with payers, Manage upcoming expirations, Meet daily productivity targets, Adhere to quality, compliance, and HIPAA standards, Review assigned accounts, Prepare and submit prior auth packets, Log approvals accurately, Monitor upcoming prior auth expirations, Prioritize work, Capture all actions, decisions, and documentation, Ensure secure handling of PHI, Report suspected non-compliance, Achieve daily throughput goals, Meet standardized quality metrics, Share payer/process knowledge, Adapt to changes, Perform additional responsibilities", "teamCollaboration" : "Share payer/process knowledge with teammates; Support a team culture", "domainKnowledge" : "Durable medical equipment (DME); Diabetes devices; Ostomy supplies; Urological supplies; Wound care supplies; Medical billing; Medical reimbursement; Payer criteria; ICD-10/HCPCS coding", "domainList" : [ "durable-medical-equipment-dme", "diabetes-devices", "ostomy-supplies", "urological-supplies", "wound-care-supplies", "medical-billing", "medical-reimbursement", "payer-criteria", "icd-10-hcpcs-coding" ], "domainSpecificKnowledge" : [ "Durable medical equipment (DME)", "Diabetes devices", "Ostomy supplies", "Urological supplies", "Wound care supplies", "Medical billing", "Medical reimbursement", "Payer criteria", "ICD-10/HCPCS coding" ], "toolProficiency" : [ "Payer portals", "Grid" ], "communicationSkills" : "Professional communication with payers and provider", "documentationSkills" : "Compile documentation (DWO/CMN, prescriptions, clinical notes)", "problemSolvingSkills" : "Resolve complex problems independently; Modify process to resolve situations", "outcomesObjectives" : "Prevent order delays; Secure timely approvals; Prevent delays on new and reorder supply shipments; Achieve daily throughput goals; Meet standardized quality metrics", "qualificationsPreferred" : "High School diploma, GED or equivalent work experience, 3-6 years of experience in healthcare payer-facing work such as prior authorization, insurance verification, medical documentation, revenue cycle, or claims, Proven ability to meet daily productivity targets and quality standards in a queue-based environment, phone skills and professional communication with payers and provider comfortable with sustained phone work, High attention to detail and accuracy when compiling documentation (DWO/CMN, prescriptions, clinical notes), Self-motivated with time able to pace independently without inbound-call cadence, Customer-centric mindset with a sense of capable of multitasking (working web/portal tasks while on calls), Working knowledge of HIPAA and secure handling of PHI, Experience with diabetes devices (CGMs, insulin pumps), and familiarity with ostomy, urological, and wound care product categories, Knowledge of payer criteria for DME prior authorization, including common documentation requirements and medical necessity standards, Familiarity with payer portals and third-party experience with Grid or other work allocation tools, Exposure to ICD-10/HCPCS coding and basic authorization/claims terminology", "remoteFriendly" : true, "workSiteFlexibility" : "Fully Remote", "rawDescription" : "**Fully Remote: Monday - Friday 8:30am Eastern - 5:00pm Eastern Time** ** _What Customer Service Operations contributes to Cardinal Health_** Customer Service is responsible for establishing, maintaining and enhancing customer business through contract administration, customer orders, and problem resolution. Customer Service Operations is responsible for providing outsourced services to customers relating to medical billing, medical reimbursement, and/or other services by acting as a liaison in problem-solving, research and problem/dispute resolution. **_Job Summary_** The Senior Coordinator, Prior Authorization is responsible for obtaining, documenting, and tracking payer approvals for durable medical equipment (DME) orders, including diabetes devices and other clinically prescribed supply categories (e.g., ostomy, urological, wound care). This role submits prior authorization requests through payer portals or via fax, and conducts phone-based follow-ups with payers and provider offices to secure timely approvals. The Senior Coordinator proactively manages upcoming expirations to prevent order delays, meets daily productivity targets, and adheres to quality, compliance, and HIPAA standards. **_Responsibilities_** * Review assigned accounts to determine prior authorization requirements by payer and product category. * Prepare and submit complete prior auth packets via payer portals, third-party platforms, or fax (including DWO/CMN, prescriptions, clinical notes, and other required documentation). * Conduct phone-based follow-ups with payers (and provider offices when needed) to confirm receipt, resolve issues, and obtain approval or referral numbers. * Log approvals accurately so orders can be released and shipped; correct rejected/pending decisions by addressing missing documentation or criteria. * Monitor upcoming prior auth expirations and initiate re-authorization early to prevent delays on new and reorder supply shipments. * Prioritize work to give orders a “leg up” based on aging, SLA, and payer requirements. * Capture all actions, decisions, and documentation in the appropriate systems with complete, audit-ready notes. * Ensure secure handling of PHI and maintain full compliance with HIPAA, regulatory requirements, and company policy. * Promptly report suspected non-compliance or policy violations and attend required Compliance/HIPAA trainings. * Achieve daily throughput goals (accounts/records per day) across mixed work types (portal/web, fax, phone). * Meet standardized quality metrics through accurate documentation and adherence to process; participate in supervisor live-monitoring, QA reviews, and 1:1 coaching. * Share payer/process knowledge with teammates and support a strong team culture. * Adapt to changes in payer criteria, portals, and internal workflows; offer feedback to improve allocation, templates, and documentation standards. * Perform additional responsibilities or special projects as assigned. **_Qualifications_** * High School diploma, GED or equivalent work experience, preferred * 3-6 years of experience in healthcare payer-facing work such as prior authorization, insurance verification, medical documentation, revenue cycle, or claims, preferred * Proven ability to meet daily productivity targets and quality standards in a queue-based environment preferred. * Strong phone skills and professional communication with payers and provider offices; comfortable with sustained phone work preferred. * High attention to detail and accuracy when compiling documentation (DWO/CMN, prescriptions, clinical notes) preferred. * Self-motivated with strong time management; able to pace independently without inbound-call cadence preferred. * Customer-centric mindset with a sense of urgency; capable of multitasking (working web/portal tasks while on calls) preferred. * Working knowledge of HIPAA and secure handling of PHI preferred. * Experience with diabetes devices (CGMs, insulin pumps), and familiarity with ostomy, urological, and wound care product categories, preferred. * Knowledge of payer criteria for DME prior authorization, including common documentation requirements and medical necessity standards, preferred * Familiarity with payer portals and third-party platforms; experience with Grid or other work allocation tools, preferred. * Exposure to ICD-10/HCPCS coding and basic authorization/claims terminology, preferred, **_What is expected of you and others at this level_** * Effectively applies knowledge of job and company policies and procedures to complete a variety of assignments * In-depth knowledge in technical or specialty area * Applies advanced skills to resolve complex problems independently * May modify process to resolve situations * Works independently within established procedures; may receive general guidance on new assignments * May provide general guidance or technical assistance to less experienced team members **Anticipated hourly range:** $16.75 per hour - $21.75 per hour **Bonus eligible:** No **Benefits:** Cardinal Health offers a wide variety of benefits and programs to support health and well-being. * Medical, dental and vision coverage * Paid time off plan * Health savings account (HSA) * 401k savings plan * Access to wages before pay day with myFlexPay * Flexible spending accounts (FSAs) * Short- and long-term disability coverage * Work-Life resources * Paid parental leave * Healthy lifestyle programs **Application window anticipated to close:** 05/05/2026 *if interested in opportunity, please submit application as soon as possible. _The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate’s geographical location, relevant education, experience and skills and an evaluation of internal pay equity._ _Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply.___ _Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law._ _To read and review this privacy notice click_[here](https://www.cardinalhealth.com/content/dam/corp/email/documents/corp/cardinal-health-online-application-privacy-policy.pdf)", "summaryDescription" : "Senior Coordinator, Prior Authorization at Cardinal Health. Skills: Prior Authorization, Payer Portals, Documentation, Compliance. Obtain, document, and track payer approvals. Submit prior authorization requests", "postedDate" : "2026-05-31T01:26:09.325", "createdAt" : "2026-06-01T01:26:09.232", "lastUpdated" : "2026-06-01T02:20:25.499", "ingestTimestamp" : "2026-06-01T01:26:09.232", "mongoId" : "6a1b5a9658b93c861ea24a7b", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "sourceUrl" : "https://cardinalhealth.wd1.myworkdayjobs.com/EXT/job/US-Nationwide-FIELD/Senior-Coordinator--Prior-Authorization_20179036", "salaryAnnualMin" : 34840, "salaryAnnualMax" : 34840, "salaryBand" : "30k-50k", "hasSalary" : true, "allSkills" : [ "Prior authorization submission", "Documentation compilation", "Payer follow-up", "Order release", "Re-authorization initiation", "Data capture", "Compliance adherence", "Productivity target achievement", "Quality metric adherence", "Payer knowledge sharing", "Prior Authorization", "Payer Portals", "Documentation", "Compliance", "Prior authorization", "Insurance verification", "Medical documentation", "Revenue cycle", "Claims processing", "HIPAA compliance", "PHI handling", "Durable medical equipment (DME)", "Diabetes devices", "Ostomy supplies", "Urological supplies", "Wound care supplies", "Medical billing", "Medical reimbursement", "Payer criteria", "ICD-10/HCPCS coding", "Payer portals", "Grid" ], "skillCount" : 32, "jobCategory" : "other", "seniorityLevel" : "executive", "dataQualityScore" : 1.0, "_score" : 261.4237, "daysOld" : 1, "hasLocation" : true, "hasGeo" : false, "llmIndustry" : "Healthcare" }, { "id" : "6a1b390558b93c861e9fe733", "title" : "Senior Coordinator, Prior Authorization", "company" : "Cardinal Health", "industry" : "Healthcare", "salary" : { "min" : 16.75, "max" : 16.75, "currency" : "USD", "frequency" : "yearly" }, "location" : "US-Nationwide-FIELD", "locations" : [ "US-Nationwide-FIELD", "United States of America" ], "timestamp" : "2026-06-01T02:23:45.904", "fingerprint" : "aeb4b5e9c25b16c91a7e2ef1668eb6a411fd1a548e01bb54ab9394ae813e848a", "source" : "workday", "language" : "en", "applyUrl" : "https://cardinalhealth.wd1.myworkdayjobs.com/EXT/job/US-Nationwide-FIELD/Senior-Coordinator--Prior-Authorization_20179036", "externalId" : "20179036", "industryFunction" : { }, "locationPoint" : "49.1,1.96667", "structuredLocations" : [ { "country" : "United States", "continent" : "na", "workMode" : "remote" } ], "locationText" : "United States", "employmentType" : "FULL_TIME", "experienceMinYears" : 3, "experienceMaxYears" : 6, "experienceLevel" : "Mid", "professionalSkills" : [ "Prior authorization", "Insurance verification", "Medical documentation", "Revenue cycle", "Claims processing", "HIPAA compliance", "PHI handling" ], "hardSkillsList" : [ "Prior authorization submission", "Documentation compilation", "Payer follow-up", "Expiration monitoring", "Re-authorization initiation", "Data logging", "Compliance adherence" ], "hardSkills" : [ { "name" : "Prior authorization submission", "level" : "intermediate" }, { "name" : "Documentation compilation", "level" : "intermediate" }, { "name" : "Payer follow-up", "level" : "intermediate" }, { "name" : "Expiration monitoring", "level" : "intermediate" }, { "name" : "Re-authorization initiation", "level" : "intermediate" }, { "name" : "Data logging", "level" : "intermediate" }, { "name" : "Compliance adherence", "level" : "intermediate" } ], "majorSkills" : "Prior authorization, Payer communication, Documentation, Compliance", "majorSkillsList" : [ "Prior authorization", "Payer communication", "Documentation", "Compliance" ], "coreResponsibilities" : "Obtain, document, and track payer approvals, Submit prior authorization requests, Conduct phone-based follow-ups with payers, Manage upcoming expirations, Meet daily productivity targets, Adhere to quality, compliance, and HIPAA standards, Review assigned accounts, Prepare and submit prior auth packets, Log approvals accurately, Monitor upcoming prior auth expirations, Prioritize work, Capture all actions, decisions, and documentation, Ensure secure handling of PHI, Report suspected non-compliance, Achieve daily throughput goals, Meet standardized quality metrics, Share payer/process knowledge, Adapt to changes in payer criteria, Perform additional responsibilities", "teamCollaboration" : "Share payer/process knowledge with teammates; Support a team culture", "domainKnowledge" : "Durable medical equipment (DME); Diabetes devices; Ostomy supplies; Urological supplies; Wound care supplies; Medical billing; Medical reimbursement; Payer criteria; Medical necessity standards", "domainList" : [ "durable-medical-equipment-dme", "diabetes-devices", "ostomy-supplies", "urological-supplies", "wound-care-supplies", "medical-billing", "medical-reimbursement", "payer-criteria", "medical-necessity-standards" ], "domainSpecificKnowledge" : [ "Durable medical equipment (DME)", "Diabetes devices", "Ostomy supplies", "Urological supplies", "Wound care supplies", "Medical billing", "Medical reimbursement", "Payer criteria", "Medical necessity standards" ], "toolProficiency" : [ "Payer portals", "Third-party platforms", "Grid" ], "communicationSkills" : "Professional communication with payers and provider offices", "documentationSkills" : "Compile documentation (DWO/CMN, prescriptions, clinical notes)", "problemSolvingSkills" : "Resolve issues; Resolve rejected/pending decisions", "outcomesObjectives" : "Prevent order delays; Secure timely approvals; Prevent delays on new and reorder supply shipments; Achieve daily throughput goals; Meet standardized quality metrics", "qualificationsPreferred" : "High School diploma, GED or equivalent work experience, 3-6 years of experience in healthcare payer-facing work such as prior authorization, insurance verification, medical documentation, revenue cycle, or claims, Proven ability to meet daily productivity targets and quality standards in a queue-based environment, phone skills and professional communication with payers and provider comfortable with sustained phone work, High attention to detail and accuracy when compiling documentation (DWO/CMN, prescriptions, clinical notes), Self-motivated with time able to pace independently without inbound-call cadence, Customer-centric mindset with a sense of capable of multitasking (working web/portal tasks while on calls), Working knowledge of HIPAA and secure handling of PHI, Experience with diabetes devices (CGMs, insulin pumps), and familiarity with ostomy, urological, and wound care product categories, Knowledge of payer criteria for DME prior authorization, including common documentation requirements and medical necessity standards, Familiarity with payer portals and third-party experience with Grid or other work allocation tools, Exposure to ICD-10/HCPCS coding and basic authorization/claims terminology", "remoteFriendly" : true, "workSiteFlexibility" : "Fully Remote", "rawDescription" : "**Fully Remote: Monday - Friday 8:30am Eastern - 5:00pm Eastern Time** ** _What Customer Service Operations contributes to Cardinal Health_** Customer Service is responsible for establishing, maintaining and enhancing customer business through contract administration, customer orders, and problem resolution. Customer Service Operations is responsible for providing outsourced services to customers relating to medical billing, medical reimbursement, and/or other services by acting as a liaison in problem-solving, research and problem/dispute resolution. **_Job Summary_** The Senior Coordinator, Prior Authorization is responsible for obtaining, documenting, and tracking payer approvals for durable medical equipment (DME) orders, including diabetes devices and other clinically prescribed supply categories (e.g., ostomy, urological, wound care). This role submits prior authorization requests through payer portals or via fax, and conducts phone-based follow-ups with payers and provider offices to secure timely approvals. The Senior Coordinator proactively manages upcoming expirations to prevent order delays, meets daily productivity targets, and adheres to quality, compliance, and HIPAA standards. **_Responsibilities_** * Review assigned accounts to determine prior authorization requirements by payer and product category. * Prepare and submit complete prior auth packets via payer portals, third-party platforms, or fax (including DWO/CMN, prescriptions, clinical notes, and other required documentation). * Conduct phone-based follow-ups with payers (and provider offices when needed) to confirm receipt, resolve issues, and obtain approval or referral numbers. * Log approvals accurately so orders can be released and shipped; correct rejected/pending decisions by addressing missing documentation or criteria. * Monitor upcoming prior auth expirations and initiate re-authorization early to prevent delays on new and reorder supply shipments. * Prioritize work to give orders a “leg up” based on aging, SLA, and payer requirements. * Capture all actions, decisions, and documentation in the appropriate systems with complete, audit-ready notes. * Ensure secure handling of PHI and maintain full compliance with HIPAA, regulatory requirements, and company policy. * Promptly report suspected non-compliance or policy violations and attend required Compliance/HIPAA trainings. * Achieve daily throughput goals (accounts/records per day) across mixed work types (portal/web, fax, phone). * Meet standardized quality metrics through accurate documentation and adherence to process; participate in supervisor live-monitoring, QA reviews, and 1:1 coaching. * Share payer/process knowledge with teammates and support a strong team culture. * Adapt to changes in payer criteria, portals, and internal workflows; offer feedback to improve allocation, templates, and documentation standards. * Perform additional responsibilities or special projects as assigned. **_Qualifications_** * High School diploma, GED or equivalent work experience, preferred * 3-6 years of experience in healthcare payer-facing work such as prior authorization, insurance verification, medical documentation, revenue cycle, or claims, preferred * Proven ability to meet daily productivity targets and quality standards in a queue-based environment preferred. * Strong phone skills and professional communication with payers and provider offices; comfortable with sustained phone work preferred. * High attention to detail and accuracy when compiling documentation (DWO/CMN, prescriptions, clinical notes) preferred. * Self-motivated with strong time management; able to pace independently without inbound-call cadence preferred. * Customer-centric mindset with a sense of urgency; capable of multitasking (working web/portal tasks while on calls) preferred. * Working knowledge of HIPAA and secure handling of PHI preferred. * Experience with diabetes devices (CGMs, insulin pumps), and familiarity with ostomy, urological, and wound care product categories, preferred. * Knowledge of payer criteria for DME prior authorization, including common documentation requirements and medical necessity standards, preferred * Familiarity with payer portals and third-party platforms; experience with Grid or other work allocation tools, preferred. * Exposure to ICD-10/HCPCS coding and basic authorization/claims terminology, preferred, **_What is expected of you and others at this level_** * Effectively applies knowledge of job and company policies and procedures to complete a variety of assignments * In-depth knowledge in technical or specialty area * Applies advanced skills to resolve complex problems independently * May modify process to resolve situations * Works independently within established procedures; may receive general guidance on new assignments * May provide general guidance or technical assistance to less experienced team members **Anticipated hourly range:** $16.75 per hour - $21.75 per hour **Bonus eligible:** No **Benefits:** Cardinal Health offers a wide variety of benefits and programs to support health and well-being. * Medical, dental and vision coverage * Paid time off plan * Health savings account (HSA) * 401k savings plan * Access to wages before pay day with myFlexPay * Flexible spending accounts (FSAs) * Short- and long-term disability coverage * Work-Life resources * Paid parental leave * Healthy lifestyle programs **Application window anticipated to close:** 05/05/2026 *if interested in opportunity, please submit application as soon as possible. _The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate’s geographical location, relevant education, experience and skills and an evaluation of internal pay equity._ _Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply.___ _Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law._ _To read and review this privacy notice click_[here](https://www.cardinalhealth.com/content/dam/corp/email/documents/corp/cardinal-health-online-application-privacy-policy.pdf)", "summaryDescription" : "Senior Coordinator, Prior Authorization at Cardinal Health. Skills: Prior authorization, Payer communication, Documentation, Compliance. Obtain, document, and track payer approvals. Submit prior authorization requests", "postedDate" : "2026-05-31T01:25:43.830", "createdAt" : "2026-06-01T01:25:43.801", "lastUpdated" : "2026-06-01T02:23:45.904", "ingestTimestamp" : "2026-06-01T01:25:43.801", "mongoId" : "6a1b390558b93c861e9fe733", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "sourceUrl" : "https://cardinalhealth.wd1.myworkdayjobs.com/EXT/job/US-Nationwide-FIELD/Senior-Coordinator--Prior-Authorization_20179036", "salaryAnnualMin" : 34840, "salaryAnnualMax" : 34840, "salaryBand" : "30k-50k", "hasSalary" : true, "allSkills" : [ "Prior authorization submission", "Documentation compilation", "Payer follow-up", "Expiration monitoring", "Re-authorization initiation", "Data logging", "Compliance adherence", "Prior authorization", "Payer communication", "Documentation", "Compliance", "Insurance verification", "Medical documentation", "Revenue cycle", "Claims processing", "HIPAA compliance", "PHI handling", "Durable medical equipment (DME)", "Diabetes devices", "Ostomy supplies", "Urological supplies", "Wound care supplies", "Medical billing", "Medical reimbursement", "Payer criteria", "Medical necessity standards", "Payer portals", "Third-party platforms", "Grid" ], "skillCount" : 29, "jobCategory" : "other", "seniorityLevel" : "executive", "dataQualityScore" : 1.0, "_score" : 261.42365, "daysOld" : 1, "hasLocation" : true, "hasGeo" : false, "llmIndustry" : "Healthcare" }, { "id" : "6a24f28d74d8ee00a0059bbb", "title" : "Prior Authorization Specialist", "company" : "Zócalo Health", "industry" : "Healthcare", "salary" : { "min" : 25.0, "currency" : "USD", "frequency" : "yearly", "is_estimated" : false }, "location" : "United States", "locations" : [ "United States" ], "timestamp" : "2026-06-07T18:03:22.636", "fingerprint" : "ff4c44e7b5c53ea0e21b47294b1d314480e11e6721c06b8401f88d013a364d9e", "source" : "greenhouse", "language" : "en", "applyUrl" : "https://job-boards.greenhouse.io/zocalohealth/jobs/5250024008", "externalId" : "5250024008", "industryFunction" : { }, "structuredLocations" : [ { "continent" : "na", "workMode" : "remote" } ], "locationText" : "", "employmentType" : "FULL_TIME", "professionalSkills" : [ "Medical terminology", "Payer guidelines" ], "hardSkillsList" : [ "Prior authorization", "Medical documentation", "Chart notes", "CPT/ICD codes", "HIPAA compliance" ], "hardSkills" : [ { "name" : "Prior authorization", "level" : "intermediate" }, { "name" : "Medical documentation", "level" : "intermediate" }, { "name" : "Chart notes", "level" : "intermediate" }, { "name" : "CPT/ICD codes", "level" : "intermediate" }, { "name" : "HIPAA compliance", "level" : "intermediate" } ], "majorSkills" : "Prior authorization, Payer coordination, Record keeping", "majorSkillsList" : [ "Prior authorization", "Payer coordination", "Record keeping" ], "coreResponsibilities" : "Prepare and submit pre-authorization requests, Ensure medical documentation accuracy, Track prior authorization status, Clarify payer requirements, Resolve outstanding requests, Maintain accurate prior authorization records, Research prior authorization denials, Assist in resolving payer discrepancies, Collaborate with intake teams, Collaborate with clinical teams, Collaborate with billing teams, Collaborate with payer operations teams", "teamCollaboration" : "Internal operational teams; Healthcare providers; Insurance companies; Intake teams; Clinical teams; Billing teams; Payer operations teams", "domainKnowledge" : "Medical terminology; Payer guidelines; HIPAA regulations; Prior authorization workflows", "domainList" : [ "medical-terminology", "payer-guidelines", "hipaa-regulations", "prior-authorization-workflows" ], "domainSpecificKnowledge" : [ "Medical terminology", "Payer guidelines", "HIPAA regulations", "Prior authorization workflows" ], "toolProficiency" : [ "Athena" ], "communicationSkills" : "Written communication; Verbal communication", "documentationSkills" : "Medical documentation; Chart notes", "qualificationsBasic" : "High school diploma or equivalent, 1+ year prior authorization experience, Fluency in medical terminology, Understanding of major payer guidelines, Ability to maintain accuracy, confidentiality, and compliance with HIPAA", "qualificationsPreferred" : "Direct experience with Medi-Cal Managed Care Plans, Experience supporting Enhanced Care Management (ECM), Community Health Worker (CHW), and Community Support (CS) Services, Experience with electronic health record and practice management systems, Experience with Athena, Understanding of prior authorization workflows", "remoteFriendly" : true, "workSiteFlexibility" : "Remote", "rawDescription" : "Prior Authorization Specialist Remote, United States (Full Time) Compensation: $25 per hour About Us Zócalo Health is a tech-enabled, community-oriented primary care organization serving people who have historically been underserved by the one-size-fits-all healthcare system. We partner with health plans, providers, and community organizations to deliver culturally competent primary care, behavioral health, and social care. Our model is built for populations with high medical and social complexity, where fragmented care drives poor outcomes and unnecessary cost. We combine local, community-based teams with virtual care and modern technology to deliver coordinated, whole-person care where members live and receive support. Founded in 2021, Zócalo Health is backed by leading healthcare and mission-aligned investors and is scaling rapidly across states and populations. We are building a durable care platform designed to perform in constrained healthcare environments and to lead the shift toward accountable, value-based care. Role Description The Prior Authorization Specialist will join Zócalo Health during a period of rapid growth and increasing operational complexity. This role exists to help scale and execute a community-oriented primary care model that delivers measurable outcomes for high-need members and health plan partners. As a key member of our rapidly expanding team, you will drive the prior authorization process by managing timely, detailed correspondence with payers and healthcare providers to ensure strict adherence to guidelines. This role requires exceptional attention to detail in maintaining accurate, compliant, and up-to-date patient records. This position reports to the Authorizations Manager. The Prior Authorization Specialist will contribute in the following ways: Authorization Submission: Prepare and submit detailed pre-authorization requests to insurance payers, ensuring all required medical documentation, chart notes, CPT/ICD codes, and supporting documentation are accurate and submitted within required timelines. Liaison & Follow-Up: Act as the central point of coordination between healthcare providers, patients, internal operational teams, and insurance companies to track prior authorization status, clarify payer requirements, and resolve outstanding requests. Authorization Tracking & Record Keeping: Maintain accurate prior authorization records within Zocalo Electronic Medical Record, including approvals, denials, effective dates, units/visits, payer communications, and required follow-up actions. Denial Management: Research and assist in resolving prior authorization denials, missing information requests, payer discrepancies, and appeals in a timely manner. Cross-Functional Collaboration: Collaborate closely with intake, clinical, billing, and payer operations teams to support timely authorization processing and reimbursement readiness. Qualifications High school diploma or equivalent required. 1 + year of prior authorization experience. Medical & Insurance Knowledge: Fluency in medical terminology and a solid understanding of major payer guidelines. Strong organizational skills with the ability to manage multiple priorities and high-volume workflows. Ability to maintain accuracy, confidentiality, and compliance with HIPAA requirements in a remote work environment. Strong written and verbal communication skills. Preferred Qualifications Direct experience with Medi-Cal Managed Care Plans Experience supporting Enhanced Care Management (ECM), Community Health Worker (CHW), and Community Support (CS) Services. Experience working with electronic health record and practice management systems, including Athena. Strong understanding of prior authorization workflows, including clinical review, coding accuracy, submission, denial management, appeals, and follow-up What you can expect from Zócalo Health Competitive salary: $25 per hour Equity compensation package Comprehensive benefits including medical, dental, and vision 401k Generous PTO policy (up to 15 days per year for FT employees) $1,000 home office stipend We provide the equipment needed for this role. Opportunity for rapid career progression with plenty of room for personal growth. You must be authorized to work in the United States. Remote Work can be done from anywhere in the U. S. At Zócalo Health Inc., we see diversity and inclusion as a source of strength in transforming healthcare. We believe building trust and innovation are best achieved through diverse perspectives. To us, acceptance and respect are rooted in an understanding that people do not experience things in the same way, including our healthcare system. Individuals seeking employment at Zócalo Health are considered without regard to race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.  Those seeking employment at Zócalo Health are considered without regard to race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status or disability status.", "summaryDescription" : "Prior Authorization Specialist at Zócalo Health. Skills: Prior authorization, Payer coordination, Record keeping. Prepare and submit pre-authorization requests. Ensure medical documentation accuracy", "postedDate" : "2026-06-07T08:26:26.574", "createdAt" : "2026-06-07T08:26:26.574", "lastUpdated" : "2026-06-07T18:03:22.636", "ingestTimestamp" : "2026-06-07T08:26:26.574", "mongoId" : "6a24f28d74d8ee00a0059bbb", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "salaryAnnualMin" : 52000, "salaryBand" : "50k-75k", "hasSalary" : true, "allSkills" : [ "Prior authorization", "Medical documentation", "Chart notes", "CPT/ICD codes", "HIPAA compliance", "Payer coordination", "Record keeping", "Medical terminology", "Payer guidelines", "HIPAA regulations", "Prior authorization workflows", "Athena" ], "skillCount" : 12, "jobCategory" : "other", "jobSubcategory" : "administrative", "dataQualityScore" : 0.8888889, "_score" : 256.36404, "daysOld" : 0, "hasLocation" : true, "hasGeo" : false, "llmIndustry" : "Healthcare" }, { "id" : "6a257c4374d8ee00a018b75b", "title" : "Bilingual Prior Authorization Specialist", "company" : "Staffing for Doctors", "industry" : "Medical Practice", "salary" : { "min" : 1000000.0, "max" : 1500000.0, "currency" : "INR", "frequency" : "yearly", "is_estimated" : true, "estimation_basis" : "Market baseline for a Bilingual Prior Authorization Specialist in India, adjusted for mid-seniority and full-time employment in the healthcare industry." }, "location" : "Remote", "locations" : [ "Remote" ], "timestamp" : "2026-06-14T22:18:07.727", "fingerprint" : "73c955f00f1d13c144bfadb76fd2b98770c2ccd9449db9fa984fcc4fbf2f385c", "source" : "workable", "language" : "en", "applyUrl" : "https://apply.workable.com/j/3D445E9E9E/apply", "externalId" : "3D445E9E9E", "industryFunction" : { }, "locationPoint" : "13.7942,-88.8965", "structuredLocations" : [ { "workMode" : "remote" } ], "locationText" : "", "experienceMinYears" : 2, "experienceMaxYears" : 5, "experienceLevel" : "Mid", "technicalSkills" : "ModMed, EMA EHR, Optum phone system", "professionalSkills" : [ "Insurance navigation", "Clinical documentation review", "Payer guidelines", "Medical necessity", "Authorization management", "Denial appeals", "Benefit auditing", "Utilization tracking", "CPT coding", "ICD-10 coding" ], "hardSkillsList" : [ "Prior authorization", "Insurance appeals", "Clinical chart review", "Payer follow-up", "Eligibility checks", "Coverage verification", "Authorization expiration tracking", "Utilization cap tracking", "Renewal cycle tracking", "Claim rejection prevention", "Provider coordination", "Peer-to-peer review scheduling", "EMR documentation" ], "hardSkills" : [ { "name" : "Prior authorization", "level" : "intermediate" }, { "name" : "Insurance appeals", "level" : "intermediate" }, { "name" : "Clinical chart review", "level" : "intermediate" }, { "name" : "Payer follow-up", "level" : "intermediate" }, { "name" : "Eligibility checks", "level" : "intermediate" }, { "name" : "Coverage verification", "level" : "intermediate" }, { "name" : "Authorization expiration tracking", "level" : "intermediate" }, { "name" : "Utilization cap tracking", "level" : "intermediate" }, { "name" : "Renewal cycle tracking", "level" : "intermediate" }, { "name" : "Claim rejection prevention", "level" : "intermediate" }, { "name" : "Provider coordination", "level" : "intermediate" }, { "name" : "Peer-to-peer review scheduling", "level" : "intermediate" }, { "name" : "EMR documentation", "level" : "intermediate" } ], "majorSkills" : "Prior Authorizations, Denial Appeals, Insurance Verification, Utilization Tracking", "majorSkillsList" : [ "Prior Authorizations", "Denial Appeals", "Insurance Verification", "Utilization Tracking" ], "coreResponsibilities" : "Submit prior authorizations, Secure prior authorizations, Review clinical charts, Ensure medical necessity documentation, Manage authorization tracking pipelines, Follow up with insurance medical directors, Follow up with utilization management teams, Prevent treatment delays, Research appeals for denied authorizations, Write appeals for denied authorizations, Submit appeals for denied authorizations, Leverage provider clinical notes, Overturn adverse determinations, Execute eligibility checks, Verify coverage limitations, Track deductibles, Track policy exclusions, Track pending authorization expiration dates, Track utilization caps, Track required renewal cycles, Protect practice from retroactive claim rejections, Manage outbound call workflows, Manage inbound call workflows, Convey coverage updates to patients, Partner with clinicians, Partner with providers, Secure required clinical notes, Schedule peer-to-peer reviews, Obtain updated CPT codes, Obtain updated ICD-10 codes, Document authorization confirmation numbers, Document approved lines of service, Document payer correspondence paths, Document in patient EMR record", "teamCollaboration" : "Partner with clinicians; Partner with providers", "domainKnowledge" : "Payer guidelines; Clinical documentation; Insurance jargon; Medical necessity; CPT codes; ICD-10 codes; HIPAA regulations", "domainList" : [ "payer-guidelines", "clinical-documentation", "insurance-jargon", "medical-necessity", "cpt-codes", "icd-10-codes", "hipaa-regulations" ], "domainSpecificKnowledge" : [ "Payer guidelines", "Clinical documentation", "Insurance jargon", "Medical necessity", "CPT codes", "ICD-10 codes", "HIPAA regulations" ], "toolProficiency" : [ "ModMedA", "Optum phone system", "EMR" ], "communicationSkills" : "Accent-free verbal English; Professional phone demeanor; High-clarity phone support; Empathy; Extreme professionalism", "documentationSkills" : "Clinical documentation; Patient charting; EMR documentation", "problemSolvingSkills" : "Managing denial appeals; Overturning adverse determinations", "specialRequirements" : "Quiet home office setup, Secure home office setup, HIPAA compliant home office setup", "outcomesObjectives" : "Ensure procedures authorized; Ensure medications authorized; Ensure diagnostics authorized; Prevent treatment delays; Protect practice from claim rejections", "qualificationsBasic" : "2+ years prior authorization experience, 2+ years insurance appeals experience, Bilingual fluency (English/Spanish), Clear English verbal communication, Operational understanding of CPT codes, Operational understanding of ICD-10 codes, Understanding of medical necessity documentation rules, Agreement to work under automated time-tracker, Maintain quiet home office setup, HIPAA compliant home office setup", "qualificationsPreferred" : "ModMed (Modernizing Medicine) / EMA EHR familiarity, Optum VoIP phone system experience, Surgical specialties authorization experience, Advanced diagnostic imaging authorization experience", "remoteFriendly" : true, "workSiteFlexibility" : "Remote", "rawDescription" : "We are seeking a highly organized, systematic, and articulate **Virtual Prior Authorization Specialist** to lead the clinical administrative gateway for a fast-paced medical practice. This role is specifically designed for a dedicated insurance navigation expert who understands how to bridge the gap between complex payer guidelines, clinical documentation, and seamless patient scheduling. The primary anchor of this position is **Obtaining Prior Authorizations and Managing Denial Appeals**. You will be responsible for ensuring that all upcoming procedures, specialty medications, and advanced diagnostics are fully authorized before services are rendered. Because you will be communicating extensively with Texas-based insurance providers, clinical staff, and patients, **you must possess exceptional, accent-free verbal English clarity** , an authoritative command of insurance jargon, and a polished, professional phone demeanor. ** Core Responsibilities: Prior Authorizations & Denial Appeals (Primary Focus)** * **End-to-End Authorization Management:** Submit and successfully secure prior authorizations for complex procedures, specialty medications, high-level imaging, and specialty referrals. * **Clinical Review Coordination:** Review clinical charts within **ModMed/EMA** to ensure medical necessity documentation perfectly supports specific payer requirements prior to submission. * **Proactive Payer Follow-Up:** Manage authorization tracking pipelines aggressively, following up with insurance medical directors and utilization management teams to prevent treatment delays. * **Appeals & Denials Processing:** Research, write, and submit technical appeals for denied authorizations, leveraging provider clinical notes to overturn adverse determinations. **Insurance Verification & Utilization Tracking** * **Front-End Benefit Auditing:** Execute deep-dive eligibility checks and verify coverage limitations, tracking specific deductibles and policy exclusions. * **Expiration Safeguarding:** Track pending authorization expiration dates, utilization caps, and required renewal cycles to protect the practice from retroactive claim rejections. **Patient Communication & Administrative Alignment** * **High-Clarity Phone Support:** Manage outbound and inbound call workflows via the **Optum phone system** , conveying delicate coverage updates to patients with empathy and extreme professionalism. * **Provider & Clinic Synergy:** Partner directly with on-site clinicians and providers to secure required clinical notes, peer-to-peer review scheduling data, and updated CPT/ICD-10 codes. * **Precision Charting:** Document all authorization confirmation numbers, approved lines of service, and payer correspondence paths within the patient’s permanent EMR record. **Requirements** **Required Qualifications (Non-Negotiable)** * **Domain Expertise:** Minimum 2+ years of dedicated prior authorization and insurance appeals experience inside a U.S. medical practice. * **Linguistic Excellence:** High-level bilingual fluency (English/Spanish). **Must possess clear, highly articulate English verbal communication with little-to-no accent, tailored for our Texas-based patient demographic and provider market.** * **Coding Literacy:** Solid, operational understanding of **CPT codes, ICD-10 codes** , and standard medical necessity documentation rules. * **Remote Accountability:** Agreement to work under a mandatory automated time-tracker, maintaining a quiet, highly secure home office setup compliant with HIPAA regulations. **Strongly Preferred Experience** * Direct, daily operational familiarity with **ModMed (Modernizing Medicine) / EMA EHR**. * Prior experience managing communication queues through the **Optum VoIP phone system**. * Specialized background reviewing clinical charts for surgical specialties or advanced diagnostic imaging authorizations.", "summaryDescription" : "Bilingual Prior Authorization Specialist at Staffing for Doctors. Skills: Prior Authorizations, Denial Appeals, Insurance Verification, Utilization Tracking. Submit prior authorizations. 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Work closely with our care team to ensure the success of patients; Team player that can also solve problems independently", "domainKnowledge" : "addiction medicine; substance use disorders; medication for opioid use disorder (MOUD); health plans; medical benefits", "domainList" : [ "addiction-medicine", "substance-use-disorders", "medication-for-opioid-use-disorder-moud", "health-plans", "medical-benefits" ], "domainSpecificKnowledge" : [ "addiction medicine", "substance use disorders", "medication for opioid use disorder (MOUD)", "health plans", "medical benefits" ], "toolProficiency" : [ "operating system", "payer portals" ], "communicationSkills" : "Exceptional written and verbal communication skills; Communicate authorization and benefit coverage with patients and providers promptly and professionally", "documentationSkills" : "Document progress of prior authorization appropriately using our operating system", "problemSolvingSkills" : "Troubleshoot prior authorization submissions and prescription processing; Review and resolve all reported authorization issues timely and effectively; Team player that can also solve problems independently", "specialRequirements" : "Dedicated, private workspace with a lockable door, High-speed internet, Authorized to work for any employer in the U. S.", "outcomesObjectives" : "Improve patients' medication adherence by offering a quick and effortless way for patients to get their medications on time", "qualificationsBasic" : "6 months of experience working on prior authorizations, 2+ years of Medical office/clinic experience, Ability to organize workload and manage time effectively, Technologically savvy, Ability to read and interpret medical benefits for verification requests, Ability to handle a high volume of work with speed and accuracy, Access to reliable, high-speed internet", "qualificationsPreferred" : "Medical Assistant experience, Customer service experience, Remote/telehealth experience, A passion for serving the needs of people with addiction and mental health challenges, using non-stigmatizing, non-judgmental person-first language", "remoteFriendly" : true, "workSiteFlexibility" : "fully remote", "rawDescription" : "About Boulder Boulder Care is an award-winning digital clinic for addiction medicine, recognized for both innovation and high quality of patient care. Founded in 2017 by CEO Stephanie Strong, our mission is to improve the lives of people with substance use disorders through compassionate, evidence-based care. We provide Boulder patients with a fully virtual, multidisciplinary care team—including medical providers and peer recovery specialists—who deliver personalized treatment, including medication for opioid use disorder (MOUD) and ongoing support. Our approach is grounded in clinical excellence, patient-centered care, and a commitment to reducing barriers to recovery. Boulder partners with leading health plans, employers, and community organizations to ensure that our services are accessible and covered for the people who need them most. Named by Fortune as one of the Best Workplaces in Healthcare, we foster a culture of kindness, respect, and meaningful work that delivers outstanding patient outcomes and moves the addiction medicine industry forward. About the Role The Prior Authorization Specialist is responsible for obtaining all pre-authorizations for medication approvals. They will work closely with staff to review, research and complete prior authorizations, prior authorization appeals, and notify patients of status updates from insurance. The most important goal is to improve patients' medication adherence by offering a quick and effortless way for patients to get their medications on time. What You'll Do: Obtain prior-authorization for all patients requiring insurance approval for medication needs Verify patient insurance information is accurate and documented correctly Troubleshoot prior authorization submissions and prescription processing with health care providers utilizing phone or online resources Review and resolve all reported authorization issues timely and effectively Submit prior authorizations to insurance plans in a timely manner via payer-specific portals, fax, or verbally via phone Communicate authorization and benefit coverage with patients and providers promptly and professionally Obtain appropriate documentation to validate the approval or denial of authorizations Document progress of prior authorization appropriately using our operating system Follow up on pending authorizations on a regular basis to obtain the current status or to be informed of any action needed in order to obtain the authorization approval Successfully navigate between multiple systems throughout the course of the workday, this includes but is not limited to operational software and payer portals Maintain patient file security and confidentiality by adhering to appropriate confidentiality and HIPAA policies and guidelines Advise management of identified trends with payers in an effort to mitigate problems What you bring: A minimum of 6 months of experience working on prior authorizations 2+ years of Medical office/clinic experience Ability to organize workload and manage time effectively Technologically savvy Ability to read and interpret medical benefits for verification requests Ability to handle a high volume of work with speed and accuracy Passion for helping people Ability to work closely with our care team to ensure the success of patients that are recommended to us by their physician's office Team player that can also solve problems independently Exceptional written and verbal communication skills Reliable, and a self-starter Access to reliable, high-speed internet to meet the needs of remote processing Nice to haves Medical Assistant experience Customer service experience Remote/telehealth experience A passion for serving the needs of people with addiction and mental health challenges, using non-stigmatizing, non-judgmental person-first language Work environment This is a fully remote role but we are currently only hiring candidates located in the following states: AZ, FL, GA, ID, IL, KY, MA, NC, NJ, NV, NY, OH, OR, PA, SC, TN, TX, UT, WA, and WV Applicants must be authorized to work for any employer in the U. S. We are unable to sponsor or take over sponsorship of an employment Visa at this time. Office Requirements: Boulder teammates working with sensitive information must have a dedicated, private workspace with a lockable door and high-speed internet to maintain a secure, distraction-free environment, ensuring compliance with HIPAA and confidentiality standards Boulder Care employees are free to use our river-front HQ located in Portland, OR whenever they would like Expected hours of work This is a full-time position expected to work 40 hours a week, M- F. Team members are asked to work a 9-hour shift which includes an hour-long lunch break. Shift will need to fall within the hours of 8am - 6pm Mountain / Pacific Time. Hiring Process Video Panel Interview (1-hour) Start Date - Based on candidate availability and team needs Compensation The starting pay range for this position is $23 - $25/hr; base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, skills, and experience. The total compensation package for this position may also include other elements, including equity grants in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave). Some of Boulder’s amazing benefits for regular, full-time employees Contribute to meaningful, life-saving work! Comprehensive medical, dental, vision, and short-term disability benefits designed to take care of our employees and their families Mental Health Services via insurance coverage including Talkspace and EAP for continuous care 4 weeks of vacation accrued per calendar year with a tenured increase to 5 weeks at 2 years of employment Sick leave accrued at 1 hr for every 30 hrs paid 9 Paid Holidays per year 12 weeks of 100% paid parental leave for the birth or adoption of a child (after 6 months of employment) 401(k) retirement savings Our values Patients always come first Our opportunity is also our duty Move the industry forward, follow the data Facts to change minds, empathy to change hearts Turn bold ideas into even bolder action Strong individuals, stronger together Boulder Care recognizes the value that lived experience can provide to our organization, community, and patients. Applicants with lived experience and/or training as a peer recovery specialist are encouraged to apply. For Internal Applicants: Please note: This role is housed under BCI. If your current position is in a different entity, moving into this role would require a transfer to that entity, including a shift to its associated benefits package. Please review your current entity and consider how a transfer may impact your benefits. Boulder Care believes the people who manage our product and team should be representative of those who use the platform. This includes people from backgrounds that are historically underrepresented in the industry. We celebrate differences and are committed to equal employment opportunities regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, citizenship, marital status, disability, gender identity or veteran status. If you are a qualified person with a passion for what we do, please apply!", "summaryDescription" : "Prior Authorization Specialist at Boulder Care. Skills: prior authorizations, insurance verification, patient communication. Obtain prior-authorization for all patients. Verify patient insurance information", "postedDate" : "2026-05-27T20:23:05.696", "createdAt" : "2026-05-27T20:23:05.696", "lastUpdated" : "2026-05-27T20:29:59.174", "ingestTimestamp" : "2026-05-27T20:28:57.379", "mongoId" : "6a172fac58b93c861ed0f7bb", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "salaryAnnualMin" : 47840, "salaryAnnualMax" : 52000, "salaryBand" : "30k-50k", "hasSalary" : true, "allSkills" : [ "prior authorizations", "insurance verification", "prescription processing", "medical benefits verification", "Passion for helping people", "Team player", "Reliable", "self-starter", "patient communication", "process management", "cross-functional coordination", "vendor/stakeholder management", "operational metrics", "resource planning", "continuous improvement", "addiction medicine", "substance use disorders", "medication for opioid use disorder (MOUD)", "health plans", "medical benefits", "operating system", "payer portals" ], "skillCount" : 22, "jobCategory" : "other", "jobSubcategory" : "revenue-cycle", "dataQualityScore" : 1.0, "_score" : 239.42728, "daysOld" : 0, "hasLocation" : true, "hasGeo" : false, "llmIndustry" : "healthcare" }, { "id" : "6a0fabd758b93c861e0c2131", "title" : "Prior Authorization Specialist", "company" : "Emplify Health by Gundersen", "industry" : "healthcare", "salary" : { "min" : 19.86, "max" : 19.86, "currency" : "USD", "frequency" : "yearly" }, "location" : "La Crosse, WI", "locations" : [ "La Crosse, WI", "United States of America" ], "timestamp" : "2026-05-22T03:44:00.460", "fingerprint" : "891a85671ae270038186c246e3ce331807e0b4781cb369a94b9886366ff00a27", "source" : "workday", "language" : "en", "applyUrl" : "https://gundersenhealth.wd5.myworkdayjobs.com/Gundersen/job/La-Crosse-WI/Prior-Authorization-Specialist--La-Crosse-_JR-30792", "externalId" : "JR-30792", "industryFunction" : { }, "locationPoint" : "41.31754,-86.89141", "structuredLocations" : [ { "city" : "La Crosse", "state" : "Wisconsin", "country" : "United States", "continent" : "na", "source" : "llm", "workMode" : "hybrid" }, { "city" : "Green Bay", "state" : "Wisconsin", "country" : "United States", "continent" : "na", "source" : "llm", "workMode" : "hybrid" } ], "locationText" : "La Crosse, Wisconsin, United States; Green Bay, Wisconsin, United States", "employmentType" : "FULL_TIME", "minimumEducation" : "High School Diploma or equivalency", "experienceMinYears" : 1, "experienceMaxYears" : 2, "experienceLevel" : "Entry", "professionalSkills" : [ "Prior Authorization" ], "majorSkills" : "Prior Authorization, Insurance Regulations, Communication", "majorSkillsList" : [ "Prior Authorization", "Insurance Regulations", "Communication" ], "coreResponsibilities" : "Secure prior authorizations from insurance companies, Navigate complex insurance regulations, Process paperwork effectively and efficiently, Maintain communication both verbally and written, Specialize in DME authorizations", "domainKnowledge" : "DME authorizations", "domainList" : [ "dme-authorizations" ], "domainSpecificKnowledge" : [ "DME authorizations" ], "communicationSkills" : "communication skills, both verbal and written", "continuousLearning" : "Career Development Center; Tuition Investment Program", "problemSolvingSkills" : "Excellent problem-solving abilities", "qualificationsBasic" : "1-2 years' experience in healthcare with insurance or prior authorization experience required, High School Diploma or equivalency, Excellent problem-solving abilities, attention to detail, communication skills, both verbal and written", "qualificationsPreferred" : "Coding experience and certifications is a plus", "remoteFriendly" : false, "workSiteFlexibility" : "On-site", "rawDescription" : "# **Love + medicine is who we are, it's what we do, it's why people want to work here. If you’re looking for a job to love, apply today.** **Scheduled Weekly Hours:** 40 **Emplify Health by Gundersen is looking to add a Prior Authorization Specialist to our team! In this role you will work with hospital departments and insurance companies to obtain the necessary pre-certifications and authorizations for services ordered/scheduled from insurance. Attention to detail, strong communication, and computer and phone skills are important!** **In this role, You will:** * Secure prior authorizations from insurance companies for all hospital and clinical scheduled procedures acting as a liaison between patients, physicians, and insurance providers. * Navigate complex insurance regulations and advocate for patients' needs * Process paperwork effectively and efficiently to ensure all documentation is completed * Maintain strong communication both verbally and written * This position specializes in DME authorizations **What 's Available: ** * Full time, 1.0 FTE - 40 hours/week * Monday-Friday, hours between 7:30 am -4:30 pm, 8-hour shifts * On-site position, La Crosse Main Campus * Starting pay of **$19.86/hour** + more for experience! **What You 'll Need: ** * High School Diploma or equivalency * 1-2 years' experience in healthcare with insurance or prior authorization experience required * Excellent problem-solving abilities and strong attention to detail * Strong communication skills, both verbal and written * Coding experience and certifications is a plus! **What You 'll Get: ** * Support to grow in your career with access to our Career Development Center and Tuition Investment Program * Top-rated [retirement plan and healthcare benefits](https://www.gundersenhealth.org/careers/life/employee-benefits-compensation) * Departmental leadership that supports you as you do your best work. * Work/Life balance to love what you do and where you live **Emplify Health is comprised of two of the Midwest’s most respected healthcare systems, Bellin Health and Gundersen Health System. Once neighbors, we are now partners, united in our mission to provide exceptional care to our communities. As a not-for-profit, patient-centered healthcare network, we have headquarters in Green Bay and La Crosse, Wisconsin. Our extensive network includes 11 hospitals and more than 100 clinics, serving 67 cities and rural communities across Wisconsin, Iowa, Minnesota and Michigan’s Upper Peninsula. With over 4,500 dedicated nurses and providers, we are committed to delivering primary, specialty and emergency care, along with innovative medical education programs. Join us in making a meaningful difference in the lives of our patients and communities.** If you need assistance with any portion of the application or have questions about the position, please contact [HR-Recruitment@gundersenhealth.org](mailto:HR-Recruitment@gundersenhealth.org) or call 608-775-0267. **We inspire your best life by relentlessly caring, learning and innovating. This is our purpose. Together with our values — belonging, respect, excellence, accountability, teamwork and humility — our pillars set our foundation and our future.** **Equal Opportunity Employer**", "summaryDescription" : "Prior Authorization Specialist at Emplify Health by Gundersen. Skills: Prior Authorization, Insurance Regulations, Communication. Secure prior authorizations from insurance companies. Navigate complex insurance regulations", "postedDate" : "2026-05-16T03:41:51.850", "createdAt" : "2026-05-22T03:41:51.819", "lastUpdated" : "2026-05-22T03:44:00.460", "ingestTimestamp" : "2026-05-22T03:41:51.819", "mongoId" : "6a0fabd758b93c861e0c2131", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "sourceUrl" : "https://gundersenhealth.wd5.myworkdayjobs.com/Gundersen/job/La-Crosse-WI/Prior-Authorization-Specialist--La-Crosse-_JR-30792", "salaryAnnualMin" : 41308, "salaryAnnualMax" : 41308, "salaryBand" : "30k-50k", "hasSalary" : true, "allSkills" : [ "Prior Authorization", "Insurance Regulations", "Communication", "DME authorizations" ], "skillCount" : 4, "jobCategory" : "other", "seniorityLevel" : "mid", "dataQualityScore" : 1.0, "_score" : 239.15971, "daysOld" : 6, "hasLocation" : true, "hasGeo" : false, "llmIndustry" : "healthcare" }, { "id" : "6a2eac6674d8ee00a0e6676a", "title" : "Prior Authorization Submitter", "company" : "Tobii Dynavox", "salary" : { "min" : 20.0, "max" : 20.0, "currency" : "USD", "frequency" : "yearly" }, "location" : "United States of America", "locations" : [ "United States of America" ], "timestamp" : "2026-06-15T22:48:17.772", "fingerprint" : "36248c81c167bbcba25c847879f572640de4ee77b41c2dac1f4abf8643bdd50a", "source" : "workday", "language" : "en", "applyUrl" : "https://us.wd103.myworkdayjobs.com/Tobii_Dynavox/job/Remote-US-CA/Prior-Authorization-Submitter_JR101087", "externalId" : "JR101087", "industryFunction" : { }, "locationPoint" : "51.43667,5.97917", "structuredLocations" : [ { "country" : "United States", "continent" : "na", "workMode" : "onsite" } ], "locationText" : "United States", "employmentType" : "FULL_TIME", "minimumEducation" : "High School", "experienceMinYears" : 1, "remoteFriendly" : true, "workSiteFlexibility" : "Remote", "rawDescription" : "**Why join us?** **** We’re on a mission to empower people with disabilities to do what they once did or never thought possible. As the world-leader in assistive communication solutions, we empower our customers to [_express themselves, connect with the world, and live richer lives_](https://www.tobiidynavox.com/pages/success-stories). At Tobii Dynavox, you can grow your career within [_a dynamic, global company_](https://www.tobiidynavox.com/pages/about-us) that has a clear, impactful purpose - with the flexibility to also do what truly matters to you outside of work. What’s more, you’ll be part of a work culture where collaboration is the norm and individuality is welcomed. As a member of our team, you’ll have the power to make it happen. You’ll solve challenges, deliver solutions and develop new, efficient processes that make a direct impact on our customers’ lives. **JOB SUMMARY:** The Prior Authorization Submitter (PAS) works directly with insurance companies to request a review for medical necessity and prior authorization for durable medical equipment before providing services. The PAS creates a submission packet and submits requests via online portals, faxes, and mail. _After submitting for prior authorization, the PAS regularly follows up on the submission for payer decision_. All completed steps must be noted in our electronic database of medical records. **The Prior Authorization Submitter must live in Pacific or Mountain time zones.** **KEY RESPONSIBILITIES:** * Review funded cases and verify required information to submit is present and correct * Create prior authorization packet according to payor requirements * Submit prior authorization request according to payer requirements * Save submission packet to electronic record * Document all steps taken to move case forward with authorization process * Follow up on requests submitted to payors * Perform various other tasks as assigned. * Identify and report payor trends. * Assists with other Intake functions as need to meet team goals. * Performs various other tasks as assigned. **MINIMUM QUALIFICATIONS:** EDUCATION / EXPERIENCE REQUIREMENTS: * High school diploma * One year experience working in a medical office and familiar with diagnosis codes, prior authorizations, insurance companies OR * One year experience of submitting for prior authorization for medical services. COMMUNICATION SKILLS: * Consistently demonstrate characteristics in alignment with the Tobii Values * Ability to communicate with department managers and director COMPUTER OR TECHNICAL SKILLS: * Strong MS Office Word and Outlook skills. * Comfort with using multiple online apps and programs simultaneously. * Familiar with modifying, merging, and splitting PDFs. OTHER SKILLS REQUIREMENTS: * Knowledge of coordination of benefits of Medicare, Medicaid, and third-party insurance * Detail oriented * Spending up to 90% of working hours on the phone, making outgoing calls **WORK ENVIRONMENT REQUIREMENTS:** * Ability to work at a desk for prolonged periods * Able to work with interruptions in a fast-paced environment * Ability to travel to the Pittsburgh office for team activities/ trainings (approx. 4 times per year) **We are able to pay this Prior Authorization Submitter $20/hr.** **Apply today!** We believe in empowering individuals - including our own employees - to reach their full potential. So, if you want to change lives while growing your own career, we’d love to hear from you. **Where we stand:** We believe diversity not only enriches our workplace culture, but also gives us a strategic advantage. Working with people from a variety of backgrounds and perspectives helps us all become better communicators, better problem solvers, and better human beings. Our differences make us stronger. Tobii Dynavox values equality of opportunity, human dignity, and racial/ethnic and cultural diversity. Tobii Dynavox does not discriminate against individuals on the basis of race, color, sex, sexual orientation, gender identity, religion, disability, age, veteran status, ancestry, or national or ethnic origin. Equal Opportunity Employer/AA Women/Minorities/Veterans/Disabled", "summaryDescription" : "Prior Authorization Submitter at Tobii Dynavox", "postedDate" : "2026-06-09T21:56:49.695", "createdAt" : "2026-06-14T21:56:49.643", "lastUpdated" : "2026-06-15T22:48:17.772", "ingestTimestamp" : "2026-06-14T21:56:49.643", "mongoId" : "6a2eac6674d8ee00a0e6676a", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "sourceUrl" : "https://us.wd103.myworkdayjobs.com/Tobii_Dynavox/job/Remote-US-CA/Prior-Authorization-Submitter_JR101087", "salaryAnnualMin" : 41600, "salaryAnnualMax" : 41600, "salaryBand" : "30k-50k", "hasSalary" : true, "allSkills" : [ ], "skillCount" : 0, "jobCategory" : "operations", "jobSubcategory" : "general", "seniorityLevel" : "mid", "dataQualityScore" : 0.7777778, "_score" : 237.2911, "daysOld" : 6, "hasLocation" : true, "hasGeo" : false, "llmIndustry" : "Healthcare", "llmIndustryConfidence" : 0.95 }, { "id" : "6a0de91258b93c861eb9904d", "title" : "Surgical Authorization Advocate", "industry" : "Healthcare", "salary" : { "min" : 65000.0, "max" : 85000.0, "currency" : "USD", "frequency" : "yearly", "is_estimated" : true, "estimation_basis" : "Market baseline for a Mid-level Surgical Authorization Advocate in Tampa, FL, adjusted for the healthcare industry." }, "location" : "United States-Florida-Tampa", "locations" : [ "United States-Florida-Tampa", "
USF Faculty Office Building (AMGHFOB)
13220 USF Laurel Dr

Tampa, 33612

" ], "timestamp" : "2026-06-16T06:33:26.575", "fingerprint" : "f0c8792b468eaa61ffdca564a01f1eddec1d1989502847b3a4d14745e540af7e", "source" : "taleo", "language" : "en", "applyUrl" : "https://tas-tgh.taleo.net/careersection/ex/jobdetail.ftl?job=678479", "externalId" : "678479", "industryFunction" : { }, "structuredLocations" : [ { "city" : "Tampa", "state" : "Florida", "country" : "United States", "continent" : "na", "source" : "llm", "workMode" : "onsite", "geo" : "27.9449854,-82.4583107" } ], "locationText" : "Tampa, Florida, United States", "minimumEducation" : "High School Diploma or GED", "experienceMinYears" : 3, "experienceMaxYears" : 5, "hardSkillsList" : [ "Medical terminology", "CPT coding", "ICD-10 coding" ], "hardSkills" : [ { "name" : "Medical terminology", "level" : "intermediate" }, { "name" : "CPT coding", "level" : "intermediate" }, { "name" : "ICD-10 coding", "level" : "intermediate" } ], "majorSkills" : "Surgical pre-authorizations, Pre-determinations, Insurance authorizations", "majorSkillsList" : [ "Surgical pre-authorizations", "Pre-determinations", "Insurance authorizations" ], "coreResponsibilities" : "Obtain surgical pre-authorizations, Obtain surgical pre-determinations, Process authorizations for surgical procedures, Process authorizations for injections, Process authorizations for high-end radiology", "domainKnowledge" : "Surgical procedures; High-end radiology; Medical office operations", "domainList" : [ "surgical-procedures", "high-end-radiology", "medical-office-operations" ], "domainSpecificKnowledge" : [ "Surgical procedures", "High-end radiology", "Medical office operations" ], "qualificationsBasic" : "High School Diploma or GED, 3-5 years medical office experience, Prior authorization experience, Pre-determination experience, Familiarity with CPT coding, Familiarity with ICD-10 coding, Experience with insurance payors, Experience submitting authorization requests", "qualificationsPreferred" : "Above average knowledge of medical terminology", "remoteFriendly" : false, "workSiteFlexibility" : "Onsite", "rawDescription" : "This position is responsible for obtaining Surgical Pre-Authorizations and/or Surgical Pre-Determinations for surgical procedures including injections and high-end radiology for surgery providers in assigned locations. Required: High School Diploma or GED Work Experience and Additional Information Three (3) to five (5) years medical office experience to include prior authorization and experience with pre-determination for surgical or high-end procedures. Above average knowledge of medical terminology and familiarity with CPT and ICD-10 coding. Experience with insurance payors and submitting authorization requests. Tampa", "summaryDescription" : "Surgical Authorization Advocate. Skills: Surgical pre-authorizations, Pre-determinations, Insurance authorizations. Obtain surgical pre-authorizations. Obtain surgical pre-determinations", "createdAt" : "2026-06-14T21:30:44.319", "lastUpdated" : "2026-06-16T06:33:26.575", "ingestTimestamp" : "2026-06-14T21:30:44.319", "mongoId" : "6a0de91258b93c861eb9904d", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "salaryAnnualMin" : 65000, "salaryAnnualMax" : 85000, "salaryBand" : "50k-75k", "hasSalary" : true, "allSkills" : [ "Medical terminology", "CPT coding", "ICD-10 coding", "Surgical pre-authorizations", "Pre-determinations", "Insurance authorizations", "Surgical procedures", "High-end radiology", "Medical office operations" ], "skillCount" : 9, "jobCategory" : "operations", "jobSubcategory" : "general", "seniorityLevel" : "Mid", "dataQualityScore" : 0.5555556, "_score" : 233.78221, "hasLocation" : true, "hasGeo" : true, "llmIndustry" : "Healthcare", "llmIndustryConfidence" : 0.95 }, { "id" : "6a195a5958b93c861e4aff5e", "title" : "Prior Authorization Specialist", "company" : "Cochlear", "industry" : "hearing health care", "salary" : { "min" : 23.5, "max" : 26.0, "currency" : "USD", "frequency" : "yearly" }, "location" : "Lone Tree, Colorado", "locations" : [ "Lone Tree, Colorado", "United States of America" ], "timestamp" : "2026-05-29T12:07:01.735", "fingerprint" : "76104c636ed7d7847a1ccfa5aea83fa94fae8d69902e8ee1d8b869a5ba635994", "source" : "workday", "language" : "en", "applyUrl" : "https://cochlear.wd3.myworkdayjobs.com/Cochlear_Careers/job/Lone-Tree-Colorado/Prior-Authorization-Specialist_R-623563", "externalId" : "R-623563", "industryFunction" : { }, "locationPoint" : "41.48808,-91.42599", "structuredLocations" : [ { "city" : "Lone Tree", "state" : "Colorado", "country" : "United States", "continent" : "na", "source" : "llm", "workMode" : "hybrid" } ], "locationText" : "Lone Tree, Colorado, United States", "employmentType" : "FULL_TIME", "minimumEducation" : "Bachelors or Equivalent Work Experience", "experienceMinYears" : 2, "experienceMaxYears" : 3, "experienceLevel" : "Mid", "technicalSkills" : "Microsoft Office", "professionalSkills" : [ "full-cycle prior authorization submissions", "Insurance Verification", "Prior Authorization", "Coordination of Benefits", "Out of Pocket cost estimate calculations" ], "hardSkillsList" : [ "Insurance Verification", "Prior Authorization", "Coordination of Benefits", "Out of Pocket cost estimate calculations" ], "hardSkills" : [ { "name" : "Insurance Verification", "level" : "intermediate" }, { "name" : "Prior Authorization", "level" : "intermediate" }, { "name" : "Coordination of Benefits", "level" : "intermediate" }, { "name" : "Out of Pocket cost estimate calculations", "level" : "intermediate" } ], "majorSkills" : "Prior Authorization, Insurance Verification, Customer Service", "majorSkillsList" : [ "Prior Authorization", "Insurance Verification", "Customer Service" ], "coreResponsibilities" : "Verify eligibility, Investigate insurance benefits, Validate and collect recipient out of pocket estimates, Navigate and utilize operational resources, Manage orders following date and urgency prioritization workflow, Collect documentation based on payor requirements, Evaluate medical documentation for accuracy, Submit to insurance for prior authorization, Communicate professionally with customers, Secure in network exceptions, Negotiate one-time agreements with insurance payors", "teamCollaboration" : "Work collaboratively with your peers within a region setting; Develop subject matter expertise; Work with internal stakeholders in Billing and Collections, Customer Experience and other operations teams; engage with cross functional business partners to support reimbursement processes", "domainKnowledge" : "health insurance", "domainList" : [ "health-insurance" ], "domainSpecificKnowledge" : [ "health insurance" ], "toolProficiency" : [ "phone", "fax", "copier", "email" ], "communicationSkills" : "Excellent verbal and written communication skills; Communicate professionally, effectively and clearly with customers", "continuousLearning" : "opportunity to develop your knowledge; grow professionally", "problemSolvingSkills" : "utilize problem solving/critical thinking skills; critical thinking; problem solving; reasoning; discernment of items such as product specifications, procedures and processes", "specialRequirements" : "In-person comprehensive role-based training provided, Fixed 8-hour shift schedule within business hours 8:00 a.m. – 5:00 p.m. Mountain Time, Monday through possible Saturday shift depending on business needs, Hybrid work model once training is completed and cleared by your supervisor, full in-person attendance during the initial training period, Regularly required to be in a stationary (seated/standing), Utilize business technology for work product delivery, Communicate orally and in writing with others internal or external to the organization, May be asked to occasionally transport/move up to 30 pounds, Specific vision abilities required by this job include ability to adjust focus, The individual is regularly required to utilize comprehension, critical thinking, communication, problem solving, organization reasoning, relating to others and discernment of items such as product specifications, procedures and processes to customers (whether internal or external), Influence, organization/classification of information and planning are also required, The work environment is a home/office environment", "outcomesObjectives" : "Facilitate all pre-claim activity for reimbursement orders; Providing exceptional service to internal and external customers; Provide the most efficient order process for our recipients", "qualificationsBasic" : "Bachelors or Equivalent Work Experience, 2-3 years of experience ideally working with health insurance, Insurance Verification, Prior Authorization, Coordination of Benefits, Out of Pocket cost estimate calculations, Proven ability to work collaboratively and positively in a team environment to build strong, professional relationships, Excellent computer skills (preferably in Microsoft Office), experience utilizing common office resources (phone, fax, copier and email), Excellent verbal and written communication skills", "remoteFriendly" : true, "workSiteFlexibility" : "Hybrid", "rawDescription" : "Change people’s lives and love what you do! Cochlear is the most recognized brand in hearing health care. **Prior Authorization Specialist** (Internal title: Reimbursement Operations PreClaim Specialist) **_Position Spotlight:_** * **_In-person comprehensive role-based training provided_** * ** _Fixed 8-hour shift schedule within business hours 8:00 a.m. – 5:00 p.m. Mountain Time, Monday through Friday; possible Saturday shift depending on business needs_** * ** _Hybrid work model once training is completed and cleared by your supervisor_** ** _About the role_** Change people’s lives and love what you do at Cochlear—the most recognized brand in hearing health care—helping people hear and be heard around the world, while being part of one of Denver Business Journal’s 2026 Best Places to Work honorees in Denver! In this role, you will be based in our Americas head office based in Lone Tree, CO. This role requires full in-person attendance during the initial training period and transitions to a hybrid work model based on performance, as assessed by your supervisor. If you bring experience in full-cycle prior authorization submissions and are eager to further develop your skills and advance your career, this is a fantastic opportunity to join the Reimbursement Operations team at the global leader in implantable hearing devices! Your success in this role is measured by your ability to facilitate all pre-claim activity for reimbursement orders while providing exceptional service to internal and external customers. Work collaboratively with your peers within a region setting where you will develop subject matter expertise, as well as with internal stakeholders in Billing and Collections, Customer Experience and other operations teams to provide the most efficient order process for our recipients. **_Key Responsibilities_** * Verify eligibility, investigate insurance benefits and validate coverage; calculate and collect recipient out of pocket estimates based on their deductible, coinsurance and out of pocket maximum * Navigate and utilize operational resources while managing orders following date and urgency prioritization workflow * Collect documentation based on payor requirements and medical professional preferred method * Evaluate medical documentation for accuracy, requirements and validity and submit to insurance for prior authorization when required * Communicate professionally, effectively and clearly with customers to ensure understanding and meet the customer need; engage with cross functional business partners to support reimbursement processes, orders and customers * Secure in network exceptions and negotiate one-time agreements with insurance payors in which Cochlear is non-participating ** _Key Requirements_** To add value to Cochlear in this role you'll be able to meet and demonstrate the following knowledge, skills and abilities in your application and at interview: * Bachelors or Equivalent Work Experience * 2-3 years of experience ideally working with health insurance, including but not limited to: * Insurance Verification * Prior Authorization * Coordination of Benefits * Out of Pocket cost estimate calculations * Proven ability to work collaboratively and positively in a team environment to build strong, professional relationships * Excellent computer skills (preferably in Microsoft Office) and experience utilizing common office resources (phone, fax, copier and email). * Excellent verbal and written communication skills ** _Salary and Benefits_** In addition to the opportunity to develop your knowledge and grow professionally, we offer competitive wages and benefits. * Target Salary Range/Rate: $23.50 - $26.00 per hour based upon experience, as well as an annual bonus opportunity of 5% of base salary. Compensation offered to candidate may vary based on work experience, education and/or skill level. * Benefit package includes medical, dental, vision, life and disability insurance as well as 401(K) matching with immediate vesting, Paid Time Off, tuition reimbursement, maternity and paternity leave, Employee Stock Purchase Plan and pet insurance. **_Who are we?_** Human needs have always been our inspiration, ever since Professor Graeme Clark set out to create the first multi-channel cochlear implant because he saw his father struggle with hearing loss. We always start with people in mind – thinking about their needs. For this reason, our products, services and support will continue to evolve and improve. We are by our customers’ side through the entire hearing journey, so they can experience a life full of hearing. Our employees tell us that the number one reason they enjoy working for Cochlear is the opportunity to make a difference to people’s lives and working in an organization where they can be part of bringing the mission to life each day. **_Learn more about what our employees are saying about working at Cochlear:_** _[What makes Cochlear a great place to work?](https://youtu.be/_HOqpfzjqLE)_ _[How has Cochlear supported your career development?](https://youtu.be/-hO7nPTEmdA)_ **_Physical & Mental Demands_** The physical and mental demands described below are representative of those that must be met to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the individual is regularly required to be in a stationary (seated/standing) position; utilize business technology for work product delivery, communicate orally and in writing with others internal or external to the organization, utilize problem solving/critical thinking skills to discern and convey information. May be asked to occasionally transport/move up to 30 pounds, depending on the position. Specific vision abilities required by this job include ability to adjust focus. The individual is regularly required to utilize comprehension, critical thinking, communication, problem solving, organization reasoning, relating to others and discernment of items such as product specifications, procedures and processes to customers (whether internal or external). Influence, organization/classification of information and planning are also required. The work environment is a home/office environment and are representative of those an individual encounters while performing the essential functions of this job. **_Apply now_** by completing your application form online. Applicants must meet the job specific application criteria to be considered. Visit our careers site at [www.cochlear.us/careers](http://www.cochlear.us/careers) to learn more. Cochlear Americas is an Equal Opportunity Employer. We will provide reasonable accommodations for qualified individuals with disabilities. If you require accommodation with completing the online application, please contact us via web or phone at 303-264-2549. _Application deadline: June 21, 2026_", "summaryDescription" : "Prior Authorization Specialist at Cochlear. Skills: Prior Authorization, Insurance Verification, Customer Service. Verify eligibility. Investigate insurance benefits", "postedDate" : "2026-05-26T12:03:26.384", "createdAt" : "2026-05-29T12:03:26.345", "lastUpdated" : "2026-05-29T12:07:01.735", "ingestTimestamp" : "2026-05-29T12:03:26.345", "mongoId" : "6a195a5958b93c861e4aff5e", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "sourceUrl" : "https://cochlear.wd3.myworkdayjobs.com/Cochlear_Careers/job/Lone-Tree-Colorado/Prior-Authorization-Specialist_R-623563", "salaryAnnualMin" : 48880, "salaryAnnualMax" : 54080, "salaryBand" : "30k-50k", "hasSalary" : true, "allSkills" : [ "Insurance Verification", "Prior Authorization", "Coordination of Benefits", "Out of Pocket cost estimate calculations", "Customer Service", "full-cycle prior authorization submissions", "health insurance", "phone", "fax", "copier", "email" ], "skillCount" : 11, "jobCategory" : "other", "seniorityLevel" : "mid", "dataQualityScore" : 1.0, "_score" : 233.05855, "daysOld" : 3, "hasLocation" : true, "hasGeo" : false, "llmIndustry" : "hearing health care" }, { "id" : "6a25b61674d8ee00a01be994", "title" : "Prior Authorization Specialist", "company" : "University of Rochester", "industry" : "Healthcare", "salary" : { "min" : 19.62, "max" : 26.49, "currency" : "USD", "frequency" : "yearly" }, "location" : "United States of America", "locations" : [ "United States of America" ], "timestamp" : "2026-06-12T15:16:57.152", "fingerprint" : "8cea6739ea4e8fa3e54ed4155b5e6aad6fd9f7d12b31acc53fdef1f64b9b250c", "source" : "workday", "language" : "en", "applyUrl" : "https://rochester.wd5.myworkdayjobs.com/UR_Staff/job/135-Corporate-Woods-Suite-200C/Prior-Authorization-Specialist_R271905", "externalId" : "R271905", "industryFunction" : { }, "locationPoint" : "51.43667,5.97917", "structuredLocations" : [ { "city" : "Rochester", "state" : "New York", "country" : "United States", "continent" : "na", "source" : "llm", "workMode" : "onsite", "geo" : "43.1572850,-77.6152140" } ], "locationText" : "Rochester, New York, United States", "employmentType" : "FULL_TIME", "minimumEducation" : "High School", "experienceMinYears" : 2, "professionalSkills" : [ "Medical terminology", "Insurance policies" ], "hardSkillsList" : [ "Prior authorization", "Appeals process" ], "hardSkills" : [ { "name" : "Prior authorization", "level" : "intermediate" }, { "name" : "Appeals process", "level" : "intermediate" } ], "majorSkills" : "Prior authorization, Patient scheduling, Insurance carriers", "majorSkillsList" : [ "Prior authorization", "Patient scheduling", "Insurance carriers" ], "coreResponsibilities" : "Oversee data and ensure compliance, Communicate with patients and staff, Identify insurance company barriers, Track all assistance provided, Plan and execute appeals, Follow through on process aspects, Review reporting for incomplete orders, Outreach to patients for compliance, Adhere to approved protocols, Serve as point of contact, Answer questions and solve problems, Assist in problem identification, Assist in problem quantification, Assist in problem resolution, Prepare and provide details to carriers, Obtain prior authorizations, Communicate medical information, Coordinate peer-to-peer reviews, Anticipate insurer questions, Prepare request by applying knowledge, Resolve obstacles presented by insurance, Persevere with process, Ensure applications are approved, Determine relevant information needed, Review patient charts, Outreach to patients for testing, Obtain healthcare plan referral, Work with office generated referrals", "teamCollaboration" : "Communicate with clinical staff; Communicate with non-clinical staff", "domainKnowledge" : "International Classification of Diseases; Current Procedure Technology; Medical terminology", "domainList" : [ "international-classification-of-diseases", "current-procedure-technology", "medical-terminology" ], "domainSpecificKnowledge" : [ "International Classification of Diseases", "Current Procedure Technology", "Medical terminology" ], "toolProficiency" : [ "Epic", "Payer platform" ], "documentationSkills" : "Medical information", "problemSolvingSkills" : "Problem identification; Problem resolution", "outcomesObjectives" : "Ensure applications are approved", "qualificationsBasic" : "High school diploma or equivalent, 2 years of relevant experience, Equivalent combination of education and experience", "remoteFriendly" : false, "workSiteFlexibility" : "Onsite", "rawDescription" : "As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. _**Job Location (Full Address):**_ 135 Corporate Woods, Suite 200C, Rochester, New York, United States of America, 14623 _**Opening:**_ Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500912 Primary Care Administration Work Shift: UR - Day (United States of America) Range: UR URC 205 H Compensation Range: $19.62 - $26.49 _The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job 's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations._ _**Responsibilities:**_ Oversees data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, clinical and non-clinical staff, identifying barriers insurance company barriers and tracking all assistance provided. Plans and executes, appeals and follows through on all aspects of the process which has direct, multifaceted impact on patient scheduling, treatment, care and follow up. Reviews reporting for incomplete lab and imaging orders and following protocols outreaches to patients and ancillary departments to ensure patient compliance with timely testing. Adheres to approved protocols for working referrals and prior authorizations. **ESSENTIAL FUNCTIONS** * Serves as point of contact to answer questions and solve problems for difficult and unusual authorizations. Assists in problem identification, quantification, and resolution. * Prepares and provides multiple, complex details to insurance carriers to obtain prior authorizations for both standard and complex requests, such as imaging, medications, and communicating medical information to the insurance carrier and coordinating peer-to-peer reviews for denied services. * Anticipates insurer’s various questions and prepares request by applying prior insurer decisions general medical experience and terminology, International Classification of Diseases (ICD) and Current Procedure Technology (CPT), insurance policies, permissible and non-permissible requests, necessary and appropriate medical terminology to use in order for claim to be approved, previous treatments that are necessary to report, appropriate verbiage for treatments that have been tried and not successful. Resolves obstacles presented by the insurance company by applying knowledge and experience of previous authorization requests, denials, and approvals. On behalf of the provider and the University, perseveres with the process to ensure as many applications are approved as possible without provider intervention. Determines relevant information needed, based on previous authorization request experience, for submission to carrier if first or second request is denied. * Utilizing standard Epic reporting, reviews patient charts, and as necessary, outreaches to patients to ensure completion of all provider ordered testing * Working proactively with standard Epic reporting of office generated specialist referrals, utilizes payer platform to obtain a health care plan referral for necessary specialty care * Other duties as assigned **MINIMUM EDUCATION & EXPERIENCE** * High School diploma or equivalent required * Minimum of 2 years of relevant experience required; * Or an equivalent combination of education and experience required. **KNOWLEDGE, SKILLS AND ABILITIES** * Medical terminology, EMR experience, Epic preferred; demonstrated customer service skills The University of Rochester is committed to fostering, cultivating, and preserving an inclusive and welcoming culture to advance the University’s Mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion, creed, sex, sexual orientation, citizenship status, or any other characteristic protected by federal, state, or local law (Protected Characteristics). This commitment extends to non-discrimination in the administration of our policies, admissions, employment, access, and recruitment of candidates, for all persons consistent with our values and based on applicable law.", "summaryDescription" : "Prior Authorization Specialist at University of Rochester. Skills: Prior authorization, Patient scheduling, Insurance carriers. Oversee data and ensure compliance. Communicate with patients and staff", "postedDate" : "2026-06-07T12:00:30.426", "createdAt" : "2026-06-11T12:00:30.190", "lastUpdated" : "2026-06-12T15:16:57.152", "ingestTimestamp" : "2026-06-11T12:00:30.190", "mongoId" : "6a25b61674d8ee00a01be994", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "sourceUrl" : "https://rochester.wd5.myworkdayjobs.com/UR_Staff/job/135-Corporate-Woods-Suite-200C/Prior-Authorization-Specialist_R271905", "salaryAnnualMin" : 40809, "salaryAnnualMax" : 55099, "salaryBand" : "30k-50k", "hasSalary" : true, "allSkills" : [ "Prior authorization", "Appeals process", "Patient scheduling", "Insurance carriers", "Medical terminology", "Insurance policies", "International Classification of Diseases", "Current Procedure Technology", "Epic", "Payer platform" ], "skillCount" : 10, "jobCategory" : "other", "seniorityLevel" : "mid", "dataQualityScore" : 0.8888889, "_score" : 228.13495, "daysOld" : 5, "hasLocation" : true, "hasGeo" : true, "llmIndustry" : "Healthcare" }, { "id" : "6a169fb958b93c861eb4eba3", "title" : "Prior Authorization Clerk", "company" : "MedImpact Healthcare Systems, Inc.", "industry" : "Healthcare", "salary" : { "min" : 16.72, "max" : 20.9, "currency" : "USD", "frequency" : "yearly" }, "location" : "Tempe, AZ", "locations" : [ "Tempe, AZ", "United States of America" ], "certifications" : [ "Pharmacy Technician License", "Pharmacy Technician Trainee License", "National Pharmacy Certification" ], "timestamp" : "2026-05-27T11:32:23.614", "fingerprint" : "53ae6caf1302f2593dfeab2872df0c1563f7fba7b3873bc4afb365f93062739f", "source" : "workday", "language" : "en", "applyUrl" : "https://medimpact.wd5.myworkdayjobs.com/MedImpact/job/Tempe-AZ/Prior-Authorization-Clerk-I_JR102543", "externalId" : "JR102543", "industryFunction" : { }, "locationPoint" : "-33.92335,151.1602", "structuredLocations" : [ { "city" : "Tempe", "state" : "Arizona", "country" : "United States", "continent" : "na", "source" : "llm", "workMode" : "onsite" } ], "locationText" : "Tempe, Arizona, United States", "employmentType" : "FULL_TIME", "minimumEducation" : "GED/HS Diploma", "experienceMinYears" : 1, "experienceMaxYears" : 2, "experienceLevel" : "Entry", "technicalSkills" : "MS Office, Word, Excel, Outlook, Windows based database programs, Medreponse", "professionalSkills" : [ "Data entry", "Fax verification", "Research", "Workload management", "Task instructions", "Monitoring priorities", "Process improvement", "System enhancement" ], "hardSkillsList" : [ "Data entry of Medical Exception Request Forms", "Working letters out of Failed Fax queue", "Working letters out of Unable to Mail queue", "Working letters out of Manual Print queues", "Fax verification", "Research accuracy of fax transmissions", "Initiate PA letter print", "QA of others’ work", "Handle complex research issues", "Run/create reports" ], "softSkillsList" : [ "Customer service skills", "Interpersonal communication skills", "Listening skills", "Verbal 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"name" : "Customer service skills" }, { "name" : "Interpersonal communication skills" }, { "name" : "Listening skills" }, { "name" : "Verbal communication skills" }, { "name" : "Written communication skills" }, { "name" : "Manage difficult or emotional client" }, { "name" : "Respond promptly to client" }, { "name" : "Solicit client feedback" }, { "name" : "Respond to requests for service" }, { "name" : "Meet commitments to clients" } ], "majorSkills" : "Data entry, Process improvement, Customer service", "majorSkillsList" : [ "Data entry", "Process improvement", "Customer service" ], "coreResponsibilities" : "Data entry of incoming MRFs, Dispense MRF to appropriate PA Coordinator, Fax verification and research, Work cases out of the PA Unable to Mail queue, Initiate PA letter print in Medreponse, Attend and participate in monthly staff meetings, Mentor and train PA Clerks and PACs, Accountable for QA of others’ work, Make recommendations for RTL, coaching and training, Handle complex research issues, Assist with managing the workload, Provide task instructions, Monitor priorities for the PA Clerk Team, Act as a subject matter expert", "teamCollaboration" : "Work with a team that cares about making a difference; Mentor and train PA Clerks and PACs; Provide task instructions and monitoring priorities for the PA Clerk Team; Be available for regular interactions and coordination of work with other employees, colleagues, clients; Facilitate effective decisions through collaboration with stakeholders", "domainKnowledge" : "Healthcare; Pharmacy Benefits Management", "domainList" : [ "healthcare", "pharmacy-benefits-management" ], "domainSpecificKnowledge" : [ "Healthcare", "Pharmacy Benefits Management" ], "toolProficiency" : [ "MS Office", "Word", "Excel", "Outlook", "Windows based database programs", "Medreponse" ], "communicationSkills" : "Interpersonal communication skills; Listening/verbal/written communication skills; Speak effectively before groups", "documentationSkills" : "Write simple correspondence; Write routine reports and correspondence", "continuousLearning" : "Learning on the Fly", "innovationCreativity" : "Innovative professionals; Innovative products, systems, and services", "problemSolvingSkills" : "Problem Solving; Deal with problems involving a few concrete variables in standardized situations", "specialRequirements" : "Must provide adequate support to internal, Must be available for regular interactions and coordination of work with other employees, colleagues, clients, Must be available to facilitate effective decisions through collaboration with stakeholders, Ability to work overtime from time to time, Ability to work nights, weekends or on holidays as required, Regularly required to sit, Regularly required to walk, Regularly required to use hands to finger, handle, or feel, Regularly required to reach with hands and arms, Occasionally lift and/or move up to 25 pounds, May regularly be exposed to moving mechanical parts, May regularly be exposed to high, precarious places, May regularly be exposed to fumes or airborne particles, May regularly be exposed to toxic or caustic chemicals, May regularly be exposed to outdoor weather conditions, May regularly be exposed to risk of electrical shock or vibration", "outcomesObjectives" : "Ensure prompt and accurate data entry; Improve the value of health care; Provide superior outcomes; Optimize satisfaction, service, cost, and quality", "qualificationsBasic" : "GED/HS Diploma, 1+ year experience or equivalent combination of education and experience, Intermediate knowledge of MS Office/Word, Excel, and Outlook, Aptitude for new programs, Experience with Windows based database programs, Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form, Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions, Ability to deal with problems involving a few concrete variables in standardized situations, Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals, Ability to compute rate, ratio, and percent and to draw and interpret bar graphs, Ability to read and comprehend simple instructions, short correspondence, and memos, Ability to write simple correspondence, Ability to write routine reports and correspondence, Ability to speak effectively before groups of customers or employees of organization, Composure, Decision Quality, Organizational Agility, Problem Solving, Customer Focus, Drive for Results, Peer Relations, Time Management, Dealing with Ambiguity, Learning on the Fly, Political Savvy, Sit and talk or hear, Use hands to finger, handle, or feel and reach with hands and arms, Occasionally lift and/or move up to 25 pounds", "qualificationsPreferred" : "Current Pharmacy Technician License, Pharmacy Technician Trainee License, National Pharmacy Certification", "remoteFriendly" : true, "workSiteFlexibility" : "On-site", "rawDescription" : "### Exemption Status: United States of America (Non-Exempt) ### $16.72 - $20.90 - $25.08 “Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.” This position is not eligible for Sponsorship. MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team! Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare. At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution! # **Job Description** To ensure prompt and accurate data entry of Medical Exception Request Forms (MRFs), working letters out of the Failed Fax queue, Unable to Mail, and Manual Print queues. **Essential Duties and Responsibilities** include the following. Other duties may be assigned. * Data entry of incoming MRFs as required. * Dispense MRF to appropriate PA Coordinator using established department policy and procedures in a timely manner or as needed. * Fax verification and research to ensure accuracy of fax transmissions to complete cases out of the failed fax queue. * Work cases out of the PA Unable to Mail queue as needed. * Initiate PA letter print in Medreponse out of the Manual Print queue. * Attend and participate in monthly staff meetings. * Mentor and train PA Clerks and PACs on data entry, failed faxes, manual prints, and other team related tasks as an extension of support to facilitate team growth. * Accountable for QA of others’ work and make recommendations for RTL, coaching and training. * Handle complex research issues, assist with managing the workload by running/creating reports, provide task instructions and monitoring priorities for the PA Clerk Team. * Act as a subject matter expert in process improvement and system enhancement activities pertaining to the scope of the PA Clerk role. **Supervisory Responsibilities** No supervisory responsibilities **Client Responsibilities** This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written). One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients. **Qualifications** To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. **Education and/or Experience** GED/HS Diploma and 1+ year experience or equivalent combination of education and experience **Computer Skills** Intermediate knowledge of MS Office/Word, Excel, and Outlook and aptitude for new programs. Experience with Windows based database programs is also required. **Certificates, Licenses, Registrations** Current Pharmacy Technician License, Pharmacy Technician Trainee License or National Pharmacy Certification preferred **Reasoning Ability** * Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. * Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations. **Mathematical Skills** * Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs. **Language Skills** * Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. * Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization. **Competencies** To perform the job successfully, an individual should demonstrate the following competencies: Composure Decision Quality Organizational Agility Problem Solving Customer Focus Drive for Results Peer Relations Time Management Dealing with Ambiguity Learning on the Fly Political Savvy **Physical Demands** The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee is regularly required to sit and talk or hear. The employee is regularly required to stand; walk; use hands to finger, handle, or feel and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds. **Work****Environment** The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. This position may regularly be exposed to or encounter moving mechanical parts, high, precarious places, fumes or airborne particles, toxic or caustic chemicals, outdoor weather conditions, risk of electrical shock or vibration. The noise level in the work environment is usually moderate (examples: business office with computers and printers, light traffic). **Work Location** This position works on-site at the San Diego Headquarters or other company location (or from a remote location with management approval based on business requirements). Must provide adequate support to internal clients; be available for regular interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as be available to facilitate effective decisions through collaboration with stakeholders. **Working Hours** This is a full-time non-exempt position requiring one to be able to work overtime from time to time in order to get the job done. Therefore, one must have the ability to work nights, weekends or on holidays as required. This may be changed at any time to meet the needs of the business. The typical working hours for this position are Monday through Friday from 8:00am to 5:00pm. **Travel** This position requires no travel; however, attendance may be required at various local conferences and meetings. # **_The Perks:_** * Medical / Dental / Vision / Wellness Programs * Paid Time Off / Company Paid Holidays * Incentive Compensation * 401K with Company match * Life and Disability Insurance * Tuition Reimbursement * Employee Referral Bonus To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to [www.medimpact.com/careers](http://www.medimpact.com/careers) MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets. ## Equal Opportunity Employer, Male/Female/Disabilities/Veterans ## OSHA/ADA: To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. ## Disclaimer: The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.", "summaryDescription" : "Prior Authorization Clerk at MedImpact Healthcare Systems, Inc.. Skills: Data entry, Process improvement, Customer service. Data entry of incoming MRFs. Dispense MRF to appropriate PA Coordinator", "postedDate" : "2026-05-26T11:26:17.556", "createdAt" : "2026-05-27T11:26:17.539", "lastUpdated" : "2026-05-27T11:32:23.614", "ingestTimestamp" : "2026-05-27T11:26:17.539", "mongoId" : "6a169fb958b93c861eb4eba3", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "sourceUrl" : "https://medimpact.wd5.myworkdayjobs.com/MedImpact/job/Tempe-AZ/Prior-Authorization-Clerk-I_JR102543", "salaryAnnualMin" : 34777, "salaryAnnualMax" : 43472, "salaryBand" : "30k-50k", "hasSalary" : true, "allSkills" : [ "Data entry of Medical Exception Request Forms", "Working letters out of Failed Fax queue", "Working letters out of Unable to Mail queue", "Working letters out of Manual Print queues", "Fax verification", "Research accuracy of fax transmissions", "Initiate PA letter print", "QA of others’ work", "Handle complex research issues", "Run/create reports", "Customer service skills", "Interpersonal communication skills", "Listening skills", "Verbal communication skills", "Written communication skills", "Manage difficult or emotional client", "Respond promptly to client", "Solicit client feedback", "Respond to requests for service", "Meet commitments to clients", "Data entry", "Process improvement", "Customer service", "Research", "Workload management", "Task instructions", "Monitoring priorities", "System enhancement", "Healthcare", "Pharmacy Benefits Management", "Pharmacy Technician License", "Pharmacy Technician Trainee License", "National Pharmacy Certification", "MS Office", "Word", "Excel", "Outlook", "Windows based database programs", "Medreponse" ], "skillCount" : 39, "jobCategory" : "other", "seniorityLevel" : "mid", "dataQualityScore" : 1.0, "_score" : 227.71294, "daysOld" : 1, "hasLocation" : true, "hasGeo" : false, "llmIndustry" : "Healthcare" }, { "id" : "6a257a0f74d8ee00a01877c5", "title" : "Prior Authorization Specialist", "company" : "University of Rochester", "industry" : "Healthcare", "salary" : { "min" : 19.62, "max" : 26.49, "currency" : "USD", "frequency" : "yearly" }, "location" : "United States of America", "locations" : [ "United States of America" ], "timestamp" : "2026-06-12T04:30:09.764", "fingerprint" : "1a2c9b8f0650171f1803cdb54505eadd05ee23ba121776f2179251eb0feeef2f", "source" : "workday", "language" : "en", "applyUrl" : "https://rochester.wd5.myworkdayjobs.com/UR_Staff/job/135-Corporate-Woods-Suite-200C/Prior-Authorization-Specialist_R271905", "externalId" : "R271905", "industryFunction" : { }, "locationPoint" : "51.43667,5.97917", "structuredLocations" : [ { "city" : "Rochester", "state" : "New York", "country" : "United States", "continent" : "na", "source" : "llm", "workMode" : "onsite", "geo" : "43.1572850,-77.6152140" } ], "locationText" : "Rochester, New York, United States", "employmentType" : "FULL_TIME", "minimumEducation" : "High School", "experienceMinYears" : 2, "professionalSkills" : [ "Medical terminology", "Insurance policies" ], "hardSkillsList" : [ "Prior authorization", "Appeals process" ], "hardSkills" : [ { "name" : "Prior authorization", "level" : "intermediate" }, { "name" : "Appeals process", "level" : "intermediate" } ], "majorSkills" : "Prior authorization, Patient scheduling, Insurance carrier communication", "majorSkillsList" : [ "Prior authorization", "Patient scheduling", "Insurance carrier communication" ], "coreResponsibilities" : "Oversee data and ensure compliance, Communicate with patients and staff, Identify insurance company barriers, Track all assistance provided, Plan and execute appeals, Follow through on process aspects, Review reporting for incomplete orders, Outreach to patients for compliance, Adhere to approved protocols, Serve as point of contact, Answer questions and solve problems, Assist in problem identification, Assist in problem quantification, Assist in problem resolution, Prepare details for insurance carriers, Obtain prior authorizations, Communicate medical information, Coordinate peer-to-peer reviews, Anticipate insurer questions, Prepare request by applying knowledge, Resolve obstacles presented by insurance, Persevere with process, Ensure applications are approved, Determine relevant information needed, Review patient charts, Outreach to patients for testing, Obtain healthcare plan referral, Work with office generated referrals", "teamCollaboration" : "Communicate with clinical staff; Communicate with non-clinical staff", "domainKnowledge" : "International Classification of Diseases; Current Procedure Technology; Medical terminology", "domainList" : [ "international-classification-of-diseases", "current-procedure-technology", "medical-terminology" ], "domainSpecificKnowledge" : [ "International Classification of Diseases", "Current Procedure Technology", "Medical terminology" ], "toolProficiency" : [ "Epic", "Payer platform" ], "documentationSkills" : "Clinical documentation", "problemSolvingSkills" : "Problem identification; Problem resolution", "qualificationsBasic" : "High school diploma or equivalent, 2 years of relevant experience, Equivalent combination of education and experience", "remoteFriendly" : false, "workSiteFlexibility" : "Onsite", "rawDescription" : "As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. _**Job Location (Full Address):**_ 135 Corporate Woods, Suite 200C, Rochester, New York, United States of America, 14623 _**Opening:**_ Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500912 Primary Care Administration Work Shift: UR - Day (United States of America) Range: UR URC 205 H Compensation Range: $19.62 - $26.49 _The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job 's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations._ _**Responsibilities:**_ Oversees data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, clinical and non-clinical staff, identifying barriers insurance company barriers and tracking all assistance provided. Plans and executes, appeals and follows through on all aspects of the process which has direct, multifaceted impact on patient scheduling, treatment, care and follow up. Reviews reporting for incomplete lab and imaging orders and following protocols outreaches to patients and ancillary departments to ensure patient compliance with timely testing. Adheres to approved protocols for working referrals and prior authorizations. **ESSENTIAL FUNCTIONS** * Serves as point of contact to answer questions and solve problems for difficult and unusual authorizations. Assists in problem identification, quantification, and resolution. * Prepares and provides multiple, complex details to insurance carriers to obtain prior authorizations for both standard and complex requests, such as imaging, medications, and communicating medical information to the insurance carrier and coordinating peer-to-peer reviews for denied services. * Anticipates insurer’s various questions and prepares request by applying prior insurer decisions general medical experience and terminology, International Classification of Diseases (ICD) and Current Procedure Technology (CPT), insurance policies, permissible and non-permissible requests, necessary and appropriate medical terminology to use in order for claim to be approved, previous treatments that are necessary to report, appropriate verbiage for treatments that have been tried and not successful. Resolves obstacles presented by the insurance company by applying knowledge and experience of previous authorization requests, denials, and approvals. On behalf of the provider and the University, perseveres with the process to ensure as many applications are approved as possible without provider intervention. Determines relevant information needed, based on previous authorization request experience, for submission to carrier if first or second request is denied. * Utilizing standard Epic reporting, reviews patient charts, and as necessary, outreaches to patients to ensure completion of all provider ordered testing * Working proactively with standard Epic reporting of office generated specialist referrals, utilizes payer platform to obtain a health care plan referral for necessary specialty care * Other duties as assigned **MINIMUM EDUCATION & EXPERIENCE** * High School diploma or equivalent required * Minimum of 2 years of relevant experience required; * Or an equivalent combination of education and experience required. **KNOWLEDGE, SKILLS AND ABILITIES** * Medical terminology, EMR experience, Epic preferred; demonstrated customer service skills The University of Rochester is committed to fostering, cultivating, and preserving an inclusive and welcoming culture to advance the University’s Mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion, creed, sex, sexual orientation, citizenship status, or any other characteristic protected by federal, state, or local law (Protected Characteristics). This commitment extends to non-discrimination in the administration of our policies, admissions, employment, access, and recruitment of candidates, for all persons consistent with our values and based on applicable law.", "summaryDescription" : "Prior Authorization Specialist at University of Rochester. Skills: Prior authorization, Patient scheduling, Insurance carrier communication. Oversee data and ensure compliance. Communicate with patients and staff", "postedDate" : "2026-06-07T08:50:14.141", "createdAt" : "2026-06-11T08:50:13.893", "lastUpdated" : "2026-06-12T04:30:09.764", "ingestTimestamp" : "2026-06-11T08:50:13.893", "mongoId" : "6a257a0f74d8ee00a01877c5", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "sourceUrl" : "https://rochester.wd5.myworkdayjobs.com/UR_Staff/job/135-Corporate-Woods-Suite-200C/Prior-Authorization-Specialist_R271905", "salaryAnnualMin" : 40809, "salaryAnnualMax" : 55099, "salaryBand" : "30k-50k", "hasSalary" : true, "allSkills" : [ "Prior authorization", "Appeals process", "Patient scheduling", "Insurance carrier communication", "Medical terminology", "Insurance policies", "International Classification of Diseases", "Current Procedure Technology", "Epic", "Payer platform" ], "skillCount" : 10, "jobCategory" : "other", "seniorityLevel" : "mid", "dataQualityScore" : 0.8888889, "_score" : 227.096, "daysOld" : 4, "hasLocation" : true, "hasGeo" : true, "llmIndustry" : "Healthcare" }, { "id" : "6a10566558b93c861e17ee00", "title" : "Prior Authorization Specialist", "location" : "Columbus, OH", "locations" : [ "Columbus, OH", "United States of America" ], "timestamp" : "2026-05-22T18:19:03.187", "fingerprint" : "53ff5ec4d8998c26ee0969f992a57d6f220e98cc2b9e60b6ffd205aceedcd642", "source" : "workday", "language" : "en", "applyUrl" : "https://nationwidechildrens.wd5.myworkdayjobs.com/NCHCareers/job/255-E-Main-St-Columbus-OH/Prior-Authorization-Specialist_R-23730-1", "externalId" : "R-23730", "locationPoint" : "42.68396,-75.37267", "structuredLocations" : [ { "city" : "Columbus", "state" : "Ohio", "country" : "United States", "continent" : "na", "source" : "llm", "workMode" : "onsite" } ], "locationText" : "Columbus, Ohio, United States", "employmentType" : "FULL_TIME", "minimumEducation" : "High School Diploma or equivalent", "experienceMinYears" : 2, "experienceMaxYears" : 2, "experienceLevel" : "Entry", "technicalSkills" : "Computerized billing system", "professionalSkills" : [ "Billing", "Reimbursement", "Insurance claims" ], "hardSkillsList" : [ "Insurance verification", "Claim processing", "Patient records maintenance" ], "hardSkills" : [ { "name" : "Insurance verification", "level" : "intermediate" }, { "name" : "Claim processing", "level" : "intermediate" }, { "name" : "Patient records maintenance", "level" : "intermediate" } ], "majorSkills" : "Prior Authorization, Billing, Insurance claims", "majorSkillsList" : [ "Prior Authorization", "Billing", "Insurance claims" ], "coreResponsibilities" : "Verify patient insurance coverage, Process and submit insurance claims, Communicate with patients and insurance companies, Maintain patient records, Monitor outstanding claims, Ensure compliance with regulations", "domainKnowledge" : "Homecare billing; Homecare reimbursement; Medical billing regulations", "domainList" : [ "homecare-billing", "homecare-reimbursement", "medical-billing-regulations" ], "domainSpecificKnowledge" : [ "Homecare billing", "Homecare reimbursement", "Medical billing regulations" ], "toolProficiency" : [ "Computerized billing system" ], "problemSolvingSkills" : "Resolve billing issues; Problem solving", "specialRequirements" : "Temporary position, Flexing/extending of neck, Lifting / Carrying: 0-10 lbs, Standing, Walking, Audible speech, Color vision, Computer skills, Decision Making, Depth perception, Hand use: grasping, gripping, turning, Hearing acuity, Interpreting Data, Peripheral vision, Repetitive hand/arm use, Seeing – Far/near, Sitting, Talking on the phone / in person", "qualificationsBasic" : "Two years of experience billing public and private insurers for medical services using computerized billing system", "qualificationsPreferred" : "Homecare services experience", "remoteFriendly" : true, "rawDescription" : "**Overview:** Schedule: M-F (Day shift, 40 hours per week) This is a temporary position without guarantee of conversion to full-time employment. **Job Description Summary:** Coordinates patient accounts from prior authorization to point of bill payment or referral to collection, including processing billing for home health agencies to appropriate agencies, including Medicaid and self-pay. Maintains current knowledge of changes in billing requirements and regulations and assists in resolving billing problems. **Job Description:** **Essential Functions:** * Verifies patient insurance coverage and eligibility for homecare services. * Processes and submits insurance claims for reimbursement. * Communicates with patients, insurance companies, and healthcare providers to resolve billing issues. * Maintains accurate and up-to-date patient records and billing information. * Monitors and tracks outstanding claims and follows up on unpaid or denied claims. * Ensures compliance with all relevant regulations and guidelines related to homecare billing and reimbursement. **Education Requirement:** High School Diploma or equivalent, required. **Licensure Requirement:** (not specified) **Certifications:** (not specified) **Skills:** (not specified) **Experience:** * Two years ofexperience billing public and private insurers for medical services using computerized billing system, required. * Homecare services experience, preferred. **Physical Requirements:** OCCASIONALLY: Flexing/extending of neck, Lifting / Carrying: 0-10 lbs, Standing, Walking FREQUENTLY: (none specified) CONTINUOUSLY: Audible speech, Color vision, Computer skills, Decision Making, Depth perception, Hand use: grasping, gripping, turning, Hearing acuity, Interpreting Data, Peripheral vision, Problem solving, Repetitive hand/arm use, Seeing – Far/near, Sitting **Additional Physical Requirements performed but not listed above:** Talking on the phone / in person Frequently (34 - 66%) \"The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet\"", "summaryDescription" : "Prior Authorization Specialist. Skills: Prior Authorization, Billing, Insurance claims. Verify patient insurance coverage. Process and submit insurance claims", "postedDate" : "2026-05-05T18:06:39.581", "createdAt" : "2026-05-22T18:06:39.307", "lastUpdated" : "2026-05-22T18:19:03.187", "ingestTimestamp" : "2026-05-22T18:06:39.307", "mongoId" : "6a10566558b93c861e17ee00", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "sourceUrl" : "https://nationwidechildrens.wd5.myworkdayjobs.com/NCHCareers/job/255-E-Main-St-Columbus-OH/Prior-Authorization-Specialist_R-23730-1", "hasSalary" : false, "allSkills" : [ "Insurance verification", "Claim processing", "Patient records maintenance", "Prior Authorization", "Billing", "Insurance claims", "Reimbursement", "Homecare billing", "Homecare reimbursement", "Medical billing regulations", "Computerized billing system" ], "skillCount" : 11, "jobCategory" : "other", "seniorityLevel" : "mid", "dataQualityScore" : 0.7777778, "_score" : 223.12631, "daysOld" : 17, "hasLocation" : true, "hasGeo" : false }, { "id" : "6a21c6bd74d8ee00a0d04b0b", "title" : "Prior Authorization Specialist", "company" : "Prior Authorization Specialist", "industry" : "Healthcare", "salary" : { "min" : 25.42, "max" : 30.97, "currency" : "USD", "frequency" : "yearly" }, "location" : "Remote", "locations" : [ "Remote", "United States of America" ], "timestamp" : "2026-06-05T14:15:03.012", "fingerprint" : "9a88a8f0365ca9ea317229f200b7455b0300c5097f359992e56e75b20a50cad6", "source" : "workday", "language" : "en", "applyUrl" : "https://bmc.wd1.myworkdayjobs.com/BMC/job/Remote/Prior-Authorization-Specialist-I---Patient-Access-Services_48791", "externalId" : "48791", "industryFunction" : { }, "structuredLocations" : [ { "continent" : "na", "workMode" : "remote" } ], "locationText" : "", "employmentType" : "PART_TIME", "technicalSkills" : "Epic, ADT, Prelude, Grand Centrale", "professionalSkills" : [ "Medical terminology", "ICD-9 coding", "CPT coding", "Insurance verification", "Referral authorization", "Third party billing", "Financial clearance" ], "hardSkillsList" : [ "Medical terminology", "ICD-9 coding", "CPT coding", "Insurance verification", "Referral authorization", "Third party billing", "Financial clearance" ], "softSkillsList" : [ "Independent decision making", "Judgment", "Attention to detail" ], "hardSkills" : [ { "name" : "Medical terminology", "level" : "intermediate" }, { "name" : "ICD-9 coding", "level" : "intermediate" }, { "name" : "CPT coding", "level" : "intermediate" }, { "name" : "Insurance verification", "level" : "intermediate" }, { "name" : "Referral authorization", "level" : "intermediate" }, { "name" : "Third party billing", "level" : "intermediate" }, { "name" : "Financial clearance", "level" : "intermediate" } ], "softSkills" : [ { "name" : "Independent decision making" }, { "name" : "Judgment" }, { "name" : "Attention to detail" } ], "majorSkills" : "Prior Authorization, Financial Clearance, Insurance Verification", "majorSkillsList" : [ "Prior Authorization", "Financial Clearance", "Insurance Verification" ], "coreResponsibilities" : "Screen prior-authorization requests, Coordinate specialized services requests, Adhere to policies and procedures, Maintain knowledge of network resources, Authorize specified services, Forward requests to clinician, Answer ACD line calls, Redirect calls, Coordinate financial clearance activities, Acquire patient demographic information, Validate patient demographic information, Acquire insurance information, Validate insurance information, Obtain referral authorization, Obtain precertification number, Ensure timely access to care, Maximize hospital reimbursement, Adhere to quality assurance guidelines, Support productivity standards, Prioritize incoming Prior Authorization requests, Process incoming requests, Refer authorization requests to clinician, Support Prior Authorization Clinicians, Verify member eligibility, Enter information into CCMS, Enter information into Facets, Identify network providers, Inform callers of services, Inform callers of member benefits, Inform provider of decision, Coordinate resolution of escalated inquiries, Promote understanding of requirements, Promote understanding of processes, Maintain understanding of member handbooks, Maintain understanding of evidence of coverage, Monitor registration work queues, Monitor prior authorization work queues, Obtain patient financial clearance elements, Obtain payer-specific financial clearance elements, Comply with insurance companies' requirements, Complete activities to facilitate financial clearance, Navigate BMC policies, Navigate payer policies, Obtain appropriate approvals, Obtain authorizations, Obtain pre-certs, Obtain referrals, Help clinicians understand payer requirements, Use appropriate strategies for insurance verification, Use appropriate strategies for authorizations, Use appropriate strategies for referrals, Obtain referral prior authorizations, Document referral prior authorizations, Obtain managed care referrals, Obtain prior authorizations for specialty visits, Record referrals, Record prior authorizations, Ensure approval numbers are linked, Obtain necessary information, Obtain payer permissions, Liaise between physician and payer, Escalate denied accounts, Escalate accounts not financially cleared, Interview patients via telephone, Interview families via telephone, Interview referring physicians via telephone, Obtain financial information, Obtain demographic information, Ensure updated demographic information is recorded, Ensure updated insurance information is recorded, Reconcile registration information, Reconcile insurance information", "teamCollaboration" : "Interact with stakeholders; Collaborate with insurance company representatives; Collaborate with patients; Collaborate with physicians; Collaborate with BMC practice staff; Collaborate with case management; Collaborate with Patient Financial Counseling; Collaborate with primary care practices; Collaborate with specialty practices; Collaborate with referring physicians; Collaborate with primary care physicians; Collaborate with insurance carriers; Collaborate with other departments; Collaborate with managers; Collaborate with colleagues; Collaborate with third party payers", "domainKnowledge" : "Medical care management; Managed care; Payer policies; BMC policies; Patient access; Revenue Cycle; Health insurance; Medical terminology; ICD-9 coding; CPT coding", "domainList" : [ "medical-care-management", "managed-care", "payer-policies", "bmc-policies", "patient-access", "revenue-cycle", "health-insurance", "medical-terminology", "icd-9-coding", "cpt-coding" ], "domainSpecificKnowledge" : [ "Medical care management", "Managed care", "Payer policies", "BMC policies", "Patient access", "Revenue Cycle", "Health insurance", "Medical terminology", "ICD-9 coding", "CPT coding" ], "toolProficiency" : [ "CCMS", "Facets", "Epic" ], "communicationSkills" : "Oral communication; Written communication", "documentationSkills" : "Document referral prior authorizations", "problemSolvingSkills" : "Independent decision making; Judgment; Problem solving", "specialRequirements" : "Maintain confidentiality of sensitive information", "outcomesObjectives" : "Meet or exceed position metrics; Meet Turn-Around Timeframes; Maintain full caseload", "qualificationsBasic" : "Process high volume requests with 95% accuracy, Prioritize work load per guidelines, Meet Turn-Around Timeframes, Maintain full caseload, Thorough knowledge of financial clearance process, Familiarity with insurances, Familiarity with referral authorizations, Familiarity with third party billing procedures, Basic computer proficiency, Proficiency in Microsoft Suite, Proficiency in Excel, Proficiency in Word, Proficiency in Outlook, Proficiency in Zoom, Maintain strict confidentiality", "qualificationsPreferred" : "Bilingual preferred, Knowledge of basic medical terminology, Knowledge of ICD-9/CPT coding, Experience within Epic preferred, Knowledge of medical terminology, Knowledge of coding", "remoteFriendly" : true, "workSiteFlexibility" : "Remote", "rawDescription" : "**POSITION SUMMARY** : Responsible for screening prior-authorization and coordination of specialized services requests in the medical care management program, including a broad range of requests for inpatient, outpatient and ancillary services. Adheres to policies and procedures in order to comply with performance and compliance standards and to ensure cost effective and appropriate healthcare delivery. Maintains current knowledge of network resources for referral and linkage to member’s and provider’s needs. Authorizes certain specified services, under the supervision of the manager, according to departmental guidelines. Per standard workflows, forwards specified requests to the clinician for review and processing. Answers ACD line calls from providers and other departments and redirects, as needed. The Prior Authorization Specialist role belongs to the Revenue Cycle Patient Access team and is responsible for coordinating all financial clearance activities by navigating all pre-registration (to include acquiring or validating patient demographic, insurance, and other required elements along with insurance verification activities), obtaining referral authorization, or precertification number(s). The role ensures timely access to care while maximizing BMC hospital reimbursement. This role requires adherence to quality assurance guidelines as well as established productivity standards to support the work unit’s performance expectations. This position reports to the Patient Access Supervisor and requires interaction and collaboration with important stakeholders in the financial clearance process including but not limited to insurance company representatives, patients, physicians, Boston Medical Center (BMC) practice staff, case management and Patient Financial Counseling. This is a Remote Position. **Position** : Prior Authorization Specialist **Department** : Insurance Verification **Schedule** : Part Time (8:30A-3P) **ESSENTIAL RESPONSIBILITIES & DUTIES**: * Prioritizes incoming Prior Authorization requests. * Processes incoming requests, including authorizing specified services, as outlined in departmental policies, procedures, and workflow guidelines. * Refers authorization requests that require clinical judgment to Prior Authorization Clinician, Manager, or Medical Director. * Meets or exceeds position metrics and Turn-Around Timeframes while maintaining a full caseload. * Supports Prior Authorization Clinicians. * Answers ACD line calls, verifies member eligibility and enters into CCMS or Facets the information necessary to complete the caller’s request. * Identifies and informs callers of network providers, services, and available member benefits. * Informs provider of decision per department procedure. * Coordinates resolution of escalated member or provider inquiries as related to Prior Authorization. * Works with members, providers and key departments to promote an understanding of Prior Authorization requirements and processes. * Maintains general understanding of applicable sections of member handbooks, and evidence of coverage. * Monitors accounts routed to registration and prior authorization work queues and clears work queues by obtaining all necessary patient and/or payer-specific financial clearance elements in accordance with established management guidelines. * Maintains knowledge of and complies with insurance companies’ requirements for obtaining prior authorizations/referrals, and completes other activities to facilitate all aspects of financial clearance. * Acts as subject matter experts in navigating both the BMC and payer policies to get the appropriate approvals (authorizations, pre-certs, referrals, for example) for the scheduled care to proceed. The Authorization Specialist is an important part of the larger patient care team and helps clinicians understand what payer requirements are necessary for the widest possible patient access to services. * Uses appropriate strategies to underscore the most efficient process to obtaining insurance verification, authorizations and referrals, including on line databases, electronic correspondence, faxes, and phone calls. * Obtains and clearly documents all referral/prior authorizations for scheduled services prior to admission within the Epic environment. * Works collaboratively with primary care practices, specialty practices, referring physicians, primary care physicians, insurance carriers, patients and any other parties to ensure that required managed care referrals and prior authorizations for specified specialty visits and other services are obtained and appropriately recorded in the relevant practice management systems for patient appointments/visits prior to scheduled patient visits or retro-actively if not in place at the time of the appointment/visit. Ensure that approval numbers are appropriately linked to the relevant patient appointment/visit. * Collaborates with patients, providers, and departments to obtain all necessary information and payer permissions prior to patients’ scheduled services. * Liaison between physician and payer for peer to peer review when needed * Escalates accounts that have been denied or will not be financially cleared as outlined by department policy * Interview patients, families or referring physicians via telephone in advance of the patient’s appointment/visit whenever possible, to obtain all necessary information, including but not limited to, financial and demographic information required for reimbursement and compliance for services rendered. * Ensure that all updated demographic and insurance information is accurately recorded in the appropriate registration systems for primary, secondary and tertiary insurances. * Review all registration and insurance information in systems and reconcile with information available from insurance carriers. For any insurance updates, utilize any available resources to validate the updated insurance information, insurance plan eligibility, primary care physician, subscriber information, employer information and appointment/visit information. Contact patients as necessary if clarifications or other follow-up is required, and at all times maintain sensitivity and a clear customer friendly approach. * For self-pay patients or patients with unresolved insurance, and for financial counseling, refer patients Patient Financial Counseling. * Maintains confidentiality of patient’s financial and medical records; adheres to the State and Federal laws regulating collection in healthcare; adheres to enterprise and other regulatory confidentiality policies; and advises management of any potential compliance issues immediately. * Participates in educational offerings sponsored by BMC or other development opportunities as assigned/available and complies with all applicable organizational workflows, as well as established policies and procedures. * Demonstrates knowledge & skills necessary to provide level of customer experience as aligned with BMC management expectations. * Demonstrates the ability to recognize situations that require escalation to the Supervisor. * Takes opportunity to know and learn other roles and processes and works together to assist with process improvement initiatives as directed. * Consistently meets productivity and quality expectations to align performance with assigned roles and responsibilities. * Handle ACD telephone calls and emails in a timely fashion, following applicable scripting and customer service standards. Appropriately manage all calls by either working with the customer or referring the call to the appropriate party. * Regularly undergo Quality Audits to achieve the required standard. * Contact the Help Desk in the BMC Information Technology Department to report faulty systems or hardware. Notify area supervisor or manager if problem is not addressed in a timely manner. For other broken or malfunctioning equipment to be serviced, contact the appropriate vendor or department and notify supervisor. * Communicate with all internal and external customers effectively and courteously. * Attend all necessary hospital and department training as required. * Assists in the orientation of new personnel under the direction of a manager or Supervisor. * Perform other related duties as assigned or required. * Must adhere to all of BMC’s RESPECT behavioral standards. (The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required). **JOB REQUIREMENTS** **EDUCATION** : * High school diploma or GED required. * Associate’s Degree or higher preferred. **EXPERIENCE** : * 4-5 years of office experience, specifically in either a high volume data entry office, customer service call center or health care office or hospital administration is required. * Experience using Insurance payer websites (i.e Blue Cross Blue Shield, Medicare, etc.) * Customer service experience preferred. * Experience with insurance verification, prior authorization, pre-certification and financial clearance process. **KNOWLEDGE, SKILLS & ABILITIES (KSAs):** * Bilingual preferred * Ability to process high volume of requests with a 95% or greater accuracy rate * Ability to prioritize work load when processing referrals and authorization requests per guidelines and within specified Turn Around Timeframes * Effective collaboration skills * Strong oral and written communication skills * Thorough knowledge of financial clearance process is a must. Familiarity with insurances, referral authorizations and third party billing procedures. * Knowledge of basic medical terminology and ICD-9/CPT coding is helpful. * Excellent interpersonal skills to build and maintain strong relationships with managers, colleagues, and third party payers. * Must be self-directed and highly organized with the ability to multitask, manage complex processes, and maintain fair sense of urgency. * Requires ability to make independent decisions under pressure. * Requires excellent judgment, diplomacy, collaboration, partnering, teamwork, and customer service skills. * Ability to maintain confidentiality of all personal/health sensitive information. * Must be comfortable with ambiguity, exhibit good decision making and judgment capabilities, attention to detail. * Knowledge of and experience within Epic is preferred. * Demonstrates technical proficiency within assigned Epic work queues and applicable ancillary systems, including but not limited to: ADT/Prelude/Grand Centrale. * Must be able to maintain strict confidentiality of all personal/health sensitive information. * Basic computer proficiency inclusive of ability to access, enter and interpret computerized data/information including proficiency in Microsoft Suite applications, specifically Excel, Word, Outlook and Zoom. * Knowledge of medical terminology and/ or coding. **Compensation Range:** $25.42- $30.97 This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, and licensure/certifications directly related to position requirements. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), contract increases, Flexible Spending Accounts, 403(b) savings matches, earned time cash out, paid time off, career advancement opportunities, and resources to support employee and family wellbeing. Equal Opportunity Employer/Disabled/Veterans According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or “apps” job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.", "summaryDescription" : "Prior Authorization Specialist at Prior Authorization Specialist. Skills: Prior Authorization, Financial Clearance, Insurance Verification. Screen prior-authorization requests. Coordinate specialized services requests", "postedDate" : "2026-06-03T21:49:31.267", "createdAt" : "2026-06-04T21:49:31.217", "lastUpdated" : "2026-06-05T14:15:03.012", "ingestTimestamp" : "2026-06-04T21:49:31.217", "mongoId" : "6a21c6bd74d8ee00a0d04b0b", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "sourceUrl" : "https://bmc.wd1.myworkdayjobs.com/BMC/job/Remote/Prior-Authorization-Specialist-I---Patient-Access-Services_48791", "salaryAnnualMin" : 52873, "salaryAnnualMax" : 64417, "salaryBand" : "50k-75k", "hasSalary" : true, "allSkills" : [ "Medical terminology", "ICD-9 coding", "CPT coding", "Insurance verification", "Referral authorization", "Third party billing", "Financial clearance", "Independent decision making", "Judgment", "Attention to detail", "Prior Authorization", "Financial Clearance", "Insurance Verification", "Medical care management", "Managed care", "Payer policies", "BMC policies", "Patient access", "Revenue Cycle", "Health insurance", "CCMS", 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"https://aah.wd5.myworkdayjobs.com/External/job/Winston-Salem-NC---1200-N-Martin-Luther-King-Jr-Dr/Pharmacy-Technician-Specialist-I--Downtown-Health-Plaza_R235091", "externalId" : "R235091", "industryFunction" : { }, "locationPoint" : "36.09986,-80.24422", "structuredLocations" : [ { "city" : "Winston Salem", "state" : "North Carolina", "country" : "United States", "continent" : "na", "source" : "llm", "workMode" : "onsite" } ], "locationText" : "Winston Salem, North Carolina, United States", "employmentType" : "FULL_TIME", "minimumEducation" : "High school diploma or GED equivalent", "technicalSkills" : "EHR, payer portals, fax systems", "professionalSkills" : [ "process management", "cross-functional coordination", "vendor/stakeholder management", "operational metrics", "resource planning", "continuous improvement", "medication prior authorization (PA) processes", "insurance processing", "ambulatory pharmacy workflows", "insurance plans", "formularies", "medication access processes" ], "hardSkillsList" : [ "Complete and submit prior authorization requests for medications prescribed in primary care clinics", "Review patient charts and insurance requirements to gather necessary clinical documentation", "Prepare and submit PA forms via EHR, payer portals, and fax systems as required", "Track and follow up on submitted prior authorizations to ensure timely approvals or denials", "Communicate PA status updates to providers, nurses, and care teams in a timely manner", "Partner closely with embedded pharmacists (if applicable) for complex cases", "Communicate with payers and pharmacy benefit managers (PBMs) to obtain coverage details", "Coordinate appeals and resubmissions for denied authorizations as directed", "Identify formulary alternatives and escalate to pharmacists/providers when appropriate", "Maintain accurate documentation of all PA activity within the electronic health record", "Collaborate with clinic staff to resolve medication access barriers (coverage, cost, delays)", "Support urgent or high-priority requests to prevent interruptions in patient therapy", "Complies with legal, regulatory, and accreditation standards.", "Keeps current with changes in the specialized field and collaborates with department leadership to adopt best practices.", "Maintains updated knowledge and skills and contributes to the education of others.", "Contributes positively to execution of pharmacy department initiatives", "Accepts assignments of tasks from other pharmacy teammate roles when workload dictates." ], "softSkillsList" : [ "attention to detail", "ability to manage high-volume workflows", "Effective communication with interdisciplinary teams", "Time management and prioritization across multiple clinics", "Problem-solving skills related to medication access barriers", "Ability to navigate payer systems and documentation requirements" ], "hardSkills" : [ { "name" : "Complete and submit prior authorization requests for medications prescribed in primary care clinics", "level" : "intermediate" }, { "name" : "Review patient charts and insurance requirements to gather necessary clinical documentation", "level" : "intermediate" }, { "name" : "Prepare and submit PA forms via EHR, payer portals, and fax systems as required", "level" : "intermediate" }, { "name" : "Track and follow up on submitted prior authorizations to ensure timely approvals or denials", "level" : "intermediate" }, { "name" : "Communicate PA status updates to providers, nurses, and care teams in a timely manner", "level" : "intermediate" }, { "name" : "Partner closely with embedded pharmacists (if applicable) for complex cases", "level" : "intermediate" }, { "name" : "Communicate with payers and pharmacy benefit managers (PBMs) to obtain coverage details", "level" : "intermediate" }, { "name" : "Coordinate appeals and resubmissions for denied authorizations as directed", "level" : "intermediate" }, { "name" : "Identify formulary alternatives and escalate to pharmacists/providers when appropriate", "level" : "intermediate" }, { "name" : "Maintain accurate documentation of all PA activity within the electronic health record", "level" : "intermediate" }, { "name" : "Collaborate with clinic staff to resolve medication access barriers (coverage, cost, delays)", "level" : "intermediate" }, { "name" : "Support urgent or high-priority requests to prevent interruptions in patient therapy", "level" : "intermediate" }, { "name" : "Complies with legal, regulatory, and accreditation standards.", "level" : "intermediate" }, { "name" : "Keeps current with changes in the specialized field and collaborates with department leadership to adopt best practices.", "level" : "intermediate" }, { "name" : "Maintains updated knowledge and skills and contributes to the education of others.", "level" : "intermediate" }, { "name" : "Contributes positively to execution of pharmacy department initiatives", "level" : "intermediate" }, { "name" : "Accepts assignments of tasks from other pharmacy teammate roles when workload dictates.", "level" : "intermediate" } ], "softSkills" : [ { "name" : "attention to detail" }, { "name" : "ability to manage high-volume workflows" }, { "name" : "Effective communication with interdisciplinary teams" }, { "name" : "Time management and prioritization across multiple clinics" }, { "name" : "Problem-solving skills related to medication access barriers" }, { "name" : "Ability to navigate payer systems and documentation requirements" } ], "majorSkills" : "medication prior authorization (PA) processes, cross-functional coordination, vendor/stakeholder management, operational metrics, resource planning, continuous improvement", "majorSkillsList" : [ "medication prior authorization (PA) processes", "cross-functional coordination", "vendor/stakeholder management", "operational metrics", "resource planning", "continuous improvement" ], "coreResponsibilities" : "Supports two primary care clinics by managing medication prior authorization (PA) processes., Serves as a liaison between providers, payers, pharmacies, and patients to ensure timely medication access., Works under pharmacist and/or clinic leadership to optimize medication access outcomes., Complete and submit prior authorization requests for medications prescribed in primary care clinics, Review patient charts and insurance requirements to gather necessary clinical documentation, Prepare and submit PA forms via EHR, payer portals, and fax systems as required, Track and follow up on submitted prior authorizations to ensure timely approvals or denials, Communicate PA status updates to providers, nurses, and care teams in a timely manner, Partner closely with embedded pharmacists (if applicable) for complex cases, Communicate with payers and pharmacy benefit managers (PBMs) to obtain coverage details, Coordinate appeals and resubmissions for denied authorizations as directed, Identify formulary alternatives and escalate to pharmacists/providers when appropriate, Maintain accurate documentation of all PA activity within the electronic health record, Collaborate with clinic staff to resolve medication access barriers (coverage, cost, delays), Support urgent or high-priority requests to prevent interruptions in patient therapy", "teamCollaboration" : "Serves as a liaison between providers, payers, pharmacies, and patients to ensure timely medication access.; Partner closely with embedded pharmacists (if applicable) for complex cases; Collaborate with clinic staff to resolve medication access barriers (coverage, cost, delays); Effective communication with interdisciplinary teams.", "domainKnowledge" : "pharmacy; medication prior authorization (PA) processes; insurance processing; ambulatory pharmacy workflows; insurance plans; formularies; medication access processes", "domainList" : [ "pharmacy", "medication-prior-authorization-pa-processes", "insurance-processing", "ambulatory-pharmacy-workflows", "insurance-plans", "formularies", "medication-access-processes" ], "domainSpecificKnowledge" : [ "pharmacy", "medication prior authorization (PA) processes", "insurance processing", "ambulatory pharmacy workflows", "insurance plans", "formularies", "medication access processes" ], "toolProficiency" : [ "EHR", "payer portals", "fax systems", "Epic" ], "communicationSkills" : "Effective communication with interdisciplinary teams.; Communicate PA status updates to providers, nurses, and care teams in a timely manner; Communicate with payers and pharmacy benefit managers (PBMs) to obtain coverage details", "documentationSkills" : "Maintain accurate documentation of all PA activity within the electronic health record", "continuousLearning" : "Keeps current with changes in the specialized field and collaborates with department leadership to adopt best practices.; Maintains updated knowledge and skills and contributes to the education of others.", "problemSolvingSkills" : "Problem-solving skills related to medication access barriers.", "specialRequirements" : "Fully onsite clinic-supporting role, Mondays-Fridays 8a-5p, Winston Salem, Downtown Health Plaza and Winston East (Kennedy Hopkins Clinic), $6,000 sign-on bonus eligible position for qualified candidates!", "outcomesObjectives" : "Turnaround time for PA submissions.; Approval rate and appeal success rate.; Timely communication with clinic teams.; Reduction in delays to therapy initiation.", "qualificationsBasic" : "High school diploma or GED equivalent required., For technicians in NC with validating technician responsibilities- an associate’s degree in pharmacy technology is required per guidelines on PTCB., Registration/Licensure with state board of pharmacy per state of employment requirements., Certification through Pharmacy Technician Certification Board (CPhT) or National Health Career Association (ExCPT) required.", "qualificationsPreferred" : "Experience with prior authorizations, insurance processing, or ambulatory pharmacy workflows preferred., Familiarity with Epic or similar EHR systems preferred., understanding of insurance plans, formularies, and medication access processes., Bilingual (Spanish-speaking) preferred but not required.", "remoteFriendly" : true, "workSiteFlexibility" : "No", "rawDescription" : "**Department:** 12847 Wake Forest Baptist Medical Center - Administration: Regional Facilities; Downtown Hlth Plz **Status:** Full time **Benefits Eligible:** Yes **Hou****rs Per Week:** 40 **Schedule Details/Additional Information:** Mondays-Fridays 8a-5p **Pay Range** $24.10 - $36.15 ** _Position Highlights_** * Fully onsite clinic-supporting role * Full-Time, Days * 1st shift, M-F, 8a-5p * Winston Salem, Downtown Health Plaza and Winston East (Kennedy Hopkins Clinic) * Bilingual (Spanish-speaking) preferred but not required. * $6,000 sign-on bonus eligible position for qualified candidates! _Click_[ _here_](https://www.wakehealth.edu/specialty/n/nursing/sign-on-bonus-program) _for more information!_ **Summary:** * Supports two primary care clinics by managing medication prior authorization (PA) processes. * Serves as a liaison between providers, payers, pharmacies, and patients to ensure timely medication access. * Works under pharmacist and/or clinic leadership to optimize medication access outcomes. **Major Responsibilities:** * Complete and submit prior authorization requests for medications prescribed in primary care clinics * Review patient charts and insurance requirements to gather necessary clinical documentation * Prepare and submit PA forms via EHR, payer portals, and fax systems as required * Track and follow up on submitted prior authorizations to ensure timely approvals or denials * Communicate PA status updates to providers, nurses, and care teams in a timely manner * Partner closely with embedded pharmacists (if applicable) for complex cases * Communicate with payers and pharmacy benefit managers (PBMs) to obtain coverage details * Coordinate appeals and resubmissions for denied authorizations as directed * Identify formulary alternatives and escalate to pharmacists/providers when appropriate * Maintain accurate documentation of all PA activity within the electronic health record * Collaborate with clinic staff to resolve medication access barriers (coverage, cost, delays) * Support urgent or high-priority requests to prevent interruptions in patient therapy * Complies with legal, regulatory, and accreditation standards. * Keeps current with changes in the specialized field and collaborates with department leadership to adopt best practices. * Maintains updated knowledge and skills and contributes to the education of others. * Contributes positively to execution of pharmacy department initiatives * Accepts assignments of tasks from other pharmacy teammate roles when workload dictates. **What You Will Need:** * High school diploma or GED equivalent required. * For technicians in NC with validating technician responsibilities- an associate’s degree in pharmacy technology is required per guidelines on PTCB. * Registration/Licensure with state board of pharmacy per state of employment requirements. * Certification through Pharmacy Technician Certification Board (CPhT) or National Health Career Association (ExCPT) required. **Nice to Have (Not Required):** * Experience with prior authorizations, insurance processing, or ambulatory pharmacy workflows preferred. * Familiarity with Epic or similar EHR systems preferred. * Strong understanding of insurance plans, formularies, and medication access processes. * Bilingual (Spanish-speaking) preferred but not required. **Key Skills** * Strong attention to detail and ability to manage high-volume workflows. * Effective communication with interdisciplinary teams. * Time management and prioritization across multiple clinics. * Problem-solving skills related to medication access barriers. * Ability to navigate payer systems and documentation requirements. **Performance Focus Areas** * Turnaround time for PA submissions. * Approval rate and appeal success rate. * Timely communication with clinic teams. * Reduction in delays to therapy initiation. _This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties._ **Our Commitment to You:** Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including: **Compensation** * Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training * Premium pay such as shift, on call, and more based on a teammate's job * Incentive pay for select positions * Opportunity for annual increases based on performance **Benefits and more** * Paid Time Off programs * Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability * Flexible Spending Accounts for eligible health care and dependent care expenses * Family benefits such as adoption assistance and paid parental leave * Defined contribution retirement plans with employer match and other financial wellness programs * Educational Assistance Program Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview. **About Advocate Health** [Advocate Health](https://www.advocatehealth.org/) is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names [Advocate Health Care](https://www.advocatehealth.com/) in Illinois; [Atrium Health](https://atriumhealth.org/) in the Carolinas, Georgia and Alabama; and [Aurora Health Care](https://www.aurorahealthcare.org/) in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with [Wake Forest University School of Medicine](https://school.wakehealth.edu/) serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.", "summaryDescription" : "Pharmacy Technician Specialist - Prior Authorizations at Wake Forest Baptist Medical Center. Skills: medication prior authorization (PA) processes, cross-functional coordination, vendor/stakeholder management, operational metrics, resource planning, continuous improvement. Supports two primary care clinics by managing medication prior authorization (PA) processes.. 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"Epic" ], "skillCount" : 42, "jobCategory" : "engineering", "seniorityLevel" : "mid", "dataQualityScore" : 0.8888889, "_score" : 218.30786, "daysOld" : 4, "hasLocation" : true, "hasGeo" : false, "llmIndustry" : "health system" }, { "id" : "6a0a15671663d49372b4bc52", "title" : "Pharmacy Technician Specialist - Prior Authorizations", "company" : "Wake Forest Baptist Medical Center", "industry" : "health system", "salary" : { "min" : 24.1, "max" : 36.15, "currency" : "USD", "frequency" : "yearly" }, "location" : "Winston Salem, NC - 1200 N Martin Luther King Jr Dr", "locations" : [ "Winston Salem, NC - 1200 N Martin Luther King Jr Dr", "United States of America" ], "certifications" : [ "Pharmacy Technician Certification Board (CPhT)", "National Health Career Association (ExCPT)" ], "timestamp" : "2026-05-18T04:23:23.301", "fingerprint" : "1aadaa48770d447c661bf92d17d5895181b2dcd7f0cf90765e0230b5ab2fdd7e", "source" : "workday", "language" : "en", "applyUrl" : "https://aah.wd5.myworkdayjobs.com/External/job/Winston-Salem-NC---1200-N-Martin-Luther-King-Jr-Dr/Pharmacy-Technician-Specialist-I--Downtown-Health-Plaza_R235091", "externalId" : "R235091", "industryFunction" : { }, "locationPoint" : "36.09986,-80.24422", "structuredLocations" : [ { "city" : "Winston Salem", "state" : "North Carolina", "country" : "United States", "continent" : "na", "source" : "llm", "workMode" : "onsite" } ], "locationText" : "Winston Salem, North Carolina, United States", "employmentType" : "FULL_TIME", "minimumEducation" : "High school diploma or GED equivalent", "technicalSkills" : "EHR, payer portals, fax systems", "professionalSkills" : [ "process management", "cross-functional coordination", "vendor/stakeholder management", "operational metrics", "resource planning", "continuous improvement", "medication prior authorization (PA) processes", "insurance processing", "ambulatory pharmacy workflows", "insurance plans", "formularies", "medication access processes" ], "hardSkillsList" : [ "Complete and submit prior authorization requests for medications prescribed in primary care clinics", "Review patient charts and insurance requirements to gather necessary clinical documentation", "Prepare and submit PA forms via EHR, payer portals, and fax systems as required", "Track and follow up on submitted prior authorizations to ensure timely approvals or denials", "Communicate PA status updates to providers, nurses, and care teams in a timely manner", "Partner closely with embedded pharmacists (if applicable) for complex cases", "Communicate with payers and pharmacy benefit managers (PBMs) to obtain coverage details", "Coordinate appeals and resubmissions for denied authorizations as directed", "Identify formulary alternatives and escalate to pharmacists/providers when appropriate", "Maintain accurate documentation of all PA activity within the electronic health record", "Collaborate with clinic staff to resolve medication access barriers (coverage, cost, delays)", "Support urgent or high-priority requests to prevent interruptions in patient therapy", "Complies with legal, regulatory, and accreditation standards.", "Keeps current with changes in the specialized field and collaborates with department leadership to adopt best practices.", "Maintains updated knowledge and skills and contributes to the education of others.", "Contributes positively to execution of pharmacy department initiatives", "Accepts assignments of tasks from other pharmacy teammate roles when workload dictates." ], "softSkillsList" : [ "attention to detail", "ability to manage high-volume workflows", "Effective communication with interdisciplinary teams", "Time management and prioritization across multiple clinics", "Problem-solving skills related to medication access barriers", "Ability to navigate payer systems and documentation requirements" ], "hardSkills" : [ { "name" : "Complete and submit prior authorization requests for medications prescribed in primary care clinics", "level" : "intermediate" }, { "name" : "Review patient charts and insurance requirements to gather necessary clinical documentation", "level" : "intermediate" }, { "name" : "Prepare and submit PA forms via EHR, payer portals, and fax systems as required", "level" : "intermediate" }, { "name" : "Track and follow up on submitted prior authorizations to ensure timely approvals or denials", "level" : "intermediate" }, { "name" : "Communicate PA status updates to providers, nurses, and care teams in a timely manner", "level" : "intermediate" }, { "name" : "Partner closely with embedded pharmacists (if applicable) for complex cases", "level" : "intermediate" }, { "name" : "Communicate with payers and pharmacy benefit managers (PBMs) to obtain coverage details", "level" : "intermediate" }, { "name" : "Coordinate appeals and resubmissions for denied authorizations as directed", "level" : "intermediate" }, { "name" : "Identify formulary alternatives and escalate to pharmacists/providers when appropriate", "level" : "intermediate" }, { "name" : "Maintain accurate documentation of all PA activity within the electronic health record", "level" : "intermediate" }, { "name" : "Collaborate with clinic staff to resolve medication access barriers (coverage, cost, delays)", "level" : "intermediate" }, { "name" : "Support urgent or high-priority requests to prevent interruptions in patient therapy", "level" : "intermediate" }, { "name" : "Complies with legal, regulatory, and accreditation standards.", "level" : "intermediate" }, { "name" : "Keeps current with changes in the specialized field and collaborates with department leadership to adopt best practices.", "level" : "intermediate" }, { "name" : "Maintains updated knowledge and skills and contributes to the education of others.", "level" : "intermediate" }, { "name" : "Contributes positively to execution of pharmacy department initiatives", "level" : "intermediate" }, { "name" : "Accepts assignments of tasks from other pharmacy teammate roles when workload dictates.", "level" : "intermediate" } ], "softSkills" : [ { "name" : "attention to detail" }, { "name" : "ability to manage high-volume workflows" }, { "name" : "Effective communication with interdisciplinary teams" }, { "name" : "Time management and prioritization across multiple clinics" }, { "name" : "Problem-solving skills related to medication access barriers" }, { "name" : "Ability to navigate payer systems and documentation requirements" } ], "majorSkills" : "medication prior authorization (PA) processes, cross-functional coordination, vendor/stakeholder management, operational metrics, resource planning, continuous improvement", "majorSkillsList" : [ "medication prior authorization (PA) processes", "cross-functional coordination", "vendor/stakeholder management", "operational metrics", "resource planning", "continuous improvement" ], "coreResponsibilities" : "Supports two primary care clinics by managing medication prior authorization (PA) processes., Serves as a liaison between providers, payers, pharmacies, and patients to ensure timely medication access., Works under pharmacist and/or clinic leadership to optimize medication access outcomes., Complete and submit prior authorization requests for medications prescribed in primary care clinics, Review patient charts and insurance requirements to gather necessary clinical documentation, Prepare and submit PA forms via EHR, payer portals, and fax systems as required, Track and follow up on submitted prior authorizations to ensure timely approvals or denials, Communicate PA status updates to providers, nurses, and care teams in a timely manner, Partner closely with embedded pharmacists (if applicable) for complex cases, Communicate with payers and pharmacy benefit managers (PBMs) to obtain coverage details, Coordinate appeals and resubmissions for denied authorizations as directed, Identify formulary alternatives and escalate to pharmacists/providers when appropriate, Maintain accurate documentation of all PA activity within the electronic health record, Collaborate with clinic staff to resolve medication access barriers (coverage, cost, delays), Support urgent or high-priority requests to prevent interruptions in patient therapy", "teamCollaboration" : "Serves as a liaison between providers, payers, pharmacies, and patients to ensure timely medication access.; Works under pharmacist and/or clinic leadership to optimize medication access outcomes.; Communicate PA status updates to providers, nurses, and care teams in a timely manner; Partner closely with embedded pharmacists (if applicable) for complex cases; Collaborate with clinic staff to resolve medication access barriers (coverage, cost, delays); Effective communication with interdisciplinary teams.", "domainKnowledge" : "medication prior authorization (PA) processes; insurance processing; ambulatory pharmacy workflows; insurance plans; formularies; medication access processes", "domainList" : [ "medication-prior-authorization-pa-processes", "insurance-processing", "ambulatory-pharmacy-workflows", "insurance-plans", "formularies", "medication-access-processes" ], "domainSpecificKnowledge" : [ "medication prior authorization (PA) processes", "insurance processing", "ambulatory pharmacy workflows", "insurance plans", "formularies", "medication access processes" ], "toolProficiency" : [ "EHR", "payer portals", "fax systems", "Epic" ], "communicationSkills" : "Effective communication with interdisciplinary teams.", "documentationSkills" : "Maintain accurate documentation of all PA activity within the electronic health record", "continuousLearning" : "Keeps current with changes in the specialized field and collaborates with department leadership to adopt best practices.; Maintains updated knowledge and skills and contributes to the education of others.", "problemSolvingSkills" : "Problem-solving skills related to medication access barriers.", "specialRequirements" : "Fully onsite clinic-supporting role, Mondays-Fridays 8a-5p, Winston Salem, Downtown Health Plaza and Winston East (Kennedy Hopkins Clinic), $6,000 sign-on bonus eligible position for qualified candidates!", "outcomesObjectives" : "Turnaround time for PA submissions.; Approval rate and appeal success rate.; Timely communication with clinic teams.; Reduction in delays to therapy initiation.", "qualificationsBasic" : "High school diploma or GED equivalent required., For technicians in NC with validating technician responsibilities- an associate’s degree in pharmacy technology is required per guidelines on PTCB., Registration/Licensure with state board of pharmacy per state of employment requirements., Certification through Pharmacy Technician Certification Board (CPhT) or National Health Career Association (ExCPT) required.", "qualificationsPreferred" : "Experience with prior authorizations, insurance processing, or ambulatory pharmacy workflows preferred., Familiarity with Epic or similar EHR systems preferred., understanding of insurance plans, formularies, and medication access processes., Bilingual (Spanish-speaking) preferred but not required.", "remoteFriendly" : true, "workSiteFlexibility" : "Onsite", "rawDescription" : "**Department:** 12847 Wake Forest Baptist Medical Center - Administration: Regional Facilities; Downtown Hlth Plz **Status:** Full time **Benefits Eligible:** Yes **Hou****rs Per Week:** 40 **Schedule Details/Additional Information:** Mondays-Fridays 8a-5p **Pay Range** $24.10 - $36.15 ** _Position Highlights_** * Fully onsite clinic-supporting role * Full-Time, Days * 1st shift, M-F, 8a-5p * Winston Salem, Downtown Health Plaza and Winston East (Kennedy Hopkins Clinic) * Bilingual (Spanish-speaking) preferred but not required. * $6,000 sign-on bonus eligible position for qualified candidates! _Click_[ _here_](https://www.wakehealth.edu/specialty/n/nursing/sign-on-bonus-program) _for more information!_ **Summary:** * Supports two primary care clinics by managing medication prior authorization (PA) processes. * Serves as a liaison between providers, payers, pharmacies, and patients to ensure timely medication access. * Works under pharmacist and/or clinic leadership to optimize medication access outcomes. **Major Responsibilities:** * Complete and submit prior authorization requests for medications prescribed in primary care clinics * Review patient charts and insurance requirements to gather necessary clinical documentation * Prepare and submit PA forms via EHR, payer portals, and fax systems as required * Track and follow up on submitted prior authorizations to ensure timely approvals or denials * Communicate PA status updates to providers, nurses, and care teams in a timely manner * Partner closely with embedded pharmacists (if applicable) for complex cases * Communicate with payers and pharmacy benefit managers (PBMs) to obtain coverage details * Coordinate appeals and resubmissions for denied authorizations as directed * Identify formulary alternatives and escalate to pharmacists/providers when appropriate * Maintain accurate documentation of all PA activity within the electronic health record * Collaborate with clinic staff to resolve medication access barriers (coverage, cost, delays) * Support urgent or high-priority requests to prevent interruptions in patient therapy * Complies with legal, regulatory, and accreditation standards. * Keeps current with changes in the specialized field and collaborates with department leadership to adopt best practices. * Maintains updated knowledge and skills and contributes to the education of others. * Contributes positively to execution of pharmacy department initiatives * Accepts assignments of tasks from other pharmacy teammate roles when workload dictates. **What You Will Need:** * High school diploma or GED equivalent required. * For technicians in NC with validating technician responsibilities- an associate’s degree in pharmacy technology is required per guidelines on PTCB. * Registration/Licensure with state board of pharmacy per state of employment requirements. * Certification through Pharmacy Technician Certification Board (CPhT) or National Health Career Association (ExCPT) required. **Nice to Have (Not Required):** * Experience with prior authorizations, insurance processing, or ambulatory pharmacy workflows preferred. * Familiarity with Epic or similar EHR systems preferred. * Strong understanding of insurance plans, formularies, and medication access processes. * Bilingual (Spanish-speaking) preferred but not required. **Key Skills** * Strong attention to detail and ability to manage high-volume workflows. * Effective communication with interdisciplinary teams. * Time management and prioritization across multiple clinics. * Problem-solving skills related to medication access barriers. * Ability to navigate payer systems and documentation requirements. **Performance Focus Areas** * Turnaround time for PA submissions. * Approval rate and appeal success rate. * Timely communication with clinic teams. * Reduction in delays to therapy initiation. _This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties._ **Our Commitment to You:** Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including: **Compensation** * Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training * Premium pay such as shift, on call, and more based on a teammate's job * Incentive pay for select positions * Opportunity for annual increases based on performance **Benefits and more** * Paid Time Off programs * Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability * Flexible Spending Accounts for eligible health care and dependent care expenses * Family benefits such as adoption assistance and paid parental leave * Defined contribution retirement plans with employer match and other financial wellness programs * Educational Assistance Program Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview. **About Advocate Health** [Advocate Health](https://www.advocatehealth.org/) is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names [Advocate Health Care](https://www.advocatehealth.com/) in Illinois; [Atrium Health](https://atriumhealth.org/) in the Carolinas, Georgia and Alabama; and [Aurora Health Care](https://www.aurorahealthcare.org/) in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with [Wake Forest University School of Medicine](https://school.wakehealth.edu/) serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.", "summaryDescription" : "Pharmacy Technician Specialist - Prior Authorizations at Wake Forest Baptist Medical Center. Skills: medication prior authorization (PA) processes, cross-functional coordination, vendor/stakeholder management, operational metrics, resource planning, continuous improvement. Supports two primary care clinics by managing medication prior authorization (PA) processes.. Serves as a liaison between providers, payers, pharmacies, and patients to ensure timely medication access.", "postedDate" : "2026-05-14T22:29:39.417", "createdAt" : "2026-05-17T22:29:39.376", "lastUpdated" : "2026-05-18T04:23:23.301", "ingestTimestamp" : "2026-05-17T22:29:39.376", "mongoId" : "6a0a15671663d49372b4bc52", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "sourceUrl" : "https://aah.wd5.myworkdayjobs.com/External/job/Winston-Salem-NC---1200-N-Martin-Luther-King-Jr-Dr/Pharmacy-Technician-Specialist-I--Downtown-Health-Plaza_R235091", "salaryAnnualMin" : 50128, "salaryAnnualMax" : 75192, "salaryBand" : "50k-75k", "hasSalary" : true, "allSkills" : [ "Complete and submit prior authorization requests for medications prescribed in primary care clinics", "Review patient charts and insurance requirements to gather necessary clinical documentation", "Prepare and submit PA forms via EHR, payer portals, and fax systems as required", "Track and follow up on submitted prior authorizations to ensure timely approvals or denials", "Communicate PA status updates to providers, nurses, and care teams in a timely manner", "Partner closely with embedded pharmacists (if applicable) for complex cases", "Communicate with payers and pharmacy benefit managers (PBMs) to obtain coverage details", "Coordinate appeals and resubmissions for denied authorizations as directed", "Identify formulary alternatives and escalate to pharmacists/providers when appropriate", "Maintain accurate documentation of all PA activity within the electronic health record", "Collaborate with clinic staff to resolve medication access barriers (coverage, cost, delays)", "Support urgent or high-priority requests to prevent interruptions in patient therapy", "Complies with legal, regulatory, and accreditation standards.", "Keeps current with changes in the specialized field and collaborates with department leadership to adopt best practices.", "Maintains updated knowledge and skills and contributes to the education of others.", "Contributes positively to execution of pharmacy department initiatives", "Accepts assignments of tasks from other pharmacy teammate roles when workload dictates.", "attention to detail", "ability to manage high-volume workflows", "Effective communication with interdisciplinary teams", "Time management and prioritization across multiple clinics", "Problem-solving skills related to medication access barriers", "Ability to navigate payer systems and documentation requirements", "medication prior authorization (PA) processes", "cross-functional coordination", "vendor/stakeholder management", "operational metrics", "resource planning", "continuous improvement", "process management", "insurance processing", "ambulatory pharmacy workflows", "insurance plans", "formularies", "medication access processes", "Pharmacy Technician Certification Board (CPhT)", "National Health Career Association (ExCPT)", "EHR", "payer portals", "fax systems", "Epic" ], "skillCount" : 41, "jobCategory" : "engineering", "seniorityLevel" : "mid", "dataQualityScore" : 0.8888889, "_score" : 218.30786, "daysOld" : 3, "hasLocation" : true, "hasGeo" : false, "llmIndustry" : "health system" }, { "id" : "6a2185da74d8ee00a0c4a659", "title" : "Prior Authorization Specialist", "company" : "Wake Forest Baptist Medical Center", "industry" : "Healthcare", "salary" : { "min" : 22.9, "max" : 34.35, "currency" : "USD", "frequency" : "yearly" }, "location" : "Winston Salem, NC - 1 Medical Center Blvd", "locations" : [ "Winston Salem, NC - 1 Medical Center Blvd", "United States of America" ], "timestamp" : "2026-06-05T06:59:17.171", "fingerprint" : "199597a09f873aa95484432aff0d95030b86453a6438f96c8533154be467cf4f", "source" : "workday", "language" : "en", "applyUrl" : "https://aah.wd5.myworkdayjobs.com/External/job/Winston-Salem-NC---1-Medical-Center-Blvd/Prior-Authorization-Specialist_R243162", "externalId" : "R243162", "industryFunction" : { }, "locationPoint" : "36.09986,-80.24422", "structuredLocations" : [ { "city" : "Winston Salem", "state" : "North Carolina", "country" : "United States", "continent" : "na", "source" : "llm", "workMode" : "onsite", "geo" : "36.0998131,-80.2440518" } ], "locationText" : "Winston Salem, North Carolina, United States", "employmentType" : "FULL_TIME", "minimumEducation" : "High School", "experienceMinYears" : 2, "professionalSkills" : [ "Prior authorization" ], "hardSkillsList" : [ "Computer systems knowledge" ], "hardSkills" : [ { "name" : "Computer systems knowledge", "level" : "intermediate" } ], "majorSkills" : "Prior authorization, Administrative support", "majorSkillsList" : [ "Prior authorization", "Administrative support" ], "coreResponsibilities" : "Call third-party insurance companies, Check prior authorization status, Check third-party payor portal, Handle facsimiles related to prior authorization status, Scan correspondence into electronic medical record, Sort surgical cases, Check status of prior authorization, Document prior authorization activities, Communicate necessary information, Evaluate processes, Participate in departmental continuous improvement programs, Enhance workflow processes, Maintain working knowledge of computer systems, Prioritize daily work, Organize daily work, Maintain professional development, Assist management in developing training materials, Perform other duties as assigned", "teamCollaboration" : "SCORE Prior Authorization team", "domainKnowledge" : "Third party payers; Healthcare administrative support; General clerical experience; Electronic medical record", "domainList" : [ "third-party-payers", "healthcare-administrative-support", "general-clerical-experience", "electronic-medical-record" ], "domainSpecificKnowledge" : [ "Third party payers", "Healthcare administrative support", "General clerical experience", "Electronic medical record" ], "communicationSkills" : "Oral communication skills; Written communication skills", "documentationSkills" : "Document prior authorization activities", "continuousLearning" : "Maintain professional development", "innovationCreativity" : "Participate in departmental continuous improvement programs", "problemSolvingSkills" : "Evaluate processes; Problem solving", "specialRequirements" : "Subject to many interruptions, Operates keyboard, Operates photocopier, Operates telephone, Operates other office equipment, Work may be stressful, Occasionally subject to irregular hours", "outcomesObjectives" : "Enhance workflow processes; Enhance patient-centered outcomes", "qualificationsBasic" : "High school, Two years' experience in third party payers, Two years' experience in healthcare administrative support, Two years' experience in general clerical experience", "qualificationsPreferred" : "Authorization process experience, Associate degree, Bachelor's degree", "remoteFriendly" : true, "workSiteFlexibility" : "Hybrid", "rawDescription" : "**Department:** 12856 Wake Forest Baptist Medical Center - VP: Clinical Operations **Status:** Full time **Benefits Eligible:** Yes **Hou****rs Per Week:** 40 **Schedule Details/Additional Information:** Monday-Friday, 8 hour days **Pay Range** $22.90 - $34.35 **Job Summary:** The incumbent for this position is responsible for doing follow-up for the SCORE Prior Authorization team. This position will be responsible for calling third-party insurance companies to check prior authorization status, checking third-party payor portal for prior authorization status, handling facsimiles related to prior authorization status, and scan correspondence into the patient's electronic medical record. **Education/Experience:** * High school and two years' experience in third party payers, healthcare administrative support or general clerical experience. * Authorization process experience preferred. * Associate or bachelor's degree preferred. **Essential Functions:** * Expedites sorting of surgical cases and checks status of prior authorization with shortest lead times. * Documents prior authorization activities appropriately and communicates necessary information to SCORE Prior Authorization team. * Evaluates processes, problem solving, and participates in departmental continuous improvement programs to enhance workflow processes and patient-centered outcomes. * Maintains a working knowledge of computer systems supported by the department. * Prioritizes and organizes daily work to ensure completion on time. * Maintains professional development. * Assists management in developing training materials. * Performs other duties as assigned. **Skills/Qualifications:** * Strong oral and written communication skills * Ability to exercise independent judgment in unusual or stressful situations * Strong computer skills * Ability to establish and maintain effective working relationships **Work Environment:** * This is a virtual and in-office position. * Subject to many interruptions * Operates keyboard, photocopier, telephone, and other office equipment * Work may be stressful at times * Occasionally subject to irregular hours **Our Commitment to You:** Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including: **Compensation** * Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training * Premium pay such as shift, on call, and more based on a teammate's job * Incentive pay for select positions * Opportunity for annual increases based on performance **Benefits and more** * Paid Time Off programs * Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability * Flexible Spending Accounts for eligible health care and dependent care expenses * Family benefits such as adoption assistance and paid parental leave * Defined contribution retirement plans with employer match and other financial wellness programs * Educational Assistance Program Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview. **About Advocate Health** [Advocate Health](https://www.advocatehealth.org/) is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names [Advocate Health Care](https://www.advocatehealth.com/) in Illinois; [Atrium Health](https://atriumhealth.org/) in the Carolinas, Georgia and Alabama; and [Aurora Health Care](https://www.aurorahealthcare.org/) in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with [Wake Forest University School of Medicine](https://school.wakehealth.edu/) serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.", "summaryDescription" : "Prior Authorization Specialist at Wake Forest Baptist Medical Center. Skills: Prior authorization, Administrative support. Call third-party insurance companies. Check prior authorization status", "postedDate" : "2026-06-03T18:09:41.003", "createdAt" : "2026-06-04T18:09:40.908", "lastUpdated" : "2026-06-05T06:59:17.171", "ingestTimestamp" : "2026-06-04T18:09:40.908", "mongoId" : "6a2185da74d8ee00a0c4a659", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "sourceUrl" : "https://aah.wd5.myworkdayjobs.com/External/job/Winston-Salem-NC---1-Medical-Center-Blvd/Prior-Authorization-Specialist_R243162", "salaryAnnualMin" : 47632, "salaryAnnualMax" : 71448, "salaryBand" : "30k-50k", "hasSalary" : true, "allSkills" : [ "Computer systems knowledge", "Prior authorization", "Administrative support", "Third party payers", "Healthcare administrative support", "General clerical experience", "Electronic medical record" ], "skillCount" : 7, "jobCategory" : "other", "seniorityLevel" : "mid", "dataQualityScore" : 0.8888889, "_score" : 217.979, "daysOld" : 1, "hasLocation" : true, "hasGeo" : true, "llmIndustry" : "Healthcare" }, { "id" : "6a15f3d758b93c861e82763b", "title" : "Prior Authorization Coordinator", "company" : "The Potential People Bring To Our Organization", "salary" : { "min" : 22.0, "max" : 22.0, "currency" : "USD", "frequency" : "yearly" }, "location" : "United States of America", "locations" : [ "United States of America" ], "timestamp" : "2026-05-26T22:04:04.487", "fingerprint" : "272c5127cd3b56a5421acff46c75f837afc0bb629ed1bfc59d57051fd24c3f43", "source" : "workday", "language" : "en", "applyUrl" : "https://ih.wd1.myworkdayjobs.com/IHA_Careers/job/Hybrid-Career/Prior-Authorization-Coordinator_R0012386", "externalId" : "R0012386", "locationPoint" : "51.43667,5.97917", "structuredLocations" : [ { "country" : "United States", "continent" : "na", "workMode" : "hybrid" } ], "locationText" : "United States", "employmentType" : "FULL_TIME", "minimumEducation" : "High school diploma or GED", "experienceMinYears" : 1, "experienceMaxYears" : 2, "technicalSkills" : "Pharmacy systems", "professionalSkills" : [ "Process management", "Cross-functional coordination", "Vendor/stakeholder management", "Operational metrics", "Resource planning", "Continuous improvement" ], "hardSkillsList" : [ "Faxing", "Copying", "Filing", "Document scanning", "Data entry", "Call documentation" ], "hardSkills" : [ { "name" : "Faxing", "level" : "intermediate" }, { "name" : "Copying", "level" : "intermediate" }, { "name" : "Filing", "level" : "intermediate" }, { "name" : "Document scanning", "level" : "intermediate" }, { "name" : "Data entry", "level" : "intermediate" }, { "name" : "Call documentation", "level" : "intermediate" } ], "majorSkills" : "Prior authorization, Pharmacy, Health insurance", "majorSkillsList" : [ "Prior authorization", "Pharmacy", "Health insurance" ], "coreResponsibilities" : "Facilitate logging of prior authorization, appeal, reimbursement, grievance requests, Follow-up on requests to ensure timely resolution, Ensure all process steps are completed, Meet or exceed regulatory requirements, Address provider questions regarding formularies, Fax prior authorization requests, Complete decision letters by faxing, Make decision notification phone calls, File documents, Prepare documents for scanning, Verify member and provider eligibility, File requests into correct member folder, Enter data and ensure accuracy on statistics, Log prior authorization requests into pharmacy systems, Enter override into pharmacy system, Update information in documentation systems, Transcribe Medical Director decisions into systems, Complete reports, reimbursement requests, Review vendor emails/reports, Initiate outbound calls to members/physicians, Answer provider and internal caller questions, Log all calls into call documentation systems, Research and respond to escalated inquiries, Provide callbacks when necessary, Provide support for required letters, Copy and mail completed requests, Maintain proper storage of all files", "teamCollaboration" : "Assist Clinical Review Pharmacist; Work with provider and internal callers", "domainKnowledge" : "Pharmacy; Health insurance operations; Drug names; Therapeutic categories; Dosage forms; Manufacturers; Packaging; HMO concept; Formularies", "domainList" : [ "pharmacy", "health-insurance-operations", "drug-names", "therapeutic-categories", "dosage-forms", "manufacturers", "packaging", "hmo-concept", "formularies" ], "domainSpecificKnowledge" : [ "Pharmacy", "Health insurance operations", "Drug names", "Therapeutic categories", "Dosage forms", "Manufacturers", "Packaging", "HMO concept", "Formularies" ], "toolProficiency" : [ "Pharmacy on-line system" ], "communicationSkills" : "Written communication skills; Verbal communication skills", "documentationSkills" : "Document scanning preparation; Filing; Maintain proper storage of all files", "continuousLearning" : "Ability to absorb new concepts; Adapt to a changing environment", "innovationCreativity" : "Exhibit creativity", "problemSolvingSkills" : "Effectively solve problems as they arise", "specialRequirements" : "Occasional holidays, weekends and overtime will be a requirement, Sponsorship will not be provided", "qualificationsBasic" : "High school diploma or GED required, Two (2) years of experience in pharmacy or health insurance operations required OR one (1) year of experience as a temporary associate in the Prior Authorization Coordinator role or Prior Authorization department required, Written and verbal communication skills, Excellent organizational and time management skills, Excellent ability to absorb new concepts and adapt to a changing environment, Demonstration of math aptitude for purposes of calculating simple drug requirements when given dose and price calculations", "qualificationsPreferred" : "Associates degree preferred, Pharmacy experience strongly preferred, General knowledge of drug names, therapeutic categories, dosage forms, manufacturers and packaging preferred, Familiarity with HMO concept, Experience with pharmacy on-line system preferred, Exhibit creativity and self-motivation, with the ability to effectively solve problems as they arise, Proven examples of displaying the PBD values: Trusted Advisor, Innovative, Excellence, Guardianship, Dedication and Caring", "remoteFriendly" : true, "rawDescription" : "# **FIND YOUR FUTURE** We're excited about the potential people bring to our organization. You can grow your career here while enjoying first-class perks, benefits and a culture that fosters growth, innovation and collaboration. # **Overview** The Prior Authorization Coordinator will facilitate the logging in and out of all prior authorization, appeal, reimbursement and grievance requests, and follow-up on requests to ensure that all are resolved and completed in a timely manner. The coordinator will ensure that all steps involved with the process are completed and all regulatory requirements are met or exceeded. They will also be responsible for the pharmacy medical exception line to address provider questions regarding the formularies for all lines of business serviced by Pharmacy Benefit Dimensions. The coordinator will also be assigned to provide high quality, diverse administrative support including but not limited to faxing prior authorization requests, completing decision letters by faxing and copying, making decision notification phone calls to members and physicians, filing, and document scanning preparation. Occasional holidays, weekends and overtime will be a requirement of the position. # **Qualifications** * High school diploma or GED required. Associates degree preferred. * Two (2) years of experience in pharmacy or health insurance operations required OR one (1) year of experience as a temporary associate in the Prior Authorization Coordinator role or Prior Authorization department required. Pharmacy experience strongly preferred. * General knowledge of drug names, therapeutic categories, dosage forms, manufacturers and packaging preferred. Familiarity with HMO concept. * Experience with pharmacy on-line system preferred. * Written and verbal communication skills. * Excellent organizational and time management skills. * Excellent ability to absorb new concepts and adapt to a changing environment. * Exhibit creativity and self-motivation, with the ability to effectively solve problems as they arise. * Demonstration of math aptitude for purposes of calculating simple drug requirements when given dose and price calculations. * Proven examples of displaying the PBD values: Trusted Advisor, Innovative, Excellence, Guardianship, Dedication and Caring. # **Essential Accountabilities** * Assist Clinical Review Pharmacist in making appropriate decisions by verifying member and provider eligibility and filing requests into the correct member folder according to set standards. * Enter data and ensure complete accuracy on all statistics by logging prior authorization requests into pharmacy systems according to set standards. * Complete the requests by entering override into the appropriate pharmacy system and updating all information in required documentation systems according to set standards. May also include transcribing Medical Director decision into systems. * As volume dictates, timely and accurately complete various reports, reimbursement requests, IRO and review of vendor emails/reports as assigned by the Supervisor. * Facilitate follow-up phone calls to members and providers for clinical approvals and denials according to set standards. * Initiate outbound telephone calls to members/physicians regarding decisions within all regulatory time frame requirements. * Answer and provide resolution to provider and internal callers regarding formulary/prior authorization questions for all lines of business. Log all calls into call documentation systems. * Research and respond to escalated and complex inquiries regarding Pharmacy questions or concerns. Ensure that all callers obtain accurate and up-to-date information on policies and procedures and communicate a successful resolution to inquiries. Provide callbacks when necessary. * Provide support for all required letters within the required timeframes. * Fax prior authorization requests including requests for additional information and completed requests. * Copy and mail completed requests and related documents. * Prepare completed requests for scanning into documentation systems. * Maintain proper storage of all files, in accordance with the corporate retention policy. Immigration or work visa sponsorship will not be provided for this position Hiring Compensation Range: $22.00 hourly _Compensation may vary based on factors including but not limited to skills, education, location and experience._ In addition to base compensation, associates may be eligible for a scorecard incentive, full range of benefits and generous paid time off. The base salary range is subject to change and may be modified in the future. _As an Equal Opportunity / Affirmative Action Employer, Independent Health and its affiliates will not discriminate in its employment practices due to an applicant’s race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship and immigration status, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law.__[Click here](http://www.independenthealth.com/about/careers/additional-eeo-aap-information)_ _for additional EEO/AAP_ _or Reasonable Accommodation_ _information._ Current Associates must apply internally via the Job Hub app.", "summaryDescription" : "Prior Authorization Coordinator at The Potential People Bring To Our Organization. Skills: Prior authorization, Pharmacy, Health insurance. Facilitate logging of prior authorization, appeal, reimbursement, grievance requests. Follow-up on requests to ensure timely resolution", "postedDate" : "2026-05-26T21:36:44.227", "createdAt" : "2026-05-26T21:36:44.194", "lastUpdated" : "2026-05-26T22:04:04.487", "ingestTimestamp" : "2026-05-26T21:36:44.194", "mongoId" : "6a15f3d758b93c861e82763b", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "sourceUrl" : "https://ih.wd1.myworkdayjobs.com/IHA_Careers/job/Hybrid-Career/Prior-Authorization-Coordinator_R0012386", "salaryAnnualMin" : 45760, "salaryAnnualMax" : 45760, "salaryBand" : "30k-50k", "hasSalary" : true, "allSkills" : [ "Faxing", "Copying", "Filing", "Document scanning", "Data entry", "Call documentation", "Prior authorization", "Pharmacy", "Health insurance", "Process management", "Cross-functional coordination", "Vendor/stakeholder management", "Operational metrics", "Resource planning", "Continuous improvement", "Health insurance operations", "Drug names", "Therapeutic categories", "Dosage forms", "Manufacturers", "Packaging", "HMO concept", "Formularies", "Pharmacy on-line system" ], "skillCount" : 24, "jobCategory" : "other", "seniorityLevel" : "executive", "dataQualityScore" : 0.8888889, "_score" : 215.51941, "daysOld" : 0, "hasLocation" : true, "hasGeo" : false }, { "id" : "6a0f634158b93c861e074081", "title" : "Prior Authorization Coordinator", "company" : "The Potential People Bring To Our Organization", "salary" : { "min" : 22.0, "max" : 22.0, "currency" : "USD", "frequency" : "yearly" }, "location" : "United States of America", "locations" : [ "United States of America" ], "timestamp" : "2026-05-22T01:42:26.180", "fingerprint" : "facb805b0e1fa6e29cb0bbda77aa0ad10eeaf40dfaf373567e71d309c59ddd9d", "source" : "workday", "language" : "en", "applyUrl" : "https://ih.wd1.myworkdayjobs.com/IHA_Careers/job/Hybrid-Career/Prior-Authorization-Coordinator_R0012366", "externalId" : "R0012366", "locationPoint" : "51.43667,5.97917", "structuredLocations" : [ { "city" : "Murfreesboro", "state" : "Tennessee", "country" : "United States", "continent" : "na", "source" : "llm", "workMode" : "onsite" } ], "locationText" : "Murfreesboro, Tennessee, United States", "employmentType" : "FULL_TIME", "minimumEducation" : "High school diploma or GED", "experienceMinYears" : 1, "technicalSkills" : "pharmacy on-line system", "professionalSkills" : [ "process management", "cross-functional coordination", "vendor/stakeholder management", "operational metrics", "resource planning", "continuous improvement" ], "hardSkillsList" : [ "logging prior authorization requests", "transcribing Medical Director decision", "completing various reports", "reimbursement requests", "review of vendor emails/reports", "follow-up phone calls", "initiate outbound telephone calls", "answer and provide resolution", "research and respond to escalated and complex inquiries", "provide callbacks", "provide support for all required letters", "fax prior authorization requests", "copy and mail completed requests", "prepare completed requests for scanning", "maintain proper storage of all files" ], "softSkillsList" : [ "self-motivation" ], "hardSkills" : [ { "name" : "logging prior authorization requests", "level" : "intermediate" }, { "name" : "transcribing Medical Director decision", "level" : "intermediate" }, { "name" : "completing various reports", "level" : "intermediate" }, { "name" : "reimbursement requests", "level" : "intermediate" }, { "name" : "review of vendor emails/reports", "level" : "intermediate" }, { "name" : "follow-up phone calls", "level" : "intermediate" }, { "name" : "initiate outbound telephone calls", "level" : "intermediate" }, { "name" : "answer and provide resolution", "level" : "intermediate" }, { "name" : "research and respond to escalated and complex inquiries", "level" : "intermediate" }, { "name" : "provide callbacks", "level" : "intermediate" }, { "name" : "provide support for all required letters", "level" : "intermediate" }, { "name" : "fax prior authorization requests", "level" : "intermediate" }, { "name" : "copy and mail completed requests", "level" : "intermediate" }, { "name" : "prepare completed requests for scanning", "level" : "intermediate" }, { "name" : "maintain proper storage of all files", "level" : "intermediate" } ], "softSkills" : [ { "name" : "self-motivation" } ], "majorSkills" : "Prior Authorization, Pharmacy, Health Insurance", "majorSkillsList" : [ "Prior Authorization", "Pharmacy", "Health Insurance" ], "coreResponsibilities" : "Facilitate logging of prior authorization, appeal, reimbursement, grievance requests, Follow-up on requests to ensure timely resolution, Ensure all process steps and regulatory requirements are met, Address provider questions regarding formularies, Fax prior authorization requests, Complete decision letters by faxing and copying, Make decision notification phone calls to members and physicians, File and scan documents", "teamCollaboration" : "Assist Clinical Review Pharmacist; Answer provider and internal caller questions; Respond to escalated inquiries", "domainKnowledge" : "pharmacy; health insurance operations; drug names; therapeutic categories; dosage forms; manufacturers; packaging; HMO concept; pharmacy on-line system", "domainList" : [ "pharmacy", "health-insurance-operations", "drug-names", "therapeutic-categories", "dosage-forms", "manufacturers", "packaging", "hmo-concept", "pharmacy-on-line-system" ], "domainSpecificKnowledge" : [ "pharmacy", "health insurance operations", "drug names", "therapeutic categories", "dosage forms", "manufacturers", "packaging", "HMO concept", "pharmacy on-line system" ], "toolProficiency" : [ "pharmacy systems" ], "communicationSkills" : "Written and verbal communication skills; Initiate outbound telephone calls; Answer and provide resolution; Provide callbacks", "documentationSkills" : "Filing; Document scanning preparation; Maintain proper storage of all files", "continuousLearning" : "ability to absorb new concepts and adapt to a changing environment", "innovationCreativity" : "Exhibit creativity", "problemSolvingSkills" : "effectively solve problems as they arise; Research and respond to escalated and complex inquiries", "specialRequirements" : "Occasional holidays, weekends and overtime will be a requirement, Immigration or work visa sponsorship will not be provided", "outcomesObjectives" : "ensure that all are resolved and completed in a timely manner; ensure that all steps involved with the process are completed and all regulatory requirements are met or exceeded", "qualificationsBasic" : "High school diploma or GED required, Two (2) years of experience in pharmacy or health insurance operations required OR one (1) year of experience as a temporary associate in the Prior Authorization Coordinator role or Prior Authorization department required, Written and verbal communication skills, Excellent organizational and time management skills, Excellent ability to absorb new concepts and adapt to a changing environment, Demonstration of math aptitude for purposes of calculating simple drug requirements when given dose and price calculations", "qualificationsPreferred" : "Associates degree preferred, Pharmacy experience strongly preferred, General knowledge of drug names, therapeutic categories, dosage forms, manufacturers and packaging preferred, Familiarity with HMO concept, Experience with pharmacy on-line system preferred", "remoteFriendly" : false, "rawDescription" : "# **FIND YOUR FUTURE** We're excited about the potential people bring to our organization. You can grow your career here while enjoying first-class perks, benefits and a culture that fosters growth, innovation and collaboration. # **Overview** The Prior Authorization Coordinator will facilitate the logging in and out of all prior authorization, appeal, reimbursement and grievance requests, and follow-up on requests to ensure that all are resolved and completed in a timely manner. The coordinator will ensure that all steps involved with the process are completed and all regulatory requirements are met or exceeded. They will also be responsible for the pharmacy medical exception line to address provider questions regarding the formularies for all lines of business serviced by Pharmacy Benefit Dimensions. The coordinator will also be assigned to provide high quality, diverse administrative support including but not limited to faxing prior authorization requests, completing decision letters by faxing and copying, making decision notification phone calls to members and physicians, filing, and document scanning preparation. Occasional holidays, weekends and overtime will be a requirement of the position. # **Qualifications** * High school diploma or GED required. Associates degree preferred. * Two (2) years of experience in pharmacy or health insurance operations required OR one (1) year of experience as a temporary associate in the Prior Authorization Coordinator role or Prior Authorization department required. Pharmacy experience strongly preferred. * General knowledge of drug names, therapeutic categories, dosage forms, manufacturers and packaging preferred. Familiarity with HMO concept. * Experience with pharmacy on-line system preferred. * Written and verbal communication skills. * Excellent organizational and time management skills. * Excellent ability to absorb new concepts and adapt to a changing environment. * Exhibit creativity and self-motivation, with the ability to effectively solve problems as they arise. * Demonstration of math aptitude for purposes of calculating simple drug requirements when given dose and price calculations. * Proven examples of displaying the PBD values: Trusted Advisor, Innovative, Excellence, Guardianship, Dedication and Caring. # **Essential Accountabilities** * Assist Clinical Review Pharmacist in making appropriate decisions by verifying member and provider eligibility and filing requests into the correct member folder according to set standards. * Enter data and ensure complete accuracy on all statistics by logging prior authorization requests into pharmacy systems according to set standards. * Complete the requests by entering override into the appropriate pharmacy system and updating all information in required documentation systems according to set standards. May also include transcribing Medical Director decision into systems. * As volume dictates, timely and accurately complete various reports, reimbursement requests, IRO and review of vendor emails/reports as assigned by the Supervisor. * Facilitate follow-up phone calls to members and providers for clinical approvals and denials according to set standards. * Initiate outbound telephone calls to members/physicians regarding decisions within all regulatory time frame requirements. * Answer and provide resolution to provider and internal callers regarding formulary/prior authorization questions for all lines of business. Log all calls into call documentation systems. * Research and respond to escalated and complex inquiries regarding Pharmacy questions or concerns. Ensure that all callers obtain accurate and up-to-date information on policies and procedures and communicate a successful resolution to inquiries. Provide callbacks when necessary. * Provide support for all required letters within the required timeframes. * Fax prior authorization requests including requests for additional information and completed requests. * Copy and mail completed requests and related documents. * Prepare completed requests for scanning into documentation systems. * Maintain proper storage of all files, in accordance with the corporate retention policy. _Immigration or work visa sponsorship will not be provided for this position_ Hiring Compensation Range: $22.00 hourly _Compensation may vary based on factors including but not limited to skills, education, location and experience._ In addition to base compensation, associates may be eligible for a scorecard incentive, full range of benefits and generous paid time off. The base salary range is subject to change and may be modified in the future. _As an Equal Opportunity / Affirmative Action Employer, Independent Health and its affiliates will not discriminate in its employment practices due to an applicant’s race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship and immigration status, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law.__[Click here](http://www.independenthealth.com/about/careers/additional-eeo-aap-information)_ _for additional EEO/AAP_ _or Reasonable Accommodation_ _information._ Current Associates must apply internally via the Job Hub app.", "summaryDescription" : "Prior Authorization Coordinator at The Potential People Bring To Our Organization. Skills: Prior Authorization, Pharmacy, Health Insurance. Facilitate logging of prior authorization, appeal, reimbursement, grievance requests. Follow-up on requests to ensure timely resolution", "postedDate" : "2026-05-09T01:40:50.900", "createdAt" : "2026-05-22T01:40:50.864", "lastUpdated" : "2026-05-22T01:42:26.180", "ingestTimestamp" : "2026-05-22T01:40:50.864", "mongoId" : "6a0f634158b93c861e074081", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "sourceUrl" : "https://ih.wd1.myworkdayjobs.com/IHA_Careers/job/Hybrid-Career/Prior-Authorization-Coordinator_R0012366", "salaryAnnualMin" : 45760, "salaryAnnualMax" : 45760, "salaryBand" : "30k-50k", "hasSalary" : true, "allSkills" : [ "logging prior authorization requests", "transcribing Medical Director decision", "completing various reports", "reimbursement requests", "review of vendor emails/reports", "follow-up phone calls", "initiate outbound telephone calls", "answer and provide resolution", "research and respond to escalated and complex inquiries", "provide callbacks", "provide support for all required letters", "fax prior authorization requests", "copy and mail completed requests", "prepare completed requests for scanning", "maintain proper storage of all files", "self-motivation", "Prior Authorization", "Pharmacy", "Health Insurance", "process management", "cross-functional coordination", "vendor/stakeholder management", "operational metrics", "resource planning", "continuous improvement", "pharmacy", "health insurance operations", "drug names", "therapeutic categories", "dosage forms", "manufacturers", "packaging", "HMO concept", "pharmacy on-line system", "pharmacy systems" ], "skillCount" : 35, "jobCategory" : "other", "seniorityLevel" : "executive", "dataQualityScore" : 0.8888889, "_score" : 215.5137, "daysOld" : 13, "hasLocation" : true, "hasGeo" : false }, { "id" : "6a0a61841663d49372c95b93", "title" : "Prior Authorization Coordinator", "company" : "The Potential People Bring To Our Organization", "salary" : { "min" : 22.0, "max" : 22.0, "currency" : "USD", "frequency" : "yearly" }, "location" : "United States of America", "locations" : [ "United States of America" ], "timestamp" : "2026-05-18T06:38:35.584", "fingerprint" : "c7419e5b4cdfb39ec58b6b9e5cb63f5f5c39a7e490c7bb037ebe27a882195d6e", "source" : "workday", "language" : "en", "applyUrl" : "https://ih.wd1.myworkdayjobs.com/IHA_Careers/job/Hybrid-Career/Prior-Authorization-Coordinator_R0012366", "externalId" : "R0012366", "locationPoint" : "51.43667,5.97917", "structuredLocations" : [ { "city" : "Chicago", "state" : "Illinois", "country" : "United States", "continent" : "na", "source" : "llm", "workMode" : "hybrid" } ], "locationText" : "Chicago, Illinois, United States", "employmentType" : "FULL_TIME", "minimumEducation" : "High school diploma or GED", "professionalSkills" : [ "process management", "cross-functional coordination", "vendor/stakeholder management", "operational metrics", "resource planning", "continuous improvement" ], "hardSkillsList" : [ "logging prior authorization requests", "entering override into the appropriate pharmacy system", "transcribing Medical Director decision into systems", "completing reports", "completing reimbursement requests", "reviewing vendor emails/reports", "initiating outbound telephone calls", "answering and providing resolution to provider and internal callers", "logging calls", "researching and responding to escalated and complex inquiries", "providing callbacks", "providing support for all required letters", "faxing prior authorization requests", "copying and mailing completed requests and related documents", "preparing completed requests for scanning", "maintaining proper storage of all files" ], "softSkillsList" : [ "creativity", "self-motivation", "problem solving" ], "hardSkills" : [ { "name" : "logging prior authorization requests", "level" : "intermediate" }, { "name" : "entering override into the appropriate pharmacy system", "level" : "intermediate" }, { "name" : "transcribing Medical Director decision into systems", "level" : "intermediate" }, { "name" : "completing reports", "level" : "intermediate" }, { "name" : "completing reimbursement requests", "level" : "intermediate" }, { "name" : "reviewing vendor emails/reports", "level" : "intermediate" }, { "name" : "initiating outbound telephone calls", "level" : "intermediate" }, { "name" : "answering and providing resolution to provider and internal callers", "level" : "intermediate" }, { "name" : "logging calls", "level" : "intermediate" }, { "name" : "researching and responding to escalated and complex inquiries", "level" : "intermediate" }, { "name" : "providing callbacks", "level" : "intermediate" }, { "name" : "providing support for all required letters", "level" : "intermediate" }, { "name" : "faxing prior authorization requests", "level" : "intermediate" }, { "name" : "copying and mailing completed requests and related documents", "level" : "intermediate" }, { "name" : "preparing completed requests for scanning", "level" : "intermediate" }, { "name" : "maintaining proper storage of all files", "level" : "intermediate" } ], "softSkills" : [ { "name" : "creativity" }, { "name" : "self-motivation" }, { "name" : "problem solving" } ], "majorSkills" : "prior authorization, appeal, reimbursement, grievance requests, pharmacy medical exception line, provider questions, formularies", "majorSkillsList" : [ "prior authorization", "appeal", "reimbursement", "grievance requests", "pharmacy medical exception line", "provider questions", "formularies" ], "coreResponsibilities" : "facilitate the logging in and out of all prior authorization, appeal, reimbursement and grievance requests, follow-up on requests to ensure that all are resolved and completed in a timely manner, ensure that all steps involved with the process are completed and all regulatory requirements are met or exceeded, responsible for the pharmacy medical exception line to address provider questions regarding the formularies for all lines of business serviced by Pharmacy Benefit Dimensions, provide high quality, diverse administrative support including but not limited to faxing prior authorization requests, completing decision letters by faxing and copying, making decision notification phone calls to members and physicians, filing, and document scanning preparation, assist Clinical Review Pharmacist in making appropriate decisions by verifying member and provider eligibility and filing requests into the correct member folder according to set standards, enter data and ensure complete accuracy on all statistics by logging prior authorization requests into pharmacy systems according to set standards, complete the requests by entering override into the appropriate pharmacy system and updating all information in required documentation systems according to set standards, May also include transcribing Medical Director decision into systems, timely and accurately complete various reports, reimbursement requests, IRO and review of vendor emails/reports as assigned by the Supervisor, facilitate follow-up phone calls to members and providers for clinical approvals and denials according to set standards, initiate outbound telephone calls to members/physicians regarding decisions within all regulatory time frame requirements, answer and provide resolution to provider and internal callers regarding formulary/prior authorization questions for all lines of business, log all calls into call documentation systems, research and respond to escalated and complex inquiries regarding Pharmacy questions or concerns, ensure that all callers obtain accurate and up-to-date information on policies and procedures and communicate a successful resolution to inquiries, Provide callbacks when necessary, Provide support for all required letters within the required timeframes, Fax prior authorization requests including requests for additional information and completed requests, Copy and mail completed requests and related documents, Prepare completed requests for scanning into documentation systems, Maintain proper storage of all files, in accordance with the corporate retention policy", "teamCollaboration" : "cross-functional coordination", "domainKnowledge" : "pharmacy; health insurance operations; drug names; therapeutic categories; dosage forms; manufacturers; packaging; HMO concept; formularies", "domainList" : [ "pharmacy", "health-insurance-operations", "drug-names", "therapeutic-categories", "dosage-forms", "manufacturers", "packaging", "hmo-concept", "formularies" ], "domainSpecificKnowledge" : [ "pharmacy", "health insurance operations", "drug names", "therapeutic categories", "dosage forms", "manufacturers", "packaging", "HMO concept", "formularies" ], "toolProficiency" : [ "pharmacy on-line system" ], "communicationSkills" : "Written and verbal communication skills; communication skills", "documentationSkills" : "document scanning preparation; documentation systems", "continuousLearning" : "growth; innovation", "innovationCreativity" : "innovation; creativity", "problemSolvingSkills" : "effectively solve problems as they arise", "specialRequirements" : "Occasional holidays, weekends and overtime will be a requirement of the position, Immigration or work visa sponsorship will not be provided for this position", "outcomesObjectives" : "ensure that all are resolved and completed in a timely manner; ensure that all regulatory requirements are met or exceeded", "qualificationsBasic" : "High school diploma or GED required, Two (2) years of experience in pharmacy or health insurance operations required OR one (1) year of experience as a temporary associate in the Prior Authorization Coordinator role or Prior Authorization department required, Written and verbal communication skills, Excellent organizational and time management skills, Excellent ability to absorb new concepts and adapt to a changing environment, Exhibit creativity and self-motivation, with the ability to effectively solve problems as they arise, Demonstration of math aptitude for purposes of calculating simple drug requirements when given dose and price calculations", "qualificationsPreferred" : "Associates degree preferred, Pharmacy experience strongly preferred, General knowledge of drug names, therapeutic categories, dosage forms, manufacturers and packaging preferred, Familiarity with HMO concept, Experience with pharmacy on-line system preferred", "remoteFriendly" : true, "rawDescription" : "# **FIND YOUR FUTURE** We're excited about the potential people bring to our organization. You can grow your career here while enjoying first-class perks, benefits and a culture that fosters growth, innovation and collaboration. # **Overview** The Prior Authorization Coordinator will facilitate the logging in and out of all prior authorization, appeal, reimbursement and grievance requests, and follow-up on requests to ensure that all are resolved and completed in a timely manner. The coordinator will ensure that all steps involved with the process are completed and all regulatory requirements are met or exceeded. They will also be responsible for the pharmacy medical exception line to address provider questions regarding the formularies for all lines of business serviced by Pharmacy Benefit Dimensions. The coordinator will also be assigned to provide high quality, diverse administrative support including but not limited to faxing prior authorization requests, completing decision letters by faxing and copying, making decision notification phone calls to members and physicians, filing, and document scanning preparation. Occasional holidays, weekends and overtime will be a requirement of the position. # **Qualifications** * High school diploma or GED required. Associates degree preferred. * Two (2) years of experience in pharmacy or health insurance operations required OR one (1) year of experience as a temporary associate in the Prior Authorization Coordinator role or Prior Authorization department required. Pharmacy experience strongly preferred. * General knowledge of drug names, therapeutic categories, dosage forms, manufacturers and packaging preferred. Familiarity with HMO concept. * Experience with pharmacy on-line system preferred. * Written and verbal communication skills. * Excellent organizational and time management skills. * Excellent ability to absorb new concepts and adapt to a changing environment. * Exhibit creativity and self-motivation, with the ability to effectively solve problems as they arise. * Demonstration of math aptitude for purposes of calculating simple drug requirements when given dose and price calculations. * Proven examples of displaying the PBD values: Trusted Advisor, Innovative, Excellence, Guardianship, Dedication and Caring. # **Essential Accountabilities** * Assist Clinical Review Pharmacist in making appropriate decisions by verifying member and provider eligibility and filing requests into the correct member folder according to set standards. * Enter data and ensure complete accuracy on all statistics by logging prior authorization requests into pharmacy systems according to set standards. * Complete the requests by entering override into the appropriate pharmacy system and updating all information in required documentation systems according to set standards. May also include transcribing Medical Director decision into systems. * As volume dictates, timely and accurately complete various reports, reimbursement requests, IRO and review of vendor emails/reports as assigned by the Supervisor. * Facilitate follow-up phone calls to members and providers for clinical approvals and denials according to set standards. * Initiate outbound telephone calls to members/physicians regarding decisions within all regulatory time frame requirements. * Answer and provide resolution to provider and internal callers regarding formulary/prior authorization questions for all lines of business. Log all calls into call documentation systems. * Research and respond to escalated and complex inquiries regarding Pharmacy questions or concerns. Ensure that all callers obtain accurate and up-to-date information on policies and procedures and communicate a successful resolution to inquiries. Provide callbacks when necessary. * Provide support for all required letters within the required timeframes. * Fax prior authorization requests including requests for additional information and completed requests. * Copy and mail completed requests and related documents. * Prepare completed requests for scanning into documentation systems. * Maintain proper storage of all files, in accordance with the corporate retention policy. _Immigration or work visa sponsorship will not be provided for this position_ Hiring Compensation Range: $22.00 hourly _Compensation may vary based on factors including but not limited to skills, education, location and experience._ In addition to base compensation, associates may be eligible for a scorecard incentive, full range of benefits and generous paid time off. The base salary range is subject to change and may be modified in the future. _As an Equal Opportunity / Affirmative Action Employer, Independent Health and its affiliates will not discriminate in its employment practices due to an applicant’s race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship and immigration status, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law.__[Click here](http://www.independenthealth.com/about/careers/additional-eeo-aap-information)_ _for additional EEO/AAP_ _or Reasonable Accommodation_ _information._ Current Associates must apply internally via the Job Hub app.", "summaryDescription" : "Prior Authorization Coordinator at The Potential People Bring To Our Organization. Skills: prior authorization, appeal, reimbursement, grievance requests, pharmacy medical exception line, provider questions, formularies. facilitate the logging in and out of all prior authorization, appeal, reimbursement and grievance requests. follow-up on requests to ensure that all are resolved and completed in a timely manner", "postedDate" : "2026-05-09T03:54:03.033", "createdAt" : "2026-05-18T03:54:02.978", "lastUpdated" : "2026-05-18T06:38:35.584", "ingestTimestamp" : "2026-05-18T03:54:02.978", "mongoId" : "6a0a61841663d49372c95b93", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "sourceUrl" : "https://ih.wd1.myworkdayjobs.com/IHA_Careers/job/Hybrid-Career/Prior-Authorization-Coordinator_R0012366", "salaryAnnualMin" : 45760, "salaryAnnualMax" : 45760, "salaryBand" : "30k-50k", "hasSalary" : true, "allSkills" : [ "logging prior authorization requests", "entering override into the appropriate pharmacy system", "transcribing Medical Director decision into systems", "completing reports", "completing reimbursement requests", "reviewing vendor emails/reports", "initiating outbound telephone calls", "answering and providing resolution to provider and internal callers", "logging calls", "researching and responding to escalated and complex inquiries", "providing callbacks", "providing support for all required letters", "faxing prior authorization requests", "copying and mailing completed requests and related documents", "preparing completed requests for scanning", "maintaining proper storage of all files", "creativity", "self-motivation", "problem solving", "prior authorization", "appeal", "reimbursement", "grievance requests", "pharmacy medical exception line", "provider questions", "formularies", "process management", "cross-functional coordination", "vendor/stakeholder management", "operational metrics", "resource planning", "continuous improvement", "pharmacy", "health insurance operations", "drug names", "therapeutic categories", "dosage forms", "manufacturers", "packaging", "HMO concept", "pharmacy on-line system" ], "skillCount" : 41, "jobCategory" : "other", "seniorityLevel" : "executive", "dataQualityScore" : 0.8888889, "_score" : 214.11246, "daysOld" : 9, "hasLocation" : true, "hasGeo" : false }, { "id" : "6a2ca33d74d8ee00a09aada0", "title" : "Prior Law Enforcement - Court Security Officer", "company" : "Walden Security", "salary" : { "min" : 42.0, "max" : 42.0, "currency" : "USD", "frequency" : "yearly", "is_estimated" : false }, "location" : "United States Marshal Service", "locations" : [ "United States Marshal Service" ], "timestamp" : "2026-06-16T05:34:37.736", "fingerprint" : "88ea0a23b4960b537fc05aea68cde04034bcef62a488ec5168c1f4aeaec1c601", "source" : "greenhouse", "language" : "en", "applyUrl" : "https://job-boards.greenhouse.io/waldensecurity/jobs/5163340007", "externalId" : "5163340007", "industryFunction" : { }, "structuredLocations" : [ { "city" : "Providence", "state" : "Rhode Island", "country" : "United States", "continent" : "na", "source" : "llm", "workMode" : "onsite", "geo" : "41.8239891,-71.4128343" } ], "locationText" : "Providence, Rhode Island, United States", "employmentType" : "FULL_TIME", "minimumEducation" : "High School", "experienceMinYears" : 3, "coreResponsibilities" : "Provide security presence, Control access, Monitor security systems, Respond to emergencies, Enforce rules and regulations, Conduct security checks, Maintain logs and reports, Assist visitors and employees", "qualificationsBasic" : "3+ years experience, High School diploma", "remoteFriendly" : false, "workSiteFlexibility" : "Onsite", "rawDescription" : "Walden Security is currently recruiting experienced Court Security Officers. CSOs will provide armed security to courthouses under the USMS contract. Essential Duties and Responsibilities: Includes the following and other duties may be assigned: Perform entrance control: Enforce the District’s entry and identification system which includes operating security screening equipment to detect weapons, contraband, and prohibited items, checking items such as handbags, briefcases, computers, packages, baby carriages, wheelchairs, etc. Perform roving patrol: Patrol court facilities and grounds of the facility in accordance with applicable post orders. Perform stationary post assignments: Stand guard at stationary posts which include (but not limited to) monitoring closed-circuit television, duress alarm systems and other security equipment, courtrooms, judge chambers, and jury rooms. Perform escort duties: When directed, provide armed escort services for judges, court personnel, jurors, and other designated individuals. Perform garage parking and pedestrian control: Where applicable, direct traffic and control lights on court facility properties, as described in the post orders and/or standard operating procedures. Enforce law and order: Enforce federal law while in the performance of assigned duties. This includes (but not limited to) detaining any person attempting to gain unauthorized access to Government property, or a court proceeding(s), or attempting to commit acts that imperil the safety and security of Government employees, property, and the public. Prepare reports and records: Prepare various reports and records regarding contract performance issues, such as labor hours worked, accidents, fire, bomb threats, unusual incidents, or unlawful acts that occurred within the court facility area. Court attendance: Responsible for securing unattended courtrooms, an inspection of courtrooms prior to a proceeding, testing of security devices, and other duties concerning security of the court area. Preserve order: Responsible for providing security presence in the courtroom, enforcing federal law and judicial orders within the courtroom, enforcing local court rules regarding prohibited items, and providing protection to court proceedings as circumstances dictate. Requirements Education and/or Experience: High school diploma or general education degree (GED). At least three (3) calendar years of verifiable experience as a certified law enforcement officer or its military equivalency (Master-at-Arms, CGPD, Security Forces Specialist, etc.); all three (3) years must have occurred within the last seven (7) years. The experience must have included general arrest authority. Language Skills: Must have the ability to read, write, speak, and understand English. Must possess the ability to understand, explain, interpret, and apply rules, regulations, directives, and procedures. Certificates, Licenses, Registrations: Must have a valid driver's license from state of residency and a safe driving record for the past five years; Must receive clearance from the Department of Justice. Must have completed or graduated from certified Federal, state, county, local or military law enforcement training academy and able to provide certification as proof. Other Qualifications: Must be at least 21 years of age; Ability to pass a pre-employment drug screen and criminal background check. Physical Demands: Must meet medical standards as specified by the United States Marshal Service (USMS); The physical demands are based on the contract and must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Essential Duties and Responsibilities: Includes the following and other duties may be assigned: Perform entrance control: Enforce the District’s entry and identification system which includes operating security screening equipment to detect weapons, contraband, and prohibited items, checking items such as handbags, briefcases, computers, packages, baby carriages, wheelchairs, etc. Perform roving patrol: Patrol court facilities and grounds of the facility in accordance with applicable post orders. Perform stationary post assignments: Stand guard at stationary posts which include (but not limited to) monitoring closed-circuit television, duress alarm systems and other security equipment, courtrooms, judge chambers, and jury rooms. Perform escort duties: When directed, provide armed escort services for judges, court personnel, jurors, and other designated individuals. Perform garage parking and pedestrian control: Where applicable, direct traffic and control lights on court facility properties, as described in the post orders and/or standard operating procedures. Enforce law and order: Enforce federal law while in the performance of assigned duties. This includes (but not limited to) detaining any person attempting to gain unauthorized access to Government property, or a court proceeding(s), or attempting to commit acts that imperil the safety and security of Government employees, property, and the public. Prepare reports and records: Prepare various reports and records regarding contract performance issues, such as labor hours worked, accidents, fire, bomb threats, unusual incidents, or unlawful acts that occurred within the court facility area. Court attendance: Responsible for securing unattended courtrooms, an inspection of courtrooms prior to a proceeding, testing of security devices, and other duties concerning security of the court area. Preserve order: Responsible for providing security presence in the courtroom, enforcing federal law and judicial orders within the courtroom, enforcing local court rules regarding prohibited items, and providing protection to court proceedings as circumstances dictate. Requirements Education and/or Experience: High school diploma or general education degree (GED). At least three (3) calendar years of verifiable experience as a certified law enforcement officer or its military equivalency (Master-at-Arms, CGPD, Security Forces Specialist, etc.); all three (3) years must have occurred within the last seven (7) years. The experience must have included general arrest authority. Language Skills: Must have the ability to read, write, speak, and understand English. Must possess the ability to understand, explain, interpret, and apply rules, regulations, directives, and procedures. Certificates, Licenses, Registrations: Must have a valid driver's license from state of residency and a safe driving record for the past five years; Must receive clearance from the Department of Justice. Must have completed or graduated from certified Federal, state, county, local or military law enforcement training academy and able to provide certification as proof. Other Qualifications: Must be at least 21 years of age; Ability to pass a pre-employment drug screen and criminal background check. Physical Demands: Must meet medical standards as specified by the United States Marshal Service (USMS); The physical demands are based on the contract and must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws. EOE/AAP/Minorities/Females/Vet/Disabled VEVRAA Federal Contractor Pay Rate $42.62—$42.62 USD We offer every employee — from executive managers to administrative support to security professionals — unique and generous benefits, as well as opportunities for career growth. So if you’re ready to embark on a meaningful career with one of the nation’s most dynamic and fastest growing security companies, apply with Walden Security today.", "summaryDescription" : "Prior Law Enforcement - Court Security Officer at Walden Security. Provide security presence. Control access", "postedDate" : "2026-06-14T20:07:34.231", "createdAt" : "2026-06-14T20:07:34.231", "lastUpdated" : "2026-06-16T05:34:37.736", "ingestTimestamp" : "2026-06-14T20:07:34.231", "mongoId" : "6a2ca33d74d8ee00a09aada0", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "salaryAnnualMin" : 87360, "salaryAnnualMax" : 87360, "salaryBand" : "75k-100k", "hasSalary" : true, "allSkills" : [ ], "skillCount" : 0, "jobCategory" : "operations", "jobSubcategory" : "general", "seniorityLevel" : "Mid", "dataQualityScore" : 0.7777778, "_score" : 212.46318, "daysOld" : 1, "hasLocation" : true, "hasGeo" : true, "llmIndustry" : "Government", "llmIndustryConfidence" : 0.95 }, { "id" : "6a2cd30974d8ee00a0a35826", "title" : "Healthcare Prior Authorization & Insurance Verification Virtual Assistant", "company" : "Winning Assistants", "industry" : "Hospital & Health Care", "salary" : { "min" : 5.0, "max" : 6.0, "currency" : "USD", "frequency" : "yearly", "is_estimated" : false }, "location" : "Remote", "locations" : [ "Remote" ], "certifications" : [ "HIPAA certification" ], "timestamp" : "2026-06-15T09:17:13.113", "fingerprint" : "a4ec38bf82ef7233413767b3a056bd0045da4eb35e2478b2b6adc2eed0058037", "source" : "workable", "language" : "en", "applyUrl" : "https://apply.workable.com/j/B1B998B751/apply", "externalId" : "B1B998B751", "industryFunction" : { }, "locationPoint" : "12.8797,121.774", "structuredLocations" : [ { "workMode" : "remote" } ], "locationText" : "", "employmentType" : "FULL_TIME", "technicalSkills" : "CPT coding, EHRR systems", "professionalSkills" : [ "Process management", "Cross-functional coordination", "Vendor management", "Stakeholder management", "Operational metrics", "Resource planning", "Continuous improvement", "Prior authorization workflows", "Insurance verification workflows", "Clinical documentation support", "Patient estimates", "Medical records coordination", "Billing claims follow-up", "Scheduling workflows" ], "hardSkillsList" : [ "Radiology authorizations", "Insurance benefit verification", "Documentation management", "Record management" ], "softSkillsList" : [ "Critical thinking", "Independent work" ], "hardSkills" : [ { "name" : "Radiology authorizations", "level" : "intermediate" }, { "name" : "Insurance benefit verification", "level" : "intermediate" }, { "name" : "Documentation management", "level" : "intermediate" }, { "name" : "Record management", "level" : "intermediate" } ], "softSkills" : [ { "name" : "Critical thinking" }, { "name" : "Independent work" } ], "majorSkills" : "Prior authorization management, Insurance verification, Referrals management, Patient estimates", "majorSkillsList" : [ "Prior authorization management", "Insurance verification", "Referrals management", "Patient estimates" ], "coreResponsibilities" : "Manage prior authorizations, Submit radiology authorizations, Track radiology authorizations, Monitor authorization requests, Update CPT codes, Prepare authorization letters, Submit authorization letters, Communicate with insurance companies, Manage TriWest authorizations, Manage Veteran authorizations, Review patient charts, Gather clinical documentation, Collaborate with providers, Collaborate with nurses, Obtain missing clinical information, Verify insurance eligibility, Verify patient benefits, Handle HMO referrals, Follow up on referrals, Review clinical notes, Identify CPT codes, Generate patient cost estimates, Verify copays, Verify deductibles, Verify out-of-pocket expenses, Assist with patient billing inquiries, Assist with insurance questions, Process medical record requests, Follow up on medical records, Ensure imaging reports received, Ensure laboratory results received, Ensure medical records received, Review clinical notes for authorizations, Extract information from notes, Maintain documentation in EHRR, Monitor internal communications, Respond to authorization requests, Follow up on billing claims, Follow up on insurance issues, Manage referral documentation, Manage insurance documentation, Manage billing documentation, Manage patient records documentation, Provide administrative support, Support healthcare operations, Support scheduling workflows", "teamCollaboration" : "Collaborate with providers; Collaborate with nurses; Communicate with insurance companies; Communicate with patients", "domainKnowledge" : "U.S. healthcare practices; Authorization workflows; Insurance verification; CPT coding; Clinical documentation; Vascular surgery; Specialty care; Radiology authorizations; HIPAA compliance; Cybersecurity", "domainList" : [ "u-s-healthcare-practices", "authorization-workflows", "insurance-verification", "cpt-coding", "clinical-documentation", "vascular-surgery", "specialty-care", "radiology-authorizations", "hipaa-compliance", "cybersecurity" ], "domainSpecificKnowledge" : [ "U.S. healthcare practices", "Authorization workflows", "Insurance verification", "CPT coding", "Clinical documentation", "Vascular surgery", "Specialty care", "Radiology authorizations", "HIPAA compliance", "Cybersecurity" ], "toolProficiency" : [ "CGM EMD", "Microsoft Teams", "SIP Trunk VoIP", "Sangoma Digium App" ], "communicationSkills" : "Insurance communication; Provider communication; Nurse communication; Patient communication", "documentationSkills" : "Clinical documentation; Record management; Documentation maintenance", "continuousLearning" : "HIPAA training; Cybersecurity training; VA performance training", "problemSolvingSkills" : "Problem-solving abilities; Critical thinking", "specialRequirements" : "Reliable laptop/desktop, High-speed internet, Noise-canceling headset, Webcam, Quiet workspace", "outcomesObjectives" : "Timely prior authorization submission; Timely prior authorization approval; Accurate insurance verification; Accurate patient cost estimates; Efficient referral management; Efficient authorization request management; Complete EHR documentation; Accurate EHR documentation; Timely insurance follow-up; Timely medical record follow-up; Responsive to urgent needs", "qualificationsBasic" : "Extensive prior authorizations experience, Extensive insurance verification experience, Manage HMO referrals experience, Understand CPT codes, Understand medical billing processes, Experience with U.S. healthcare practices, Healthcare administrative experience, Proficient in speaking English, Proficient in writing English, Relevant work experience, Submit NBI clearance, Submit Local Police Clearance, Available for video meetings", "qualificationsPreferred" : "Vascular surgery experience, Specialty care experience, Radiology authorizations experience, Previous virtual assistant experience", "remoteFriendly" : true, "workSiteFlexibility" : "Remote", "rawDescription" : "**Job Title: Healthcare Prior Authorization & Insurance Verification Virtual Assistant** **Position Type:** Full-Time **Work Hours:** 8:00 AM – 5:00 PM CDT **Work Days:** Monday – Thursday **Salary:** $5 – $6 per hour (depending on experience) **Job Code:** KF-VCPB **Workplace:** Remote **Preferred Candidate Location:** Philippines or Latin America ### ### About the Role We are seeking an experienced Healthcare Virtual Assistant to support a busy vascular surgery practice with prior authorizations, insurance verification, referrals, patient estimates, and medical records coordination. This role requires someone who can work independently, think critically, and manage multiple time-sensitive requests while maintaining accuracy and professionalism. The ideal candidate has extensive experience working with U.S. healthcare practices and is highly skilled in authorization workflows, insurance verification, CPT coding review, and clinical documentation support. ### Core Responsibilities ### Prior Authorization Management (Top Priority) * Manage prior authorizations for vascular surgery procedures * Submit and track radiology authorizations (CT, MRI, MRA, CTA, Ultrasound) * Monitor authorization requests and update CPT codes when procedures change * Prepare and submit authorization letters and supporting documentation * Communicate with insurance companies regarding approvals, denials, modifications, and status updates * Manage TriWest and Veteran authorization requests * Review patient charts and gather supporting clinical documentation for insurance submissions * Collaborate with providers and nurses to obtain missing clinical information ### Insurance Verification, Referrals & Patient Estimates (Top Priority) * Verify insurance eligibility and patient benefits * Handle HMO referrals and referral follow-ups * Review patient notes and identify appropriate CPT codes * Generate patient cost estimates based on CPT codes and insurance coverage * Verify copays, deductibles, and out-of-pocket expenses * Assist with patient billing inquiries and insurance-related questions ### Medical Records & Clinical Documentation Coordination (Top Priority) * Process and follow up on medical record requests * Ensure imaging reports, laboratory results, and medical records are received before appointments * Review clinical notes and extract relevant information for authorizations * Maintain accurate documentation within the EHR/EMR system * Monitor internal communications and respond to authorization-related requests in real time ### Additional Administrative Support * Follow up on billing claims and insurance issues * Manage documentation related to referrals, insurance, billing, and patient records * Provide administrative support for healthcare operations and scheduling workflows ### Software & Systems * CGM EMD (CompuGroup Medical EMD) * Microsoft Teams * SIP Trunk VoIP System * Sangoma Digium App ### Key Performance Indicators (KPIs) * Timely submission and approval of prior authorizations * Accurate insurance verification and patient cost estimates * Efficient management of referrals and authorization requests * Complete and accurate documentation within the EHR * Timely follow-up on insurance and medical record requests * Responsiveness to urgent authorization and scheduling needs * Consistent communication with providers, nurses, insurance companies, and patients **Requirements** * Extensive experience with prior authorizations is required * Extensive experience with insurance verification and benefits verification is required * Experience managing HMO referrals and authorization workflows is required * Strong understanding of CPT codes and medical billing processes is required * Experience working with U.S. healthcare practices is required * Healthcare administrative experience is required * Experience with vascular surgery, specialty care, or radiology authorizations is highly preferred * Previous virtual assistant experience preferred but not required ### Required Skills * Strong understanding of prior authorization processes * Experience handling radiology authorizations (CT, MRI, MRA, CTA, Ultrasound) * Ability to review clinical notes and gather supporting documentation * Experience with patient estimates and insurance benefit verification * Strong documentation and record management skills * Proficiency with EHR/EMR systems * Strong critical thinking and problem-solving abilities * Excellent organizational and time management skills * Ability to manage multiple authorization requests simultaneously * Strong communication skills with insurance companies, providers, nurses, and patients * Ability to work independently with minimal supervision * Strong sense of urgency and follow-through ### Preferred Qualities * Highly detail-oriented and accurate * Proactive and resourceful * Professional and dependable * Comfortable in a fast-paced healthcare environment * Quick learner who can adapt to new systems and workflows * Takes ownership of tasks and follows through to resolution ### Deal Breakers * No prior authorization experience * No insurance verification experience * No experience with HMO referrals * Weak understanding of CPT codes and medical billing processes * No experience working with U.S. healthcare practices * Poor attention to detail * Inability to manage multiple requests simultaneously * Lack of responsiveness during work hours * Failure to comply with HIPAA, security, antivirus, or VPN requirements ### Basic requirements * Must be proficient in speaking and writing English very clearly * Must have relevant work experience * Be able to submit an NBI clearance and/or Local Police Clearance background check before onboarding [mandatory] * Must be available for video meetings with your camera on (when needed) ### Technical requirements * **Device:** Reliable laptop or desktop computer. * **Internet:** High-speed connection (minimum 25 Mbps). * **Audio:** Noise-canceling headset. * **Video:** Webcam for virtual meetings. * **Workspace:** Quiet, professional environment. **Benefits** * **Dedicated HR & Contractor Support Team: **Access to world-class support for questions, guidance, contract matters, and client communication. * **Premium VPN Access (Optional):** A secure VPN license can be provided upon request to enhance privacy and security for client-related tasks. * **HIPAA & Cybersecurity Training + Certification (Provided):** Access to our internal HIPAA compliance training, cybersecurity modules, and certification to help you confidently handle PHI for U.S. healthcare clients. * **Top 1% VA Performance Training:** Access to our proprietary training on communication, client management, productivity systems, and best practices to help you become a top-performing VA and increase long-term client retention. * **Client-Approved U.S. Holidays:** Contractors may take U.S. holidays off according to the client’s needs and schedule. * **Client-Approved Paid or Unpaid Time Off:** Time off may be granted by your client. Paid time off is optional and only if offered by the client. * **Access to Tools & Resources: **Templates, workflow guides, productivity tools, and client-specific SOP support to help you perform at your best. * **Optional Performance-Based Incentives:** Some clients may offer bonuses, incentives, or increased hours based on your performance. These are optional resources and client-approved allowances available to you as an independent contractor. Any resources, trainings, or allowances listed are optional contractor perks and not employee benefits.", "summaryDescription" : "Healthcare Prior Authorization & Insurance Verification Virtual Assistant at Winning Assistants. Skills: Prior authorization management, Insurance verification, Referrals management, Patient estimates. Manage prior authorizations. Submit radiology authorizations", "postedDate" : "2026-06-09T00:00:00.000", "createdAt" : "2026-06-14T02:35:44.680", "lastUpdated" : "2026-06-15T09:17:13.113", "ingestTimestamp" : "2026-06-14T02:35:44.680", "mongoId" : "6a2cd30974d8ee00a0a35826", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "sourceUrl" : "https://apply.workable.com/j/B1B998B751", "salaryAnnualMin" : 10400, "salaryAnnualMax" : 12480, "salaryBand" : "<30k", "hasSalary" : true, "allSkills" : [ "Radiology authorizations", "Insurance benefit verification", "Documentation management", "Record management", "Critical thinking", "Independent work", "Prior authorization management", "Insurance verification", "Referrals management", "Patient estimates", "Process management", "Cross-functional coordination", "Vendor management", "Stakeholder management", "Operational metrics", "Resource planning", "Continuous improvement", "Prior authorization workflows", "Insurance verification workflows", "Clinical documentation support", "Medical records coordination", "Billing claims follow-up", "Scheduling workflows", "U.S. healthcare practices", "Authorization workflows", "CPT coding", "Clinical documentation", "Vascular surgery", "Specialty care", "HIPAA compliance", "Cybersecurity", "HIPAA certification", "CGM EMD", "Microsoft Teams", "SIP Trunk VoIP", "Sangoma Digium App" ], "skillCount" : 36, "jobCategory" : "operations", "jobSubcategory" : "general", "seniorityLevel" : "mid", "dataQualityScore" : 0.8888889, "_score" : 206.01163, "daysOld" : 6, "hasLocation" : true, "hasGeo" : false, "llmIndustry" : "Healthcare", "llmIndustryConfidence" : 0.95 }, { "id" : "69fa35554c40e2acd15dc3cd", "title" : "Prior Authorization Pharmacy Technician", "company" : "Oscar Health", "industry" : "Health Insurance", "salary" : { "min" : 17.2, "max" : 22.57, "currency" : "USD", "frequency" : "yearly" }, "location" : "Arizona, United States", "locations" : [ "Arizona", "United States" ], "certifications" : [ "Pharmacy Technician certification (CPhT)" ], "timestamp" : "2026-05-05T21:23:33.488", "fingerprint" : "9ab3dadecc258b5a3c452cb23d76210d148a25d09753841f599d4067f53b9969", "source" : "greenhouse", "language" : "en", "applyUrl" : "http://www.hioscar.com/careers/7872606?gh_jid=7872606", "externalId" : "7872606", "industryFunction" : { }, "structuredLocations" : [ { "state" : "Arizona", "country" : "United States", "continent" : "na" }, { "state" : "Colorado", "country" : "United States", "continent" : "na" }, { "state" : "District of Columbia", "country" : "United States", "continent" : "na" }, { "state" : "Florida", "country" : "United States", "continent" : "na" }, { "state" : "Idaho", "country" : "United States", "continent" : "na" }, { "state" : "Indiana", "country" : "United States", "continent" : "na" }, { "state" : "Kansas", "country" : "United States", "continent" : "na" }, { "state" : "Maine", "country" : "United States", "continent" : "na" }, { "state" : "Massachusetts", "country" : "United States", "continent" : "na" }, { "state" : "Minnesota", "country" : "United States", "continent" : "na" }, { "state" : "Nevada", "country" : "United States", "continent" : "na" }, { "state" : "New York", "country" : "United States", "continent" : "na" }, { "state" : "Ohio", "country" : "United States", "continent" : "na" }, { "state" : "Pennsylvania", "country" : "United States", "continent" : "na" }, { "state" : "South Carolina", "country" : "United States", "continent" : "na" }, { "state" : "Tennessee", "country" : "United States", "continent" : "na" }, { "state" : "Utah", "country" : "United States", "continent" : "na" }, { "state" : "Virginia", "country" : "United States", "continent" : "na" } ], "locationText" : "Arizona, United States; Colorado, United States; District of Columbia, United States; Florida, United States; Idaho, United States; Indiana, United States; Kansas, United States; Maine, United States; Massachusetts, United States; Minnesota, United States; Nevada, United States; New York, United States; Ohio, United States; Pennsylvania, United States; South Carolina, United States; Tennessee, United States; Utah, United States; Virginia, United States", "experienceMinYears" : 2, "experienceMaxYears" : 5, "experienceLevel" : "Mid", "technicalSkills" : "CVS Caremark's portal", "professionalSkills" : [ "Prior authorization processing", "Pharmacy decision-making", "Member and provider experience improvement", "Pharmacy prior authorization criteria application", "Compliance with applicable laws and regulations" ], "hardSkillsList" : [ "Pharmacy Technician certification (CPhT)", "Typing skills" ], "softSkillsList" : [ "Excellent customer service", "Phone etiquette" ], "hardSkills" : [ { "name" : "Pharmacy Technician certification (CPhT)", "level" : "intermediate" }, { "name" : "Typing skills", "level" : "intermediate" } ], "softSkills" : [ { "name" : "Excellent customer service" }, { "name" : "Phone etiquette" } ], "majorSkills" : "Prior Authorization, Pharmacy Technician", "majorSkillsList" : [ "Prior Authorization", "Pharmacy Technician" ], "coreResponsibilities" : "Processing prior authorizations requests, Providing support for escalated issues related to prior authorizations, Use Oscar and vendor tools to determine eligibility, screen for required documents, create, process, and properly track pharmacy prior authorization requests, Prepare, organize, and distribute pharmacy prior authorization requests for review by pharmacist/physician and respond to pharmacist/physician requests for additional information, Collect relevant medical information (via telephone, fax, and portal) and apply the appropriate PA criteria, clearly documenting all communication and decision making, Meet required decision-making timeframes, including promptly triggering escalation for cases requiring pharmacist review, Communicate oral and written prior authorization outcome notifications that comply with standards and requirements for content and accuracy, Compliance with all applicable laws and regulations", "domainKnowledge" : "Pharmacy; Managed care plan; Pharmacy benefits manager; Step therapy rules and regulations", "domainList" : [ "pharmacy", "managed-care-plan", "pharmacy-benefits-manager", "step-therapy-rules-and-regulations" ], "domainSpecificKnowledge" : [ "Pharmacy", "Managed care plan", "Pharmacy benefits manager", "Step therapy rules and regulations" ], "toolProficiency" : [ "Oscar tools", "Vendor tools" ], "communicationSkills" : "Verbal and written communications; Interpersonal interactions", "documentationSkills" : "Clearly documenting all communication and decision making", "specialRequirements" : "Occasional travel may be required for team meetings and company events", "outcomesObjectives" : "High quality pharmacy decision-making; Improving the member and provider experience; Meet required decision-making timeframes", "qualificationsBasic" : "2+ years of work experience in a pharmacy related field in a retail or managed care plan setting and/or prior authorization experience, Active, unrestricted Pharmacy Technician certification (CPhT), Excellent customer service, phone etiquette, and typing skills", "qualificationsPreferred" : "1+ years of performing pharmacy reviews for a managed care plan or pharmacy benefits manager, Experience working with CVS Caremark's portal and criteria, In-depth understanding of how to operationalize step therapy rules and regulations", "remoteFriendly" : true, "workSiteFlexibility" : "Remote", "rawDescription" : "Hi, we're Oscar. We're hiring a Prior Authorization Pharmacy Technician to join our Pharmacy Tech team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: You will be dedicated to high quality pharmacy decision-making and improving the member and provider experience. This position is responsible for processing prior authorizations requests and providing support for escalated issues related to prior authorizations. You will report into the Pharmacy Technician Supervisor. Work Location: This is a remote position, open to candidates who reside in: Alabama; Arizona; Arkansas; Colorado; Connecticut; District of Columbia; Florida; Georgia; Idaho; Illinois; Indiana; Iowa; Kansas; Kentucky; Maine; Maryland; Massachusetts; Michigan; Minnesota; Missouri; Nevada; New Hampshire; New Jersey; New Mexico; North Carolina; Ohio; Oregon; Pennsylvania; Rhode Island; South Carolina; Tennessee; Texas; Utah; Vermont; or Virginia. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote Pay Transparency: The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $19.11 - $25.08 per hour. The base pay for this role in all other locations is: $17.20 - $22.57 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year. Responsibilities: Use Oscar and vendor tools to determine eligibility, screen for required documents, create, process, and properly track pharmacy prior authorization requests Prepare, organize, and distribute pharmacy prior authorization requests for review by pharmacist/physician and respond to pharmacist/physician requests for additional information Collect relevant medical information (via telephone, fax, and portal) and apply the appropriate PA criteria, clearly documenting all communication and decision making Meet required decision-making timeframes, including promptly triggering escalation for cases requiring pharmacist review Communicate oral and written prior authorization outcome notifications that comply with standards and requirements for content and accuracy Compliance with all applicable laws and regulations Other duties as assigned Requirements: 2+ years of work experience in a pharmacy related field in a retail or managed care plan setting and/or prior authorization experience Active, unrestricted Pharmacy Technician certification (CPhT) Excellent customer service, phone etiquette, and typing skills Bonus Points: 1+ years of performing pharmacy reviews for a managed care plan or pharmacy benefits manager Experience working with CVS Caremark's portal and criteria In-depth understanding of how to operationalize step therapy rules and regulations Strong verbal and written communications, and interpersonal interactions This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here. At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Privacy Policy.", "summaryDescription" : "Prior Authorization Pharmacy Technician at Oscar Health. Skills: Prior Authorization, Pharmacy Technician. Processing prior authorizations requests. Providing support for escalated issues related to prior authorizations", "postedDate" : "2026-05-05T21:21:34.958", "createdAt" : "2026-05-05T21:21:34.958", "lastUpdated" : "2026-05-05T21:23:33.488", "ingestTimestamp" : "2026-05-05T21:21:34.958", "mongoId" : "69fa35554c40e2acd15dc3cd", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "salaryAnnualMin" : 35360, "salaryAnnualMax" : 45760, "salaryBand" : "30k-50k", "hasSalary" : true, "allSkills" : [ "Pharmacy Technician certification (CPhT)", "Typing skills", "Excellent customer service", "Phone etiquette", "Prior Authorization", "Pharmacy Technician", "Prior authorization processing", "Pharmacy decision-making", "Member and provider experience improvement", "Pharmacy prior authorization criteria application", "Compliance with applicable laws and regulations", "Pharmacy", "Managed care plan", "Pharmacy benefits manager", "Step therapy rules and regulations", "Oscar tools", "Vendor tools" ], "skillCount" : 17, "jobCategory" : "other", "jobSubcategory" : "member-programs", "dataQualityScore" : 0.8888889, "_score" : 205.26483, "daysOld" : 0, "hasLocation" : true, "hasGeo" : false, "llmIndustry" : "Healthcare", "llmIndustryConfidence" : 1.0 }, { "id" : "6a15f0cc58b93c861e8189a7", "title" : "Associate Revenue Cycle Analyst - Prior Authorizations", "company" : "Natera", "salary" : { "min" : 58700.0, "max" : 73400.0, "currency" : "USD", "frequency" : "yearly" }, "location" : "US Remote (sup org use only)", "locations" : [ "US Remote (sup org use only)" ], "timestamp" : "2026-05-26T22:59:07.367", "fingerprint" : "bebbedb9552fa34b00165731341b26e25129d837a14166e10c22dff9e2a229c3", "source" : "greenhouse", "language" : "en", "applyUrl" : "https://job-boards.greenhouse.io/natera/jobs/6000137004", "externalId" : "6000137004", "structuredLocations" : [ { "country" : "United States", "continent" : "na", "workMode" : "remote" } ], "locationText" : "United States", "minimumEducation" : "Bachelor's degree in Business, Healthcare Administration, or a related field (or equivalent years of relevant professional experience)", "experienceMinYears" : 2, "experienceMaxYears" : 4, "experienceLevel" : "Mid", "technicalSkills" : "Microsoft Excel, Google Sheets", "professionalSkills" : [ "prior authorization analysis", "medical billing", "inventory management", "revenue cycle" ], "hardSkillsList" : [ "VLOOKUPs", "Pivot Tables", "Data Visualization" ], "softSkillsList" : [ "Collaborative Mindset" ], "hardSkills" : [ { "name" : "VLOOKUPs", "level" : "intermediate" }, { "name" : "Pivot Tables", "level" : "intermediate" }, { "name" : "Data Visualization", "level" : "intermediate" } ], "softSkills" : [ { "name" : "Collaborative Mindset" } ], "majorSkills" : "Inventory Management, Prior Authorization, Data Analysis, Stakeholder Management", "majorSkillsList" : [ "Inventory Management", "Prior Authorization", "Data Analysis", "Stakeholder Management" ], "coreResponsibilities" : "Monitors PA work to identify inventory volume, Determines interventions to move files forward, Ensures upstream data is complete and accurate, Investigates payer and vendor discrepancies, Documents specific PA job requirements, Conducts analysis on PA delays, Assists in building tracking tools, Reviews vendor performance and output, Tracks and reports on key metrics, Acts as a liaison for management, Serves as a technical resource", "teamCollaboration" : "Collaborating with internal stakeholders; Partners with Market Access; works with Claims/Denials teams; work effectively across diverse teams; liaison for management; technical resource for internal teams", "projectManagementSkills" : [ "Workflow & Tracking Development" ], "domainKnowledge" : "healthcare revenue cycle; prior authorization; medical terminology; procedure coding; payor-specific submission requirements", "domainList" : [ "healthcare-revenue-cycle", "prior-authorization", "medical-terminology", "procedure-coding", "payor-specific-submission-requirements" ], "domainSpecificKnowledge" : [ "healthcare revenue cycle", "prior authorization", "medical terminology", "procedure coding", "payor-specific submission requirements" ], "toolProficiency" : [ "Microsoft Excel", "Google Sheets" ], "communicationSkills" : "Analytical Communication", "documentationSkills" : "Requirements & Documentation Management", "continuousLearning" : "process improvement", "problemSolvingSkills" : "Technical Problem Solving; Root-Cause Trend Analysis", "specialRequirements" : "HIPAA, confidentiality protocols", "outcomesObjectives" : "meet established Service Level Agreements (SLAs); minimize front-end friction; optimize reimbursement; maintain SLA compliance; ensure submissions are 'right the first time'; drive continuous performance improvement; adhere to the organization’s high standards for reimbursement accuracy; Submission Turnaround Time (TAT); inventory 'bottleneck' age; vendor error rates", "qualificationsBasic" : "2–4 years of experience in healthcare revenue cycle, specific focus on prior authorization analysis, medical billing, inventory management, Advanced ability to manage high-volume inventory, identify specific points of failure or stagnation within a process, critical thinking skills to troubleshoot logic errors and discrepancies between payor responses and internal routing rules, High proficiency in Microsoft Excel/Google Sheets (VLOOKUPs, Pivot Tables, Data Visualization), Ability to influence and work effectively across diverse teams, Ability to translate complex data into clear, concise reports for stakeholders at all levels, Deep understanding of medical terminology and procedure coding as it relates to payor-specific submission requirements, Strict adherence to HIPAA and confidentiality protocols regarding sensitive patient and financial data", "remoteFriendly" : true, "workSiteFlexibility" : "Remote", "rawDescription" : "Job Summary: Associate Revenue Cycle Analyst The Associate Revenue Cycle Analyst is responsible for driving operational excellence and data integrity within the Prior Authorization (PA) function. This role focuses on the end-to-end health of the PA submission pipeline, ensuring inventory moves efficiently to meet established Service Level Agreements (SLAs). By collaborating with internal stakeholders – including Market Access, Genetic Counselors, Medical Records, Insurance Verification, Claims/Denials/Appeals, etc. – this analyst identifies bottlenecks, investigates systemic anomalies, and provides data-driven insights to minimize front-end friction and optimize reimbursement. Job Responsibilities Inventory Diagnostic & Management: Actively monitors the PA work to identify inventory volume, aging trends, and \"stuck\" requests. Determines necessary interventions to move files forward and maintain SLA compliance. PA Submission Integrity: Serves as the operational analyst for the submission workflow, ensuring that all upstream data is complete and accurate before submission. Cross-Functional Collaboration: Partners with Market Access to align on payor policies and works with Claims/Denials teams to bridge the gap between authorization feedback and actual payment outcomes. Anomaly Investigation: Performs deep-dive investigations into payer and vendor discrepancies (e.g., analyzing why a payer returns \"PA Not Required\" for a service specifically flagged for authorization) and recommends system logic or workflow adjustments. Requirements & Documentation Management: Identifies and documents specific PA job requirements (e.g., required clinical notes, specific forms, or portal-specific data fields) to ensure submissions are \"right the first time.\" Root-Cause Trend Analysis: Conducts analysis on PA delays or submission failures, presenting actionable findings to leadership to drive continuous performance improvement. Workflow & Tracking Development: Assists in building and refining tracking tools and standardized workflows for the PA lifecycle, specifically focusing on the hand-offs between upstream and downstream departments. Vendor Monitoring: Reviews vendor performance and output, ensuring external partners accurately process actions and adhere to the organization’s high standards for reimbursement accuracy. KPI Reporting: Tracks and reports on key metrics, including Submission Turnaround Time (TAT), inventory \"bottleneck\" age, vendor error rates, etc.. Strategic Communication: Acts as a liaison for management to explain complex operational trends, system glitches, or payer-behavior shifts affecting the revenue cycle. Knowledge Sharing: Serves as a technical resource for internal teams regarding PA submission nuances and best practices for process improvement. Qualifications Education: Bachelor’s degree in Business, Healthcare Administration, or a related field (or equivalent years of relevant professional experience). Experience: 2–4 years of experience in healthcare revenue cycle, with a specific focus on prior authorization analysis, medical billing, or inventory management. Required Knowledge, Skills, and Abilities Inventory Mastery: Advanced ability to manage high-volume inventory and identify specific points of failure or stagnation within a process. Technical Problem Solving: Strong critical thinking skills to troubleshoot logic errors and discrepancies between payor responses and internal routing rules. Data Proficiency: High proficiency in Microsoft Excel/Google Sheets (VLOOKUPs, Pivot Tables, Data Visualization). Collaborative Mindset: Ability to influence and work effectively across diverse teams. Analytical Communication: Ability to translate complex data into clear, concise reports for stakeholders at all levels. Nuanced Accuracy: Deep understanding of medical terminology and procedure coding as it relates to payor-specific submission requirements. Discretion: Strict adherence to HIPAA and confidentiality protocols regarding sensitive patient and financial data. The pay range is listed and actual compensation packages are based on a wide array of factors unique to each candidate, including but not limited to skill set, years & depth of experience, certifications and specific office location. This may differ in other locations due to cost of labor considerations. Austin, TX $58,700—$73,400 USD OUR OPPORTUNITY Natera™ is a global leader in cell-free DNA (cfDNA) testing, dedicated to oncology, women’s health, and organ health. Our aim is to make personalized genetic testing and diagnostics part of the standard of care to protect health and enable earlier and more targeted interventions that lead to longer, healthier lives. The Natera team consists of highly dedicated statisticians, geneticists, doctors, laboratory scientists, business professionals, software engineers and many other professionals from world-class institutions, who care deeply for our work and each other. When you join Natera, you’ll work hard and grow quickly. Working alongside the elite of the industry, you’ll be stretched and challenged, and take pride in being part of a company that is changing the landscape of genetic disease management. WHAT WE OFFER Competitive Benefits - Employee benefits include comprehensive medical, dental, vision, life and disability plans for eligible employees and their dependents. Additionally, Natera employees and their immediate families receive free testing in addition to fertility care benefits. Other benefits include pregnancy and baby bonding leave, 401k benefits, commuter benefits and much more. We also offer a generous employee referral program! For more information, visit www.natera.com. Natera is proud to be an Equal Opportunity Employer. We are committed to ensuring a diverse and inclusive workplace environment, and welcome people of different backgrounds, experiences, abilities and perspectives. Inclusive collaboration benefits our employees, our community and our patients, and is critical to our mission of changing the management of disease worldwide. All qualified applicants are encouraged to apply, and will be considered without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, age, veteran status, disability or any other legally protected status. We also consider qualified applicants regardless of criminal histories, consistent with applicable laws. If you are based in California, we encourage you to read this important information for California residents. Link: https://www.natera.com/notice-of-data-collection-california-residents/ Please be advised that Natera will reach out to candidates with a @natera.com email domain ONLY. Email communications from all other domain names are not from Natera or its employees and are fraudulent. Natera does not request interviews via text messages and does not ask for personal information until a candidate has engaged with the company and has spoken to a recruiter and the hiring team. Natera takes cyber crimes seriously, and will collaborate with law enforcement authorities to prosecute any related cyber crimes. For more information: - BBB announcement on job scams - FBI Cyber Crime resource page", "summaryDescription" : "Associate Revenue Cycle Analyst - Prior Authorizations at Natera. Skills: Inventory Management, Prior Authorization, Data Analysis, Stakeholder Management. Monitors PA work to identify inventory volume. Determines interventions to move files forward", "postedDate" : "2026-05-26T22:38:16.930", "createdAt" : "2026-05-26T22:38:16.930", "lastUpdated" : "2026-05-26T22:59:07.367", "ingestTimestamp" : "2026-05-26T22:38:16.930", "mongoId" : "6a15f0cc58b93c861e8189a7", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "salaryAnnualMin" : 58700, "salaryAnnualMax" : 73400, "salaryBand" : "50k-75k", "hasSalary" : true, "allSkills" : [ "VLOOKUPs", "Pivot Tables", "Data Visualization", "Collaborative Mindset", "Inventory Management", "Prior Authorization", "Data Analysis", "Stakeholder Management", "prior authorization analysis", "medical billing", "inventory management", "revenue cycle", "Workflow & Tracking Development", "healthcare revenue cycle", "prior authorization", "medical terminology", "procedure coding", "payor-specific submission requirements", "Microsoft Excel", "Google Sheets" ], "skillCount" : 20, "jobCategory" : "operations", "jobSubcategory" : "billing-operations", "dataQualityScore" : 0.8888889, "_score" : 203.83043, "daysOld" : 0, "hasLocation" : true, "hasGeo" : false }, { "id" : "68dd1eeace260f92cbea0c20", "title" : "Author Experience Manager", "company" : "Amazon Japan G. K.", "industry" : "Sales, Advertising, Account Management, Customer Success, international stores", "salary" : { "min" : 7500000.0, "max" : 1.1E7, "currency" : "JPY", "frequency" : "yearly", "is_estimated" : true, "estimation_basis" : "Market baseline for an E-Commerce Author Experience Manager in Tokyo, Japan, adjusted for mid-seniority and manager experience." }, "location" : "Tokyo, JPN", "locations" : [ "Tokyo, JPN" ], "timestamp" : "2026-06-15T13:15:49.787", "fingerprint" : "0f1d347bb94907b7e6eab3a28b5a1d233e2c45c5e485fb9738031c172cb38e1f", "source" : "amazon", "language" : "en", "applyUrl" : "https://account.amazon.com/jobs/3098715/apply", "externalId" : "e6072332-5e5f-4329-a02c-8ea0958f3a21", "industryFunction" : { }, "structuredLocations" : [ { "city" : "Tokyo", "country" : "Japan", "continent" : "as", "source" : "llm", "workMode" : "onsite", "geo" : "35.6768601,139.7638947" } ], "locationText" : "Tokyo, Japan", "employmentType" : "FULL_TIME", "minimumEducation" : "Bachelor's", "experienceLevel" : "Manager", "technicalSkills" : "SQL, BI Tools", "professionalSkills" : [ "Project management", "Customer acquisition", "Campaign management", "Growth metrics", "Brand strategy" ], "hardSkillsList" : [ "Data analysis" ], "hardSkills" : [ { "name" : "Data analysis", "level" : "intermediate" } ], "majorSkills" : "Author experience, Indie publishing, Digital marketing, Event planning", "majorSkillsList" : [ "Author experience", "Indie publishing", "Digital marketing", "Event planning" ], "coreResponsibilities" : "Plan and execute projects, Grow KDP business, Support author growth, Drive author communication, Plan author events, Conduct competitor analysis, Approve digital marketing assets, Approve influencer marketing assets, Approve tradeshow assets, Use data to support projects, Improve owned media, Manage Kindle Deals admin, Manage Prime Reading admin, Manage author reach out program, Support author acquisition activities", "teamCollaboration" : "Work with team members; Work with local teams; Work with international teams", "projectManagementSkills" : [ "Project management" ], "domainKnowledge" : "Self-publishing; Kindle Direct Publishing; Indie manga; Fliptoon", "domainList" : [ "self-publishing", "kindle-direct-publishing", "indie-manga", "fliptoon" ], "domainSpecificKnowledge" : [ "Self-publishing", "Kindle Direct Publishing", "Indie manga", "Fliptoon" ], "communicationSkills" : "Written communication; Oral communication", "problemSolvingSkills" : "Problem solving", "specialRequirements" : "Work with sensitive content, Work with adult content, Work with culturally sensitive content", "outcomesObjectives" : "Increase author engagement", "qualificationsBasic" : "Bachelor's degree or equivalent experience, Attention to detail, Excellent problem solving skills, Knowledge of SQL and BI Tools or willingness to learn, Oral and written communication skills, Fluency in English and/or Japanese", "qualificationsPreferred" : "Experience managing agencies, Demonstrated ability to work independently, Ability to work on a diverse team", "remoteFriendly" : false, "workSiteFlexibility" : "Onsite", "rawDescription" : "Amazon's Kindle Direct Publishing (KDP) is a service for self-publishing books to the Amazon Kindle store. The Author Experience Manager, Indie Publishing will be assisting to plan and execute a variety of projects to grow the KDP business in Japan, as well as supporting author growth. This position will drive author communication and event planning as a Top Author Evangelist. The ideal candidate is a strong project manager who is customer obsessed, data-driven, detail-oriented, and excited to work in a fast-paced environment. They are comfortable working both independently as well as in close partnership with team members across the organization both locally and internationally. Candidates must be able to work with sensitive content, including culturally sensitive and adult content. Key job responsibilities Author Experience Manager will support in various different author related works; Below are some examples 1. Competitor Analysis (Research basic information of the services, try out the service to check the UI/UX, etc),and make a summary chart of the comparison 2. Basic Communication/Asset Approvals with External Agencies for planning and executing Digital Marketing, Influencer Marketing, Tradeshows (Events), needed for the KDP business 3. Using various existing Data to be used to support the running projects (that is owned by the manager) and author growth 4. Dive into Owned Media (Homepage, Help Page, etc) and identify where it could be improved for Author experience 5. All admin work related to Kindle Deals, Prime Reading, etc for KDP Selection, including author communication 6. Manage the \"author reach out program\", where we reach out to top authors to obtain useful information to increase their engagement 7. Support author acquisition activities to build good relationship with potential authors About the team Amazon's Kindle Direct Publishing (KDP) is a service for self-publishing books to the Amazon Kindle store. We support and encourage individual authors as well as vendors. On top of the global KDP program, we are building JP unique manga program (Indie manga/Fliptoon) to support manga big market. Basic Qualifications: · Bachelor’s degree or equivalent experience · Strong attention to detail and excellent problem solving skills · Knowledge of SQL and BI Tools or willingness to learn with AI agent · Strong oral and written communication skills. · Fluency in English and/or Japanese Preferred Qualifications: · Experience managing agencies to deliver marketing programs at scale · Demonstrated ability to work independently and autonomously · Ability to work on a diverse team or with a diverse range of coworkers Our inclusive culture empowers Amazonians to deliver the best results for our customers. If you have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support for the interview or onboarding process, please visit https://amazon.jobs/content/en/how-we-hire/accommodations for more information. If the country/region you’re applying in isn’t listed, please contact your Recruiting Partner.", "summaryDescription" : "Author Experience Manager at Amazon Japan G. K.. Skills: Author experience, Indie publishing, Digital marketing, Event planning. Plan and execute projects. Grow KDP business", "postedDate" : "2026-06-14T06:46:33.519", "createdAt" : "2026-06-14T06:46:33.519", "lastUpdated" : "2026-06-15T13:15:49.787", "ingestTimestamp" : "2026-06-14T06:46:33.519", "mongoId" : "68dd1eeace260f92cbea0c20", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "sourceUrl" : "https://account.amazon.com/jobs/3098715/apply", "salaryBand" : "200k+", "hasSalary" : false, "allSkills" : [ "Data analysis", "Author experience", "Indie publishing", "Digital marketing", "Event planning", "Project management", "Customer acquisition", "Campaign management", "Growth metrics", "Brand strategy", "Self-publishing", "Kindle Direct Publishing", "Indie manga", "Fliptoon" ], "skillCount" : 14, "jobCategory" : "marketing", "jobSubcategory" : "growth", "seniorityLevel" : "Mid", "dataQualityScore" : 1.0, "_score" : 203.0822, "daysOld" : 1, "hasLocation" : true, "hasGeo" : true, "llmIndustry" : "E-Commerce", "llmIndustryConfidence" : 0.95 }, { "id" : "6a10b83b58b93c861e1ff520", "title" : "Authorizations Specialistilling", "company" : "ReWorks Solutions", "industry" : "Hospital & Health Care", "salary" : { "currency" : "ZAR", "frequency" : "yearly" }, "location" : "Remote", "locations" : [ "Remote" ], "timestamp" : "2026-05-22T23:27:39.565", "fingerprint" : "1e7db28dbdfc7628ae4fa92a069a5d60abc890af2992da0b1650b0e41271c5bc", "source" : "workable", "language" : "en", "applyUrl" : "https://apply.workable.com/j/83AB1BFD23/apply", "externalId" : "83AB1BFD23", "industryFunction" : { }, "locationPoint" : "-30.5595,22.9375", "structuredLocations" : [ { "city" : "Murray", "state" : "Utah", "country" : "United States", "continent" : "na", "source" : "llm", "workMode" : "onsite" }, { "country" : "United States", "continent" : "na", "workMode" : "remote" } ], "locationText" : "Murray, Utah, United States; United States", "employmentType" : "FULL_TIME", "minimumEducation" : "Associate's degree", "experienceMinYears" : 2, "experienceMaxYears" : 2, "experienceLevel" : "Entry", "technicalSkills" : "EHR, Microsoft Office Suite", "professionalSkills" : [ "medical billing", "authorization processes", "medical terminology", "coding (CPT, ICD-10)", "insurance policies" ], "hardSkillsList" : [ "medical billing", "authorization processes", "medical terminology", "coding (CPT, ICD-10)", "insurance policies" ], "hardSkills" : [ { "name" : "medical billing", "level" : "intermediate" }, { "name" : "authorization processes", "level" : "intermediate" }, { "name" : "medical terminology", "level" : "intermediate" }, { "name" : "coding (CPT, ICD-10)", "level" : "intermediate" }, { "name" : "insurance policies", "level" : "intermediate" } ], "majorSkills" : "prior authorization requests, medical billing claims, healthcare providers, insurance payers", "majorSkillsList" : [ "prior authorization requests", "medical billing claims", "healthcare providers", "insurance payers" ], "coreResponsibilities" : "Manage prior authorization requests, Prepare, submit and follow up on medical billing claims, Communicate with healthcare providers, Communicate with insurance payers, Communicate with patients, Maintain accurate records within EHR, Maintain accurate records within billing systems, Monitor authorization approvals, Monitor authorization denials, Support billing audits, Support reconciliation processes", "teamCollaboration" : "collaborate effectively with multiple stakeholders", "domainKnowledge" : "healthcare administration; medical billing; payer policies; regulations", "domainList" : [ "healthcare-administration", "medical-billing", "payer-policies", "regulations" ], "domainSpecificKnowledge" : [ "healthcare administration", "medical billing", "payer policies", "regulations" ], "toolProficiency" : [ "billing software", "EHR", "Microsoft Office Suite" ], "communicationSkills" : "communication skills to collaborate effectively with multiple stakeholders", "documentationSkills" : "Maintain accurate records", "outcomesObjectives" : "ensuring timely and accurate processing; support patient care delivery; resolve billing and authorization issues; ensuring compliance with payer policies; ensuring compliance with regulations; taking appropriate action to resolve discrepancies; ensure revenue integrity", "qualificationsBasic" : "At least 2 years of experience in medical billing and authorization processes, Proficiency with billing software, Proficiency with electronic health records (EHR), Proficiency with Microsoft Office Suite, understanding of medical terminology, understanding of coding (CPT, ICD-10), understanding of insurance policies, Excellent organizational skills, high attention to detail, communication skills to collaborate effectively with multiple stakeholders, Ability to work independently in a remote, fast-paced environment", "qualificationsPreferred" : "Associate's degree in healthcare administration, medical billing, or related field", "remoteFriendly" : true, "workSiteFlexibility" : "Remote", "rawDescription" : "**Job Title:** Authorizations Specialist/Billing **Job Type:** Full-Time, Remote (US Hours: 9am-5pm EST) **Salary:** Paid in South African Rands (ZAR) ### Key Responsibilities * Manage prior authorization requests ensuring timely and accurate processing to support patient care delivery. * Prepare, submit and follow up on medical billing claims to insurance companies and patients. * Communicate with healthcare providers, insurance payers, and patients to resolve billing and authorization issues. * Maintain accurate records within EHR and billing systems, ensuring compliance with payer policies and regulations. * Monitor authorization approvals and denials, taking appropriate action to resolve discrepancies. * Support billing audits and reconciliation processes to ensure revenue integrity. **Requirements** * Associate's degree in healthcare administration, medical billing, or related field preferred. * At least 2 years of experience in medical billing and authorization processes. * Proficiency with billing software, electronic health records (EHR), and Microsoft Office Suite. * Strong understanding of medical terminology, coding (CPT, ICD-10), and insurance policies. * Excellent organizational skills with high attention to detail. * Strong communication skills to collaborate effectively with multiple stakeholders. * Ability to work independently in a remote, fast-paced environment. **Benefits** 1. Comfortable working U.S. hours 2. Remote work from home _**Fraud Disclaimer: **_ReWorks Solutions will never request payment during recruitment or require in-person office visits. All official communication will come from a ReWorks Solutions email address. Please verify any suspicious messages with our team directly.", "summaryDescription" : "Authorizations Specialistilling at ReWorks Solutions. Skills: prior authorization requests, medical billing claims, healthcare providers, insurance payers. Manage prior authorization requests. Prepare, submit and follow up on medical billing claims", "postedDate" : "2026-05-12T00:00:00.000", "createdAt" : "2026-05-22T23:25:38.932", "lastUpdated" : "2026-05-22T23:27:39.565", "ingestTimestamp" : "2026-05-22T23:25:38.932", "mongoId" : "6a10b83b58b93c861e1ff520", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "sourceUrl" : "https://apply.workable.com/j/83AB1BFD23", "hasSalary" : false, "allSkills" : [ "medical billing", "authorization processes", "medical terminology", "coding (CPT, ICD-10)", "insurance policies", "prior authorization requests", "medical billing claims", "healthcare providers", "insurance payers", "healthcare administration", "payer policies", "regulations", "billing software", "EHR", "Microsoft Office Suite" ], "skillCount" : 15, "jobCategory" : "engineering", "jobSubcategory" : "hospital-health-care", "seniorityLevel" : "mid", "dataQualityScore" : 0.8888889, "_score" : 201.84511, "daysOld" : 10, "hasLocation" : true, "hasGeo" : false }, { "id" : "6a214e6b74d8ee00a0bcc478", "title" : "Specialty Rx Prior Authorization/Patient Assistance Specialist", "company" : "West Cancer Center", "industry" : "Healthcare", "salary" : { "min" : 48500.0, "max" : 65500.0, "currency" : "USD", "frequency" : "yearly", "is_estimated" : true, "estimation_basis" : "Market baseline for a Mid-level Specialty Rx Prior Authorization/Patient Assistance Specialist in Germantown, United States, adjusted for the healthcare industry and typical company size." }, "location" : "7945 Wolf River Blvd, Germantown TN 38138", "locations" : [ "7945 Wolf River Blvd", "Germantown TN 38138" ], "certifications" : [ "PTCB certification" ], "timestamp" : "2026-06-05T03:01:50.074", "fingerprint" : "313ab1163625bfaf8268445f1b989352ad5b40ba67e5fb7845ee042f315e884a", "source" : "greenhouse", "language" : "en", "applyUrl" : "https://job-boards.greenhouse.io/westcancercenter/jobs/8573823002", "externalId" : "8573823002", "industryFunction" : { }, "structuredLocations" : [ { "city" : "Germantown", "state" : "Tennessee", "country" : "United States", "continent" : "na", "source" : "llm", "workMode" : "onsite", "geo" : "35.0867577,-89.8100858" } ], "locationText" : "Germantown, Tennessee, United States", "employmentType" : "FULL_TIME", "minimumEducation" : "High School Diploma", "experienceMinYears" : 2, "experienceMaxYears" : 4, "technicalSkills" : "EMR documentation, Computer applications, Word processing, Email", "professionalSkills" : [ "Prior authorizations", "Patient assistance", "Benefit verifications", "Prescription drug benefits", "Adjudication processes", "Pharmacy operations" ], "hardSkillsList" : [ "Medication measurement", "Dose measurement", "Pharmacy law", "Medical terminology", "Basic mathematics" ], "softSkillsList" : [ "Interpersonal skills", "Emotional intelligence" ], "hardSkills" : [ { "name" : "Medication measurement", "level" : "intermediate" }, { "name" : "Dose measurement", "level" : "intermediate" }, { "name" : "Pharmacy law", "level" : "intermediate" }, { "name" : "Medical terminology", "level" : "intermediate" }, { "name" : "Basic mathematics", "level" : "intermediate" } ], "softSkills" : [ { "name" : "Interpersonal skills" }, { "name" : "Emotional intelligence" } ], "majorSkills" : "Prior authorizations, Patient assistance, Medication access", "majorSkillsList" : [ "Prior authorizations", "Patient assistance", "Medication access" ], "coreResponsibilities" : "Communicate with patients, physicians, nurses, reimbursement representatives, and, Complete prior authorizations, Secure patient assistance, Serve as a liaison between medical partners and, Support patients with access and affordability, Ensure timely medication delivery, Complete benefit verifications, Document in EMR, Provide high-quality customer service, Develop and maintain relationships with clinic staff, physicians,, Understand prescription drug benefits and adjudication processes, Provide consultation and support to improve patient services, Improve prescription capture rates, Research financial assistance options, Identify process improvements, Implement process improvements, Assist pharmacists and pharmacy staff with administrative duties, Process claims, Track inventory, Perform audits, File documents, Provide backup support for pharmacy operations, Perform other duties as assigned", "teamCollaboration" : "Multi-functional teams; Clinic staff; Physicians; Pharmacy contacts", "domainKnowledge" : "Pharmacy law; Medical terminology; Prescription drug benefits", "domainList" : [ "pharmacy-law", "medical-terminology", "prescription-drug-benefits" ], "domainSpecificKnowledge" : [ "Pharmacy law", "Medical terminology", "Prescription drug benefits" ], "toolProficiency" : [ "Computers", "Scanners" ], "communicationSkills" : "Verbal communication; Written communication", "documentationSkills" : "EMR documentation", "continuousLearning" : "Ongoing training; Educational resources; Growth opportunities", "innovationCreativity" : "Innovation", "problemSolvingSkills" : "Problem-solving", "outcomesObjectives" : "Improve patient outcomes; Reduce financial barriers to care; Enhance customer experience", "qualificationsBasic" : "High School Diploma or equivalent, 2–4 years of related experience, 4–5 years of related experience, PTCB certification or equivalent, Tennessee State Board of Pharmacy Registration", "qualificationsPreferred" : "Similar vocational experience through completion of a 2 to 4-year degree", "workSiteFlexibility" : "Onsite", "rawDescription" : "Job Title: Specialty Rx Prior Authorization/Patient Assistance Specialist About Us At West Cancer Center, we are dedicated to providing compassionate, patient-centered care while advancing groundbreaking research. Our team fosters collaboration, innovation, and professional growth, ensuring that every role contributes to making a difference in patients’ lives. Join us in our mission to provide comprehensive support to those navigating the challenges of cancer treatment. Position Overview The Specialty Rx Prior Authorization/Patient Assistance Specialist serves as a key liaison between patients, providers, pharmacy teams, and insurance payers to ensure timely medication access. This role is responsible for completing prior authorizations, securing financial assistance, and supporting pharmacy operations to improve patient outcomes and reduce financial barriers to care. Key Responsibilities Communicate with patients, physicians, nurses, reimbursement representatives, and insurance payers to complete prior authorizations and secure patient assistance Serve as a liaison between medical partners and pharmacy for implementation of Rx benefits Support patients with access and affordability to ensure timely medication delivery Complete prior authorizations, benefit verifications, and EMR documentation Provide high-quality customer service to patients and staff Develop and maintain relationships with clinic staff, physicians, and pharmacy contacts Understand prescription drug benefits and adjudication processes Provide consultation and support to improve patient services and prescription capture rates Research financial assistance options including copay cards, foundations, and assistance programs Identify and implement process improvements to enhance customer experience Assist pharmacists and pharmacy staff with administrative duties as needed (claims processing, inventory tracking, audits, filing) Provide backup support for pharmacy operations when needed Perform other duties as assigned Qualifications Education & Experience Required: High School Diploma or equivalent 2–4 years of related experience through an equivalent combination of education and experience OR 4–5 years of related experience PTCB certification or equivalent Tennessee State Board of Pharmacy Registration Preferred: Similar vocational experience through completion of a 2 to 4-year degree Skills & Abilities Strong organization, analytical, and follow-up skills Excellent verbal and written communication skills Strong problem-solving skills Ability to organize and prioritize work assignments Ability to manage multiple priorities in a fast-paced environment Ability to operate computers, scanners, and related equipment Basic mathematics skills Ability to work independently and efficiently Ability to analyze situations and respond in a timely manner Ability to work in multi-functional teams Strong interpersonal skills and emotional intelligence Ability to build and maintain effective working relationships within West Cancer Center Proficiency in computer applications including word processing and email Knowledge of medication and dose measurement Knowledge of pharmacy law and medical terminology Strong attention to detail and reliability Why West Cancer Center is a Great Place to Work Meaningful Impact: Play a direct role in supporting patients through one of the most challenging times of their lives. Collaborative Culture: Work alongside a multidisciplinary team of dedicated professionals committed to improving cancer care. Professional Development: Benefit from ongoing training, educational resources, and growth opportunities. Mission-Driven Environment: Be part of an organization guided by compassion, integrity, and innovation. No nights, weekends, or holidays. Comprehensive benefits package. Join Us If you are passionate about improving patient access to medications and delivering exceptional support in a fast-paced healthcare environment, we invite you to join West Cancer Center as a Specialty Rx Prior Authorization/Patient Assistance Specialist.", "summaryDescription" : "Specialty Rx Prior Authorization/Patient Assistance Specialist at West Cancer Center. Skills: Prior authorizations, Patient assistance, Medication access. Communicate with patients, physicians, nurses, reimbursement representatives, and. Complete prior authorizations", "postedDate" : "2026-06-04T16:01:37.322", "createdAt" : "2026-06-04T16:01:37.322", "lastUpdated" : "2026-06-05T03:01:50.074", "ingestTimestamp" : "2026-06-04T16:01:37.322", "mongoId" : "6a214e6b74d8ee00a0bcc478", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "salaryAnnualMin" : 48500, "salaryAnnualMax" : 65500, "salaryBand" : "30k-50k", "hasSalary" : true, "allSkills" : [ "Medication measurement", "Dose measurement", "Pharmacy law", "Medical terminology", "Basic mathematics", "Interpersonal skills", "Emotional intelligence", "Prior authorizations", "Patient assistance", "Medication access", "Benefit verifications", "Prescription drug benefits", "Adjudication processes", "Pharmacy operations", "PTCB certification", "Computers", "Scanners" ], "skillCount" : 17, "jobCategory" : "other", "jobSubcategory" : "pharmacy", "dataQualityScore" : 0.8888889, "_score" : 195.7339, "daysOld" : 0, "hasLocation" : true, "hasGeo" : true, "llmIndustry" : "Healthcare" }, { "id" : "6a19db7c58b93c861e676d29", "title" : "Prior Authorization Nurse", "company" : "Hive Health", "industry" : "Medical Operations", "location" : "HQ", "locations" : [ "HQ" ], "timestamp" : "2026-05-29T20:42:37.730", "fingerprint" : "8a5767e93363baee1cbaf2f77b950a03e8dc39cd7f3fd49231f513e36be90374", "source" : "ashby", "language" : "en", "applyUrl" : "https://jobs.ashbyhq.com/hivehealth/9bccff02-8862-4b6b-bd7c-7c0036768230/application", "externalId" : "9bccff02-8862-4b6b-bd7c-7c0036768230", "industryFunction" : { }, "structuredLocations" : [ { "city" : "Ortigas", "workMode" : "hybrid" } ], "locationText" : "Ortigas", "employmentType" : "FULL_TIME", "professionalSkills" : [ "Medical indications for adjudication" ], "coreResponsibilities" : "Process member availments and claims, Prepare, approve, and issue Letters of Authorization, Identify and resolve problems, Maintain data recording for auditing, Discharge members efficiently, Respond promptly to inbound calls, Provide accurate information regarding availments, Maintain daily log-in and call handling metrics, Follow up on inquiries or escalated cases, Serve as main point of contact for providers, Coordinate with healthcare providers and internal departments, Track progress of cases, Document interactions, updates, and outcomes", "teamCollaboration" : "Coordinate with healthcare providers and internal departments", "domainKnowledge" : "HMO guidelines; PhilHealth regulations", "domainList" : [ "hmo-guidelines", "philhealth-regulations" ], "domainSpecificKnowledge" : [ "HMO guidelines", "PhilHealth regulations" ], "communicationSkills" : "Excellent verbal and written communications", "documentationSkills" : "Maintain complete and accurate data recording; Document interactions, updates, and outcomes", "continuousLearning" : "learning opportunities", "innovationCreativity" : "Passion for innovation in healthcare", "problemSolvingSkills" : "Proficient problem-solving abilities", "specialRequirements" : "Must be willing to work hybrid in Ortigas, Must be willing to do occasional night shifts, Willingness to conduct hospital visits", "outcomesObjectives" : "Ensure high-quality service delivery; Timely call handling; Efficient coordination of inquiries and cases; Ensure all documentations and computations are complete and accurate; Ensure timely resolution", "qualificationsBasic" : "Familiarity with medical indications for adjudication, Proficient problem-solving abilities, Excellent verbal and written communications, Collaborative team player with the ability to adapt quickly in a fast-paced environment", "qualificationsPreferred" : "Prior experience in roles such as medical liaison, provider relations, hospital HMO section staff, company nurse, teleconsult nurse, etc. , is advantageous, Willingness to conduct hospital visits", "remoteFriendly" : true, "workSiteFlexibility" : "Hybrid", "rawDescription" : "Ready to make an impact? At Hive Health http://ourhivehealth.com, we’re on a mission to make healthcare radically more accessible for all—and we need passionate, driven individuals to help us make it happen. If you thrive in a fast-paced, innovative environment and want to work on solutions that truly matter, we’d love to meet you! Job Summary The Prior Authorization Nurse serves as the key interface between members, healthcare providers, and the HMO teams. The role is responsible for accurate processing of member availments, issuance of Letters of Authorization (LOAs), timely call handling, and efficient coordination of inquiries and cases to ensure high-quality service delivery. Responsibilities 1. Accurate and Efficient Adjudication of Member Availments and Issuance of LOA’s - Review and process member availments and claims in accordance with company policies, HMO guidelines, medical indication, and PhilHealth regulations. - Ensure Letters of Authorization (LOAs) are accurately prepared, approved, and issued in a timely manner or within ideal standards. - Identify and resolve problems concerning availments and LOA issuances to members. - Maintain complete and accurate data recording for auditing and utilization capture. - Discharge members efficiently ensuring all documentations and computations are complete and accurate. 2. Maintain Effective Call Handling and Timely Log-in - Respond promptly and professionally to inbound calls from providers. - Provide accurate information regarding availments, benefits, and LOA’s. - Maintain daily log-in and call handling metrics in line with departmental standards. - Follow up on inquiries or escalated cases to ensure timely resolution. 3. Efficient Handling and Coordination of Inquiries and Cases - Serve as the main point of contact for providers regarding availments, LOAs, and member concerns. - Coordinate with healthcare providers and internal departments to resolve members’ inquiries and concerns - efficiently. - Track the progress of cases and ensure timely resolution. - Document interactions, updates, and outcomes in the concerned channels. Qualifications - Must be willing to work hybrid in Ortigas - Must be willing to do occasional night shifts - Familiarity with medical indications for adjudication - Prior experience in roles such as medical liaison, provider relations, hospital HMO section staff, company nurse, teleconsult nurse, etc., is advantageous - Willingness to conduct hospital visits - Proficient problem-solving abilities - Curious, results-driven, ownership mentality with growth mindset - Excellent verbal and written communications - Collaborative team player with the ability to adapt quickly in a fast-paced environment - Passion for innovation in healthcare Join our team as we revolutionalize healthcare in the Philippines—and beyond! ✨ Day 1 benefits for full-time employees – because we practice what we preach! Enjoy comprehensive healthcare coverage for you and your dependent, and paid time off from the start. \uD83D\uDE80 Grow with us – mentorship, career development, and learning opportunities to help you thrive. \uD83C\uDF0D Global connections – gain insights and support from top minds at Harvard, Stanford, and beyond.", "summaryDescription" : "Prior Authorization Nurse at Hive Health. Process member availments and claims. 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United States", "employmentType" : "FULL_TIME", "minimumEducation" : "Bachelor’s degree", "experienceMinYears" : 3, "experienceMaxYears" : 5, "experienceLevel" : "Mid", "technicalSkills" : "Epic, PowerBI, Google Workspace, Slack, SQL", "professionalSkills" : [ "Prior Authorization", "healthcare operations", "revenue cycle workflow optimization", "data analysis", "payer portals", "HIPAA compliance", "PHI handling" ], "hardSkillsList" : [ "document processes", "analyze referral volumes", "synthesize large data volumes", "make informed decisions based on data analysis", "map workflows end-to-end", "identify bottlenecks" ], "softSkillsList" : [ "analytical mindset", "Collaborative team player", "consultative approach", "Comfort with ambiguity", "shifting priorities", "Innovative problem-solver", "curiosity", "creativity", "Adept at navigating complex challenges", "think critically" ], "hardSkills" : [ { "name" : "document processes", "level" : "intermediate" }, { "name" : "analyze referral volumes", "level" : "intermediate" }, { "name" : "synthesize large data volumes", "level" : "intermediate" }, { "name" : "make informed decisions based on data analysis", "level" : "intermediate" }, { "name" : "map workflows end-to-end", "level" : "intermediate" }, { "name" : "identify bottlenecks", "level" : "intermediate" } ], "softSkills" : [ { "name" : "analytical mindset" }, { "name" : "Collaborative team player" }, { "name" : "consultative approach" }, { "name" : "Comfort with ambiguity" }, { "name" : "shifting priorities" }, { "name" : "Innovative problem-solver" }, { "name" : "curiosity" }, { "name" : "creativity" }, { "name" : "Adept at navigating complex challenges" }, { "name" : "think critically" } ], "majorSkills" : "Prior Authorization Workflow, Epic workflows, payer portal automation, workflow automation, data analysis", "majorSkillsList" : [ "Prior Authorization Workflow", "Epic workflows", "payer portal automation", "workflow automation", "data analysis" ], "coreResponsibilities" : "Own the operational workstream deliverables for customer implementations including discovery, data collection and analysis of Prior Authorization workflows., Proactively manage all operational workstream tasks of the implementation project plan, Conduct operational workflow and portal shadowing sessions with customers, asking thoughtful and specific questions to understand their current processes., Identify risks related to the successful implementation of Humata’s PA technology., Capture and document operational workflows in Humata’s design workbook to inform solution build and develop prior authorization workflows., Review customer payer/plan mix and formulate automation workflow recommendations, Adapt future-state workflows and payer/portal additions for customers during stabilization and maintenance phases post go-live, Create payer portal credentials to support Humata’s automations, Own payer portal validation during testing and go-live project collaborate with the customer’s operations/technical teams to review automation results, Document and escalate validation issues to be reviewed/resolved by Humata’s Engineering team", "teamCollaboration" : "Be a collaborative and communicative member of the implementation project team, ensuring implementation project manager has visibility into operational progress and risks; collaborate with the customer’s operations/technical teams to review automation results", "projectManagementSkills" : [ "Own the operational workstream deliverables for customer implementations", "Proactively manage all operational workstream tasks of the implementation project plan" ], "domainKnowledge" : "Prior Authorization; healthcare operations; Epic workflows; payer portal automation; revenue cycle operations; HIPAA compliance; PHI handling", "domainList" : [ "prior-authorization", "healthcare-operations", "epic-workflows", "payer-portal-automation", "revenue-cycle-operations", "hipaa-compliance", "phi-handling" ], "domainSpecificKnowledge" : [ "Prior Authorization", "healthcare operations", "Epic workflows", "payer portal automation", "revenue cycle operations", "HIPAA compliance", "PHI handling" ], "toolProficiency" : [ "Epic", "PowerBI", "Google Workspace", "Slack" ], "communicationSkills" : "communicative member of the implementation project team; consultative approach to client engagement", "documentationSkills" : "document requirements for new ones; document workflows are fully mapped, tested, and optimized; document operational workflows in Humata’s design workbook; document processes (both current state and future-state automations) succinctly", "innovationCreativity" : "building new processes in an evolving start-up environment; Innovative problem-solver who brings curiosity, creativity, and structure to ambiguous challenges.", "problemSolvingSkills" : "analytical mindset; ability to synthesize large data volumes and make informed decisions based on data analysis; Innovative problem-solver; Adept at navigating complex challenges and can think critically to solution and remove barriers", "specialRequirements" : "Willingness to travel as required (up to 25%) for customer onsite discovery sessions and all-company meetings", "outcomesObjectives" : "ensuring seamless alignment with Humata’s automation platform; ensure workflows are fully mapped, tested, and optimized for Humata’s touchless prior authorization solution; improve healthcare efficiency and patient outcomes", "qualificationsBasic" : "Bachelor’s degree in Business, Healthcare Administration, or a related field., 3+ years hands’ on Prior Authorization experience, Familiarity with healthcare operations, prior authorization, or revenue cycle workflow optimization., Systems knowledge/expertise with Epic (referrals, work queues, coverage), payer portals, and revenue cycle operations, Hands-on data analysis experience, ability to analyze referral volumes service line/payer., Organized, able to document processes (both current state and future-state automations) succinctly, Comfort with ambiguity, shifting priorities and building new processes in an evolving start-up environment, Collaborative team player with a consultative approach to client engagement and solution development, Utilize PowerBI for reporting, Google Workspace, Slack, Willingness to travel as required (up to 25%) for customer onsite discovery sessions and all-company meetings", "qualificationsPreferred" : "Prior Authorization Expertise: Understand the end-to-end Prior Authorization process (including pre and post-auth touchpoints). Hands-on experience working with payer portals., Epic user knowledge (Cadence, Referrals, Coverage/Work Queues), comfortable pulling/analyzing data (Excel/SQL helpful)., Operational & process mindset: Can map workflows end-to-end and identify bottlenecks., Experience with healthcare software and familiarity with HIPAA compliance and PHI handling., Innovative problem-solver who brings curiosity, creativity, and structure to ambiguous challenges., Adept at navigating complex challenges and can think critically to solution and remove barriers", "remoteFriendly" : true, "workSiteFlexibility" : "Remote", "rawDescription" : "\uD83D\uDD0D What we're looking for: The Prior Authorization Workflow Consultant plays a critical role in Humata Health’s customer’s implementation process and post go-live stabilization/maintenance efforts. This role sits at the intersection of hospital operations, Epic workflows, and payer portal automation. The PA Workflow Consultant partners with hospital PA staff to review prior authorization workflows, referral volumes, and payer mappings, ensuring seamless alignment with Humata’s automation platform. They will validate existing automations, document requirements for new ones, and ensure workflows are fully mapped, tested, and optimized for Humata’s touchless prior authorization solution. \uD83D\uDCCDLocation: Remote, US or Hybrid - Orlando, Florida, US ✅ Responsibilities - Own the operational workstream deliverables for customer implementations including discovery, data collection and analysis of Prior Authorization workflows. - Proactively manage all operational workstream tasks of the implementation project plan - Be a collaborative and communicative member of the implementation project team, ensuring implementation project manager has visibility into operational progress and risks - Conduct operational workflow and portal shadowing sessions with customers, asking thoughtful and specific questions to understand their current processes. Identify risks related to the successful implementation of Humata’s PA technology. - Capture and document operational workflows in Humata’s design workbook to inform solution build and develop prior authorization workflows. Review customer payer/plan mix and formulate automation workflow recommendations - Adapt future-state workflows and payer/portal additions for customers during stabilization and maintenance phases post go-live - Create payer portal credentials to support Humata’s automations - Own payer portal validation during testing and go-live project phases; collaborate with the customer’s operations/technical teams to review automation results - Document and escalate validation issues to be reviewed/resolved by Humata’s Engineering team \uD83D\uDEE0 Role Requirements - Bachelor’s degree in Business, Healthcare Administration, or a related field. - 3+ years hands’ on Prior Authorization experience - Familiarity with healthcare operations, prior authorization, or revenue cycle workflow optimization. - Systems knowledge/expertise with Epic (referrals, work queues, coverage), payer portals, and revenue cycle operations - Hands-on data analysis experience, ability to analyze referral volumes service line/payer. This role requires a strong analytical mindset and ability to synthesize large data volumes and make informed decisions based on data analysis - Organized, able to document processes (both current state and future-state automations) succinctly - Comfort with ambiguity, shifting priorities and building new processes in an evolving start-up environment - Collaborative team player with a consultative approach to client engagement and solution development - Utilize PowerBI for reporting, Google Workspace, Slack - Willingness to travel as required (up to 25%) for customer onsite discovery sessions and all-company meetings ⭐Preferred Experience & Skills: - Prior Authorization Expertise: Understand the end-to-end Prior Authorization process (including pre and post-auth touchpoints). Hands-on experience working with payer portals. - Strong Epic user knowledge (Cadence, Referrals, Coverage/Work Queues), comfortable pulling/analyzing data (Excel/SQL helpful). - Operational & process mindset: Can map workflows end-to-end and identify bottlenecks. - Experience with healthcare software and familiarity with HIPAA compliance and PHI handling. - Innovative problem-solver who brings curiosity, creativity, and structure to ambiguous challenges. - Adept at navigating complex challenges and can think critically to solution and remove barriers \uD83D\uDE80 Why Join Humata Health? - Impactful Work: Contribute to innovative solutions that improve healthcare efficiency and patient outcomes - Remote Flexibility: Enjoy working remotely while being part of a collaborative team, with access to our new office in Winter Park, FL - Competitive Compensation: Enjoy competitive base compensation, equity through our Employee Stock Option Plan, and bonus-eligible roles - Comprehensive Benefits: Full benefits package including unlimited PTO and 401k program with employer match - Growth Opportunities: Advance your career in a fast-paced, high-impact environment with ample professional development - Inclusive Culture: Join a diverse workplace where your ideas and contributions are valued - Pay Transparency Humata Health will provide pay transparency information upon application to those in qualifying jurisdictions. Our salary ranges are based on competitive pay for our company’s size and industry. They are one part of the total compensation package that may also include equity, variable compensation, and benefits. Individual pay decisions are ultimately based on several factors, including qualifications, experience level, skillset, geography, and balancing internal equity. - Humata Health is proud to be an equal-opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, age, sex, marital status, ancestry, neurotype, physical or mental disability, veteran status, gender identity, sexual orientation or any other category protected by law. - Join us in our mission to transform healthcare while building a life that works in harmony both in and outside the office.", "summaryDescription" : "Prior Authorization Workflow Consultant at Humata Health. Skills: Prior Authorization Workflow, Epic workflows, payer portal automation, workflow automation, data analysis. Own the operational workstream deliverables for customer implementations including discovery, data collection and analysis of Prior Authorization workflows.. Proactively manage all operational workstream tasks of the implementation project plan", "postedDate" : "2026-05-17T20:20:27.920", "createdAt" : "2026-05-17T20:20:27.920", "lastUpdated" : "2026-05-17T21:22:05.907", "ingestTimestamp" : "2026-05-17T20:20:27.920", "mongoId" : "6a09f71e1663d49372aa1d24", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "hasSalary" : false, "allSkills" : [ "document processes", "analyze referral volumes", "synthesize large data volumes", "make informed decisions based on data analysis", "map workflows end-to-end", "identify bottlenecks", "analytical mindset", "Collaborative team player", "consultative approach", "Comfort with ambiguity", "shifting priorities", "Innovative problem-solver", "curiosity", "creativity", "Adept at navigating complex challenges", "think critically", "Prior Authorization Workflow", "Epic workflows", "payer portal automation", "workflow automation", "data analysis", "Prior Authorization", "healthcare operations", "revenue cycle workflow optimization", "payer portals", "HIPAA compliance", "PHI handling", "Own the operational workstream deliverables for customer implementations", "Proactively manage all operational workstream tasks of the implementation project plan", "revenue cycle operations", "Epic", "PowerBI", "Google Workspace", "Slack" ], "skillCount" : 34, "jobCategory" : "customer-service", "jobSubcategory" : "customer-delivery", "dataQualityScore" : 0.8888889, "_score" : 194.25397, "daysOld" : 0, "hasLocation" : true, "hasGeo" : false }, { "id" : "6a2abe9674d8ee00a06eda41", "title" : "Prior Auth Representative Associate", "company" : "Corewell Health", "industry" : "Healthcare", "salary" : { "min" : 38000.0, "max" : 48000.0, "currency" : "USD", "frequency" : "yearly", "is_estimated" : true, "estimation_basis" : "Market baseline data for an Entry-level Prior Auth Representative Associate in Kentwood, United States, adjusted for the healthcare industry." }, "location" : "Kentwood, MI", "locations" : [ "Kentwood, MI", "United States of America" ], "timestamp" : "2026-06-14T23:31:54.735", "fingerprint" : "17c4f88fef2ae63f05eba5b8cd7f3a3ea68968bcf4b41324e4099413622f598a", "source" : "workday", "language" : "en", "applyUrl" : "https://spectrumhealth.wd5.myworkdayjobs.com/CorewellHealthCareers/job/Kentwood-MI/Prior-Auth-Representative-Associate_R212703", "externalId" : "R212703", "industryFunction" : { }, "locationPoint" : "30.93824,-90.50898", "structuredLocations" : [ { "city" : "Kentwood", "state" : "Michigan", "country" : "United States", "continent" : "na", "source" : "llm", "workMode" : "onsite", "geo" : "42.8694731,-85.6447492" } ], "locationText" : "Kentwood, Michigan, United States", "employmentType" : "FULL_TIME", "minimumEducation" : "High School", "professionalSkills" : [ "Authorization requirements" ], "hardSkillsList" : [ "Chart abstraction", "Insurance information" ], "softSkillsList" : [ "Critical thinking" ], "hardSkills" : [ { "name" : "Chart abstraction", "level" : "intermediate" }, { "name" : "Insurance information", "level" : "intermediate" } ], "softSkills" : [ { "name" : "Critical thinking" } ], "majorSkills" : "Prior Authorization, Healthcare services", "majorSkillsList" : [ "Prior Authorization", "Healthcare services" ], "coreResponsibilities" : "Utilize payer websites, Maintain up to date credentials, Perform chart abstraction, Adhere to department procedures, Complete authorization requests, Communicate barriers effectively, Anticipate and resolve barriers, Maintain 90% or higher audit score, Obtain 15 authorizations daily", "domainKnowledge" : "Coordination of benefits", "domainList" : [ "coordination-of-benefits" ], "domainSpecificKnowledge" : [ "Coordination of benefits" ], "toolProficiency" : [ "Payer websites" ], "documentationSkills" : "Patient charting", "problemSolvingSkills" : "Root cause analysis", "outcomesObjectives" : "Maintain 90% or higher audit score; Obtain 15 authorizations daily", "qualificationsBasic" : "High School Diploma or equivalent, 1 year of relevant experience", "qualificationsPreferred" : "Basic understanding of medical terminology, Prior Authorization experience, Epic experience, Payor portal experience", "remoteFriendly" : true, "workSiteFlexibility" : "Hybrid", "rawDescription" : "## **Job Summary** Provides clerical support to assist in the delivery of quality healthcare services via a Financial Clearance model by way of obtaining accurate and timely authorizations. Crucial to obtaining an authorization is the ability to read and understand basic insurance information as well as perform a complete and accurate registration. Training will consist of six weeks of in-person instruction and will shift to remote training after that time pursuant on satisfactory progress including authorizations obtained daily and a passing audit score. ## ## **Essential Functions** * Demonstrates the ability to utilize all payer websites and maintains up to date credentials to assist verifying patient’s coordination of benefits and authorization requirements. * Able to perform chart abstraction to pull clinical data from a patient’s chart for review by a payer’s clinical team., * Adheres to all department procedures, guidelines, and standard work with the ability to utilize resources appropriately. * Complete authorization requests in a timely and efficient manor without compromising quality to ensure patients receive their care as scheduled * Communicates barriers effectively to avoid patient delays in care demonstrating critical thinking skills to anticipate and resolve barriers to success. * Maintains a 90% or higher audit score consistently and be receptive to constructive feedback. * Proficient in one primary service area with a firm understanding of the industry standard authorization requirements. * Able to obtain 15 authorizations daily (consideration for type of service line) ## **Qualifications** Required * High School Diploma or equivalent * 1 year of relevant experience in related field Preferred * Basic understanding of medical terminology * Prior Authorization experience * Epic experience * Payor portal experience **About Corewell Health** As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence. ## How Corewell Health cares for you * Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more [here](https://careers.corewellhealth.org/us/en/benefits-new). * On-demand pay program powered by Payactiv * Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more! * Optional identity theft protection, home and auto insurance * Traditional and Roth retirement options with service contribution and match savings * Eligibility for benefits is determined by employment type and status **Primary Location** SITE - Care Center Breton - 4600 Breton Rd SE - Kentwood **Department Name** Contact Center Pre Authorizations - Corporate **Employment Type** Full time **Shift** Day (United States of America) **Weekly Scheduled Hours** 40 **Hours of Work** 8:30 a.m. to 5 p.m. **Days Worked** Monday to Friday **Weekend Frequency** N/A ********CURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.******** _Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief._ _Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category._ _An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team._ _You may request assistance in completing the application process by calling 616.486.7447._", "summaryDescription" : "Prior Auth Representative Associate at Corewell Health. Skills: Prior Authorization, Healthcare services. Utilize payer websites. Maintain up to date credentials", "postedDate" : "2026-06-11T04:42:52.420", "createdAt" : "2026-06-12T04:42:52.365", "lastUpdated" : "2026-06-14T23:31:54.735", "ingestTimestamp" : "2026-06-12T04:42:52.365", "mongoId" : "6a2abe9674d8ee00a06eda41", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "sourceUrl" : "https://spectrumhealth.wd5.myworkdayjobs.com/CorewellHealthCareers/job/Kentwood-MI/Prior-Auth-Representative-Associate_R212703", "salaryAnnualMin" : 38000, "salaryAnnualMax" : 48000, "salaryBand" : "30k-50k", "hasSalary" : true, "allSkills" : [ "Chart abstraction", "Insurance information", "Critical thinking", "Prior Authorization", "Healthcare services", "Authorization requirements", "Coordination of benefits", "Payer websites" ], "skillCount" : 8, "jobCategory" : "other", "seniorityLevel" : "mid", "dataQualityScore" : 0.8888889, "_score" : 189.29536, "daysOld" : 3, "hasLocation" : true, "hasGeo" : true, "llmIndustry" : "Healthcare" }, { "id" : "6a2ca33d74d8ee00a09aad90", "title" : "Prior Law Enforcement - Court Security Officer", "company" : "Walden Security", "industry" : "Government", "salary" : { "min" : 42.0, "max" : 42.0, "currency" : "USD", "frequency" : "yearly", "is_estimated" : false }, "location" : "United States Marshal Service", "locations" : [ "United States Marshal Service" ], "certifications" : [ "Certified Federal law enforcement training academy", "Certified state law enforcement training academy", "Certified county law enforcement training academy", "Certified local law enforcement training academy", "Certified military law enforcement training academy" ], "timestamp" : "2026-06-15T08:14:31.503", "fingerprint" : "a33afebddd7ed3c8a7b6ae45b2d07a4341e9aae383bb4e7c0678c6b751e861b4", "source" : "greenhouse", "language" : "en", "applyUrl" : "https://job-boards.greenhouse.io/waldensecurity/jobs/5159706007", "externalId" : "5159706007", "industryFunction" : { }, "structuredLocations" : [ { "city" : "Boston", "state" : "Massachusetts", "country" : "United States", "continent" : "na", "source" : "llm", "workMode" : "onsite", "geo" : "42.3588336,-71.0578303" } ], "locationText" : "Boston, Massachusetts, United States", "employmentType" : "FULL_TIME", "minimumEducation" : "High School", "experienceMinYears" : 3, "professionalSkills" : [ "Process management", "Cross-functional coordination", "Vendor management", "Stakeholder management", "Operational metrics", "Resource planning", "Continuous improvement" ], "hardSkillsList" : [ "Entrance control", "Roving patrol", "Stationary post assignments", "Escort duties", "Traffic control", "Law enforcement", "Report preparation", "Record keeping", "Courtroom security", "Preserve order" ], "hardSkills" : [ { "name" : "Entrance control", "level" : "intermediate" }, { "name" : "Roving patrol", "level" : "intermediate" }, { "name" : "Stationary post assignments", "level" : "intermediate" }, { "name" : "Escort duties", "level" : "intermediate" }, { "name" : "Traffic control", "level" : "intermediate" }, { "name" : "Law enforcement", "level" : "intermediate" }, { "name" : "Report preparation", "level" : "intermediate" }, { "name" : "Record keeping", "level" : "intermediate" }, { "name" : "Courtroom security", "level" : "intermediate" }, { "name" : "Preserve order", "level" : "intermediate" } ], "majorSkills" : "Court security, Law enforcement, Security screening, Report writing", "majorSkillsList" : [ "Court security", "Law enforcement", "Security screening", "Report writing" ], "coreResponsibilities" : "Perform entrance control, Operate security screening equipment, Check items for prohibited items, Perform roving patrol, Patrol court facilities and grounds, Perform stationary post assignments, Monitor CCTV, Monitor duress alarm systems, Monitor security equipment, Provide armed escort services, Direct traffic, Control lights on court properties, Enforce federal law, Detain unauthorized persons, Prepare reports and records, Secure unattended courtrooms, Inspect courtrooms, Test security devices, Provide security presence in courtroom, Enforce judicial orders, Enforce local court rules, Provide protection to court proceedings", "domainKnowledge" : "Federal law; Court proceedings; USMS contract", "domainList" : [ "federal-law", "court-proceedings", "usms-contract" ], "domainSpecificKnowledge" : [ "Federal law", "Court proceedings", "USMS contract" ], "toolProficiency" : [ "Security screening equipment", "Closed-circuit television", "Duress alarm systems" ], "documentationSkills" : "Prepare reports; Prepare records", "specialRequirements" : "Armed security, Physical demands", "qualificationsBasic" : "High school diploma or GED, 3+ years law enforcement experience, General arrest authority, Ability to read, write, speak English, Valid driver's license, Safe driving record, DOJ clearance, Law enforcement training academy certification, At least 21 years old, Pass pre-employment drug screen, Pass criminal background check, Meet USMS medical standards", "remoteFriendly" : false, "workSiteFlexibility" : "Onsite", "rawDescription" : "Walden Security is currently recruiting experienced Court Security Officers. CSOs will provide armed security to courthouses under the USMS contract. Essential Duties and Responsibilities: Includes the following and other duties may be assigned: Perform entrance control: Enforce the District’s entry and identification system which includes operating security screening equipment to detect weapons, contraband, and prohibited items, checking items such as handbags, briefcases, computers, packages, baby carriages, wheelchairs, etc. Perform roving patrol: Patrol court facilities and grounds of the facility in accordance with applicable post orders. Perform stationary post assignments: Stand guard at stationary posts which include (but not limited to) monitoring closed-circuit television, duress alarm systems and other security equipment, courtrooms, judge chambers, and jury rooms. Perform escort duties: When directed, provide armed escort services for judges, court personnel, jurors, and other designated individuals. Perform garage parking and pedestrian control: Where applicable, direct traffic and control lights on court facility properties, as described in the post orders and/or standard operating procedures. Enforce law and order: Enforce federal law while in the performance of assigned duties. This includes (but not limited to) detaining any person attempting to gain unauthorized access to Government property, or a court proceeding(s), or attempting to commit acts that imperil the safety and security of Government employees, property, and the public. Prepare reports and records: Prepare various reports and records regarding contract performance issues, such as labor hours worked, accidents, fire, bomb threats, unusual incidents, or unlawful acts that occurred within the court facility area. Court attendance: Responsible for securing unattended courtrooms, an inspection of courtrooms prior to a proceeding, testing of security devices, and other duties concerning security of the court area. Preserve order: Responsible for providing security presence in the courtroom, enforcing federal law and judicial orders within the courtroom, enforcing local court rules regarding prohibited items, and providing protection to court proceedings as circumstances dictate. Requirements Education and/or Experience: High school diploma or general education degree (GED). At least three (3) calendar years of verifiable experience as a certified law enforcement officer or its military equivalency (Master-at-Arms, CGPD, Security Forces Specialist, etc.); all three (3) years must have occurred within the last seven (7) years. The experience must have included general arrest authority. Language Skills: Must have the ability to read, write, speak, and understand English. Must possess the ability to understand, explain, interpret, and apply rules, regulations, directives, and procedures. Certificates, Licenses, Registrations: Must have a valid driver's license from state of residency and a safe driving record for the past five years; Must receive clearance from the Department of Justice. Must have completed or graduated from certified Federal, state, county, local or military law enforcement training academy and able to provide certification as proof. Other Qualifications: Must be at least 21 years of age; Ability to pass a pre-employment drug screen and criminal background check. Physical Demands: Must meet medical standards as specified by the United States Marshal Service (USMS); The physical demands are based on the contract and must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Essential Duties and Responsibilities: Includes the following and other duties may be assigned: Perform entrance control: Enforce the District’s entry and identification system which includes operating security screening equipment to detect weapons, contraband, and prohibited items, checking items such as handbags, briefcases, computers, packages, baby carriages, wheelchairs, etc. Perform roving patrol: Patrol court facilities and grounds of the facility in accordance with applicable post orders. Perform stationary post assignments: Stand guard at stationary posts which include (but not limited to) monitoring closed-circuit television, duress alarm systems and other security equipment, courtrooms, judge chambers, and jury rooms. Perform escort duties: When directed, provide armed escort services for judges, court personnel, jurors, and other designated individuals. Perform garage parking and pedestrian control: Where applicable, direct traffic and control lights on court facility properties, as described in the post orders and/or standard operating procedures. Enforce law and order: Enforce federal law while in the performance of assigned duties. This includes (but not limited to) detaining any person attempting to gain unauthorized access to Government property, or a court proceeding(s), or attempting to commit acts that imperil the safety and security of Government employees, property, and the public. Prepare reports and records: Prepare various reports and records regarding contract performance issues, such as labor hours worked, accidents, fire, bomb threats, unusual incidents, or unlawful acts that occurred within the court facility area. Court attendance: Responsible for securing unattended courtrooms, an inspection of courtrooms prior to a proceeding, testing of security devices, and other duties concerning security of the court area. Preserve order: Responsible for providing security presence in the courtroom, enforcing federal law and judicial orders within the courtroom, enforcing local court rules regarding prohibited items, and providing protection to court proceedings as circumstances dictate. Requirements Education and/or Experience: High school diploma or general education degree (GED). At least three (3) calendar years of verifiable experience as a certified law enforcement officer or its military equivalency (Master-at-Arms, CGPD, Security Forces Specialist, etc.); all three (3) years must have occurred within the last seven (7) years. The experience must have included general arrest authority. Language Skills: Must have the ability to read, write, speak, and understand English. Must possess the ability to understand, explain, interpret, and apply rules, regulations, directives, and procedures. Certificates, Licenses, Registrations: Must have a valid driver's license from state of residency and a safe driving record for the past five years; Must receive clearance from the Department of Justice. Must have completed or graduated from certified Federal, state, county, local or military law enforcement training academy and able to provide certification as proof. Other Qualifications: Must be at least 21 years of age; Ability to pass a pre-employment drug screen and criminal background check. Physical Demands: Must meet medical standards as specified by the United States Marshal Service (USMS); The physical demands are based on the contract and must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws. EOE/AAP/Minorities/Females/Vet/Disabled VEVRAA Federal Contractor Pay Rate $42.62—$42.62 USD We offer every employee — from executive managers to administrative support to security professionals — unique and generous benefits, as well as opportunities for career growth. So if you’re ready to embark on a meaningful career with one of the nation’s most dynamic and fastest growing security companies, apply with Walden Security today.", "summaryDescription" : "Prior Law Enforcement - Court Security Officer at Walden Security. Skills: Court security, Law enforcement, Security screening, Report writing. Perform entrance control. Operate security screening equipment", "postedDate" : "2026-06-13T20:56:54.865", "createdAt" : "2026-06-13T20:56:54.865", "lastUpdated" : "2026-06-15T08:14:31.503", "ingestTimestamp" : "2026-06-13T20:56:54.865", "mongoId" : "6a2ca33d74d8ee00a09aad90", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "salaryAnnualMin" : 87360, "salaryAnnualMax" : 87360, "salaryBand" : "75k-100k", "hasSalary" : true, "allSkills" : [ "Entrance control", "Roving patrol", "Stationary post assignments", "Escort duties", "Traffic control", "Law enforcement", "Report preparation", "Record keeping", "Courtroom security", "Preserve order", "Court security", "Security screening", "Report writing", "Process management", "Cross-functional coordination", "Vendor management", "Stakeholder management", "Operational metrics", "Resource planning", "Continuous improvement", "Federal law", "Court proceedings", "USMS contract", "Certified Federal law enforcement training academy", "Certified state law enforcement training academy", "Certified county law enforcement training academy", "Certified local law enforcement training academy", "Certified military law enforcement training academy", "Security screening equipment", "Closed-circuit television", "Duress alarm systems" ], "skillCount" : 31, "jobCategory" : "operations", "jobSubcategory" : "general", "seniorityLevel" : "Mid", "dataQualityScore" : 0.8888889, "_score" : 187.93192, "daysOld" : 1, "hasLocation" : true, "hasGeo" : true, "llmIndustry" : "Government", "llmIndustryConfidence" : 0.95 }, { "id" : "6a309695f292fd229c0d50b5", "title" : "Daytime Musculoskeletal Radiologist Partner-Track", "company" : "Diversified Radiology", "industry" : "MSK Daytime", "salary" : { "min" : 500000.0, "max" : 900000.0, "currency" : "USD", "frequency" : "yearly", "is_estimated" : false }, "location" : "Denver, Colorado", "locations" : [ "Denver, Colorado" ], "timestamp" : "2026-06-16T12:54:01.256", "fingerprint" : "a21760491211d6cfaac8c6285c9d2c282d1c5cd7cc1040df7ee720dc3370a3fc", "source" : "lever", "language" : "en", "applyUrl" : "https://jobs.lever.co/DiversifiedRadiology/50401cd9-14f8-4e93-99ad-441d4907c936/apply", "externalId" : "50401cd9-14f8-4e93-99ad-441d4907c936", "industryFunction" : { }, "structuredLocations" : [ { "city" : "Denver", "state" : "Colorado", "country" : "United States", "continent" : "na", "source" : "llm", "workMode" : "onsite", "geo" : "39.7392364,-104.9848620" } ], "locationText" : "Denver, Colorado, United States", "employmentType" : "FULL_TIME", "remoteFriendly" : true, "rawDescription" : "## Description Diversified Radiology is expanding and seeking a fellowship-trained Musculoskeletal Radiologist to join our highly subspecialized, collegial practice in Denver, Colorado. This is an opportunity to practice high-quality MSK imaging in a supportive environment with a strong focus on subspecialty excellence, efficiency, and collaborative teamwork. Our group offers a well-balanced practice with competitive financial stability, a strong emphasis on quality of life, and the opportunity for partnership for those who desire it. Physicians benefit from 24/7 coverage support, a mature and stable practice infrastructure, and a dedicated team that prioritizes both clinical excellence and sustainable workflow. 100% MSK Volume Shift Hours: Daytime Location: Onsite in Denver, CO and Remote shifts available Start Date: Flexible Employment Options: Full-time or PRN available ## Responsibilities Responsible for 100% MSK imaging interpretation including MRI, CT, radiographs, spine imaging, and general body imaging High-volume, service-oriented practice requiring strong efficiency and patient-focused care ## Requirements Must be Fellowship trained Must be ABR Board Certified or, if recent graduate, Board Eligible Must be skilled or willing to learn arthrogram injections ## Benefits Partner Salary: $500,000+ plus benefits (partners can earn $500-900k+) Additional bonuses for productivity (Associate and Partner Levels) and Retention Monthly fellowship stipend offered to fellows and residents Annual CME/business expense allowance Partnership Track: 1 year for candidates with 2+ years of experience; 2 years for those with less than 2 years of experience. Student loan support Vacation: Generous time off Internal moonlighting opportunities available Moving Allowance if applicable Comprehensive benefits offerings including multiple medical coverage options, HSA and FSA options, supplemental health, dental, vision, life insurance and disability. Retirement savings including individually directed 401k, with company contributions State-of-the-art PACS system and IT, Aidoc , 24/7 IT support, radiology assistant support   Professional liability / malpractice insurance with tail Monthly cell phone / internet reimbursement Home workstation provided (with setup if desired) Cost of needed licenses covered by practice Credentialing and licensing staff that does a majority of the heavy lifting ## Additional Information Diversified Radiology is a thriving and growing 75+ radiologist group founded in 1927 and partnered with Lumexa Imaging. Our practice is dedicated to providing quality, subspecialized care and expertise in Denver, Colorado and throughout the nation via teleradiology. Our practice is truly ‘diversified’ providing subspecialized diagnostic and interventional excellence to improve patient care with different hospital systems, independent outpatient imaging centers, tertiary care centers, community hospitals, specialty practices, and stand-alone ED and urgent care centers in 18 states and growing. Our case mix and complexity rivals that of teaching hospitals, but in a relaxed practice setting that values work/life balance. Lumexa Imaging is an equal opportunity employer. All qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, age, disability, or any other protected status protected by applicable law.", "summaryDescription" : "Daytime Musculoskeletal Radiologist Partner-Track at Diversified Radiology", "postedDate" : "2026-06-15T23:24:57.002", "createdAt" : "2026-06-15T23:24:57.002", "lastUpdated" : "2026-06-16T12:54:01.256", "ingestTimestamp" : "2026-06-16T03:24:13.427", "mongoId" : "6a309695f292fd229c0d50b5", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "salaryAnnualMin" : 500000, "salaryAnnualMax" : 900000, "salaryBand" : "200k+", "hasSalary" : true, "allSkills" : [ ], "skillCount" : 0, "jobCategory" : "engineering", "jobSubcategory" : "software", "seniorityLevel" : "Lead", "dataQualityScore" : 0.7777778, "_score" : 187.71594, "daysOld" : 0, "hasLocation" : true, "hasGeo" : true, "llmIndustry" : "Healthcare", "llmIndustryConfidence" : 0.98 }, { "id" : "6a19de0758b93c861e683fc0", "title" : "Clinical Review Nurse - Prior Authorization", "company" : "Akido", "salary" : { "min" : 62400.0, "max" : 93600.0, "currency" : "USD", "frequency" : "yearly", "is_estimated" : false }, "location" : "5475 Walnut Suite C", "locations" : [ "5475 Walnut Suite C" ], "certifications" : [ "LVN", "RN" ], "timestamp" : "2026-05-29T21:03:48.908", "fingerprint" : "2ed6a3aec2b392bb7c5c41cdf4728424483b6603ced0dcaed35474a4876ad739", "source" : "greenhouse", "language" : "en", "applyUrl" : "https://job-boards.greenhouse.io/akidolabs/jobs/4680459006", "externalId" : "4680459006", "structuredLocations" : [ { "state" : "California", "country" : "United States", "continent" : "na", "workMode" : "onsite" } ], "locationText" : "California, United States", "experienceMinYears" : 3, "experienceMaxYears" : 5, "experienceLevel" : "Mid", "professionalSkills" : [ "Prior Authorization", "Utilization Management", "Medical Necessity Review", "Managed Care" ], "hardSkillsList" : [ "Clinical Review", "Documentation", "Authorization Determinations" ], "hardSkills" : [ { "name" : "Clinical Review", "level" : "intermediate" }, { "name" : "Documentation", "level" : "intermediate" }, { "name" : "Authorization Determinations", "level" : "intermediate" } ], "majorSkills" : "Prior Authorization, Clinical Review, Managed Care", "majorSkillsList" : [ "Prior Authorization", "Clinical Review", "Managed Care" ], "coreResponsibilities" : "Review and process prior authorizations, Evaluate requests using MCG guidelines, Review medical records and supporting documentation, Identify missing or insufficient documentation, Ensure all clinical determinations are documented, Maintain compliance with DMHC requirements, Communicate with physicians and providers, Identify cases requiring clinical review, Prepare clinical summaries for Medical Director, Ensure cases requiring denial are routed, Document all authorization activities accurately, Maintain detailed notes, status updates, Collaborate with UM Coordinators, Claims, Eligibility, Operations", "teamCollaboration" : "Works closely with providers, Medical Directors, and operational teams; Coordinate with providers for additional information; Communicate with physicians, medical groups, facilities, and ancillary providers; Collaborate with UM Coordinators, Claims, Eligibility, and Operations", "domainKnowledge" : "Managed care; Delegated UM operations; California managed care environment; DMHC prior authorization requirements; CMS guidelines; Health plan delegation standards", "domainList" : [ "managed-care", "delegated-um-operations", "california-managed-care-environment", "dmhc-prior-authorization-requirements", "cms-guidelines", "health-plan-delegation-standards" ], "domainSpecificKnowledge" : [ "Managed care", "Delegated UM operations", "California managed care environment", "DMHC prior authorization requirements", "CMS guidelines", "Health plan delegation standards" ], "toolProficiency" : [ "MCG guidelines", "EZCap" ], "communicationSkills" : "Effective written and verbal communication", "documentationSkills" : "Document all authorization activities accurately; Maintaining detailed notes, status updates, and decision rationale", "outcomesObjectives" : "Ensure timely and accurate authorization determinations", "qualificationsBasic" : "Active California LVN or RN license, 3-5+ years of current clinical UM review, Experience with prior authorization in managed care or delegated environment, Knowledge of MCG criteria, medical necessity review, and prior authorization workflows, Knowledge of California managed care regulations (DMHC/CMS), clinical assessment skills, attention to detail, Effective written and verbal communication, Ability to manage competing priorities in a fast-pace environment", "qualificationsPreferred" : "Experience with EZCap, Experience in a delegated MSO or health plan environment", "rawDescription" : "Akido builds AI-powered doctors. Akido is the first AI-native care provider, combining cutting-edge technology with a nationwide medical network to address America’s physician shortage and make exceptional healthcare universal. Its AI empowers doctors to deliver faster, more accurate, and more compassionate care. Serving 500K+ patients across California, Rhode Island, and New York, Akido offers primary and specialty care in 26 specialties—from serving unhoused communities in Los Angeles to ride-share drivers in New York. Founded in 2015 (YC W15), Akido is expanding its risk-bearing care models and scaling ScopeAI, its breakthrough clinical AI platform. Read more about Akido’s $60M Series B. More info at Akidolabs.com. The Opportunity The Clinical Review Nurse – Prior Authorization is responsible for reviewing and processing prior authorization requests to ensure medical necessity, appropriate level of care, and compliance with health plan and regulatory requirements. This role focuses exclusively on prior authorization activities within the Utilization Management (UM) department and supports delegated UM operations in a California managed care environment. The Clinical Review Nurse works closely with providers, Medical Directors, and operational teams to ensure timely and accurate authorization determinations in accordance with established clinical guidelines and delegation standards. What you’ll do Review and process prior authorizations for outpatient services, procedures, diagnostic testing, specialty referrals, and DME and ancillary services Evaluate requests using MCG guidelines and health plan criteria and policies Review medical records and supporting clinical documentation to ensure completeness, accuracy, and medical necessity in accordance with established clinical guidelines and health plan requirements. Identify missing or insufficient documentation and coordinate with providers for additional information Ensure all clinical determinations are properly documented in the system Maintain compliance with DMHC prior authorization requirements, CMS guidelines, health plan delegation standards, turnaround times, notification requirements, and documentation standards Communicate with physicians, medical groups, facilities, and ancillary providers to obtain additional clinical information and provide authorization status updates as needed Identify cases requiring clinical review and prepare clinical summaries for Medical Director determination Ensure cases requiring denial are routed appropriately to the Medical Director Document all authorization activities accurately within EZCap, maintaining detailed notes, status updates, and decision rationale Collaborate with UM Coordinators, Claims, Eligibility, and Operations Who you are Active California LVN or RN license 3-5+ years of current clinical UM review Experience with prior authorization in managed care or delegated environment Knowledge of MCG criteria, medical necessity review, and prior authorization workflows Experience with EZCap (preferred) Experience in a delegated MSO or health plan environment (preferred) Knowledge of California managed care regulations (DMHC/CMS) Strong clinical assessment skills and attention to detail Effective written and verbal communication Ability to manage competing priorities in a fast-pace environment Salary range $62,400—$93,600 USD Akido Labs, Inc. is an equal opportunity employer, and we encourage qualified applicants of every background, ability, and life experience to contact us about appropriate employment opportunities.", "summaryDescription" : "Clinical Review Nurse - Prior Authorization at Akido. Skills: Prior Authorization, Clinical Review, Managed Care. Review and process prior authorizations. Evaluate requests using MCG guidelines", "postedDate" : "2026-05-29T21:01:46.834", "createdAt" : "2026-05-29T21:01:46.834", "lastUpdated" : "2026-05-29T21:03:48.908", "ingestTimestamp" : "2026-05-29T21:01:46.834", "mongoId" : "6a19de0758b93c861e683fc0", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "salaryAnnualMin" : 62400, "salaryAnnualMax" : 93600, "salaryBand" : "50k-75k", "hasSalary" : true, "allSkills" : [ "Clinical Review", "Documentation", "Authorization Determinations", "Prior Authorization", "Managed Care", "Utilization Management", "Medical Necessity Review", "Managed care", "Delegated UM operations", "California managed care environment", "DMHC prior authorization requirements", "CMS guidelines", "Health plan delegation standards", "LVN", "RN", "MCG guidelines", "EZCap" ], "skillCount" : 17, "jobCategory" : "operations", "jobSubcategory" : "operations", "dataQualityScore" : 0.8888889, "_score" : 186.35051, "daysOld" : 0, "hasLocation" : true, "hasGeo" : false }, { "id" : "6a2cd30974d8ee00a0a35829", "title" : "Healthcare Virtual Assistant - Prior Authorization Support", "company" : "Winning Assistants", "industry" : "Hospital & Health Care", "salary" : { "min" : 5.0, "max" : 6.0, "currency" : "USD", "frequency" : "yearly", "is_estimated" : false }, "location" : "Remote", "locations" : [ "Remote" ], "certifications" : [ "HIPAA certification", "Cybersecurity certification" ], "timestamp" : "2026-06-15T03:27:08.520", "fingerprint" : "ffe5f95c1e78724869155efea22abecceb525e50d276137c768ae5e3ab94ef97", "source" : "workable", "language" : "en", "applyUrl" : "https://apply.workable.com/j/324FB4E992/apply", "externalId" : "324FB4E992", "industryFunction" : { }, "locationPoint" : "12.8797,121.774", "structuredLocations" : [ { "workMode" : "remote" } ], "locationText" : "", "employmentType" : "PART_TIME", "technicalSkills" : "EHR systems", "professionalSkills" : [ "Clinical administrative tasks", "Documentation support", "Prior authorization workflows", "Coding support", "Documentation organization", "Referrals", "Laboratory support", "Patient records management", "General administrative support" ], "hardSkillsList" : [ "Medical documentation", "Prior authorization", "Specialist referral coordination", "Laboratory results input", "Patient chart organization" ], "hardSkills" : [ { "name" : "Medical documentation", "level" : "intermediate" }, { "name" : "Prior authorization", "level" : "intermediate" }, { "name" : "Specialist referral coordination", "level" : "intermediate" }, { "name" : "Laboratory results input", "level" : "intermediate" }, { "name" : "Patient chart organization", "level" : "intermediate" } ], "majorSkills" : "Prior authorization, Medical documentation, Clinical support", "majorSkillsList" : [ "Prior authorization", "Medical documentation", "Clinical support" ], "coreResponsibilities" : "Assist with coding patient visits, Organize clinical documentation, Support clinical documentation, Review documentation for accuracy, Review documentation for completeness, Submit prior authorization requests, Track authorization status, Track documentation requirements, Send specialist referrals, Coordinate referral documentation, Locate appropriate specialist providers, Review laboratory results, Input laboratory results, Maintain clinical documentation, Maintain patient records, Organize patient charts, Provide general administrative support, Identify claim issues, Flag claim issues, Flag claim denials, Make phone calls for referrals, Make phone calls for coordination", "teamCollaboration" : "Work with medical provider; Coordinate with insurance providers; Coordinate with healthcare offices", "domainKnowledge" : "Healthcare workflow; Patient visits; Referrals; Authorization workflows; Medical billing concepts; Medical coding concepts; Sensitive patient information; Claim issues; Claim denials; HIPAA compliance; Cybersecurity", "domainList" : [ "healthcare-workflow", "patient-visits", "referrals", "authorization-workflows", "medical-billing-concepts", "medical-coding-concepts", "sensitive-patient-information", "claim-issues", "claim-denials", "hipaa-compliance", "cybersecurity" ], "domainSpecificKnowledge" : [ "Healthcare workflow", "Patient visits", "Referrals", "Authorization workflows", "Medical billing concepts", "Medical coding concepts", "Sensitive patient information", "Claim issues", "Claim denials", "HIPAA compliance", "Cybersecurity" ], "toolProficiency" : [ "Charm EHR", "Vonage VoIP" ], "communicationSkills" : "Professional communication", "documentationSkills" : "Clinical documentation; Documentation support; Documentation organization; Documentation requirements", "continuousLearning" : "HIPAA training; Cybersecurity training; Top 1% VA training", "specialRequirements" : "Video meetings with camera on, Reliable laptop or desktop, High-speed internet, Noise-canceling headset, Webcam, Quiet workspace, NBI clearance, Local Police Clearance", "qualificationsBasic" : "Relevant work experience, Proficient in speaking English, Proficient in writing English, Submit NBI clearance, Submit Police Clearance", "qualificationsPreferred" : "Healthcare background, Prior virtual assistant experience, Familiarity with medical billing, Familiarity with medical coding", "remoteFriendly" : true, "workSiteFlexibility" : "Remote", "rawDescription" : "**Job Title: Healthcare Virtual Assistant – Medical Documentation & Prior Authorization Support** **Position Type:** Part-time (20 hours per week) **Work Hours:** Flexible schedule between 9:00 AM – 5:00 PM EDT **Work Days:** Monday – Friday **Salary:** $5 – $6 per hour (depending on experience) **Job Code:** TSA-TEMP **Workplace:** Remote **Preferred Candidate Location:** ### About Our Client The client is seeking a detail-oriented Healthcare Virtual Assistant to support a medical provider with clinical administrative tasks, documentation support, and prior authorization workflows. This role is primarily a Medical Administrative Assistant position, helping reduce the provider’s administrative workload by assisting with coding support, documentation organization, referrals, and prior authorizations. The ideal candidate has healthcare workflow knowledge, strong organizational skills, and the ability to work independently while handling sensitive patient information responsibly. ### Primary Responsibilities ### **Medical Documentation & Coding Support** * Assist with coding patient visits at the end of each day * Help organize and support clinical documentation for patient visits * Review documentation to ensure accuracy and completeness ### **Prior Authorization Management** * Submit prior authorization requests to insurance providers * Track authorization status and documentation requirements ### **Specialist Referral Coordination** * Send specialist referrals * Coordinate referral documentation * Research and locate appropriate specialist providers when necessary ### Secondary Responsibilities * Laboratory & Documentation Support * Review and input laboratory results into the system * Maintain accurate clinical documentation and patient records ### **Administrative Support** * Assist with organizing patient charts and documentation * Provide general administrative support to reduce the provider’s workload ### **Limited / Occasional Tasks** * Identify and flag potential claim issues or denials for provider review * Make occasional phone calls related to referrals or administrative coordination ### Important Role Clarification This position does NOT handle full medical billing or denial management. * A separate medical biller will handle billing and denial management * The VA’s role is focused on clinical administrative support and documentation assistance. ### Systems & Tools Used * Charm EHR (full access required) * Vonage VoIP (phone system) **Requirements** * Healthcare background preferred (nursing, medical assistant, clinical support, or similar) * Prior virtual assistant experience preferred * Familiarity with medical billing and coding concepts helpful but not required * Medical license or certification not required ### Required Skills ### **Healthcare Workflow Knowledge** * Understanding of patient visits, referrals, and authorization workflows ### **Attention to Detail** * Ability to review documentation carefully and identify missing information ### **Clinical Documentation Support** * Comfortable assisting with visit documentation and coding preparation ### **Prior Authorization Experience** * Familiarity with submitting and tracking authorization requests ### **Strong Organizational Skills** * Ability to manage multiple tasks and patient records efficiently ### **Independent Work Ability** * Comfortable completing tasks without constant supervision ### **Professional Communication** * Clear and professional communication with healthcare offices and providers ### **EHR Experience** * Comfortable working within electronic health record systems (Charm preferred) ### Basic requirements * Must be proficient in speaking and writing English very clearly * Must have relevant work experience * Be able to submit an NBI clearance and/or Local Police Clearance background check before onboarding [mandatory] * Must be available for video meetings with your camera on (when needed) ### Technical requirements * **Device:** Reliable laptop or desktop computer. * **Internet:** High-speed connection (minimum 25 Mbps). * **Audio:** Noise-canceling headset. * **Video:** Webcam for virtual meetings. * **Workspace:** Quiet, professional environment. **Benefits** * **Dedicated HR & Contractor Support Team: **Access to world-class support for questions, guidance, contract matters, and client communication. * Premium VPN Access (Optional): A secure VPN license can be provided upon request to enhance privacy and security for client-related tasks. * **HIPAA & Cybersecurity Training + Certification (Provided): **Access to our internal HIPAA compliance training, cybersecurity modules, and certification to help you confidently handle PHI for U.S. healthcare clients. * **Top 1% VA Performance Training:** Access to our proprietary training on communication, client management, productivity systems, and best practices to help you become a top-performing VA and increase long-term client retention. * **Client-Approved U.S. Holidays:** Contractors may take U.S. holidays off according to the client’s needs and schedule. * **Client-Approved Paid or Unpaid Time Off:** Time off may be granted by your client. Paid time off is optional and only if offered by the client. * **Access to Tools & Resources: **Templates, workflow guides, productivity tools, and client-specific SOP support to help you perform at your best. * **Optional Performance-Based Incentives:** Some clients may offer bonuses, incentives, or increased hours based on your performance. These are optional resources and client-approved allowances available to you as an independent contractor. Any resources, trainings, or allowances listed are optional contractor perks and not employee benefits.", "summaryDescription" : "Healthcare Virtual Assistant - Prior Authorization Support at Winning Assistants. Skills: Prior authorization, Medical documentation, Clinical support. Assist with coding patient visits. Organize clinical documentation", "postedDate" : "2026-06-09T00:00:00.000", "createdAt" : "2026-06-13T22:42:33.666", "lastUpdated" : "2026-06-15T03:27:08.520", "ingestTimestamp" : "2026-06-13T22:42:33.666", "mongoId" : "6a2cd30974d8ee00a0a35829", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "sourceUrl" : "https://apply.workable.com/j/324FB4E992", "salaryAnnualMin" : 10400, "salaryAnnualMax" : 12480, "salaryBand" : "<30k", "hasSalary" : true, "allSkills" : [ "Medical documentation", "Prior authorization", "Specialist referral coordination", "Laboratory results input", "Patient chart organization", "Clinical support", "Clinical administrative tasks", "Documentation support", "Prior authorization workflows", "Coding support", "Documentation organization", "Referrals", "Laboratory support", "Patient records management", "General administrative support", "Healthcare workflow", "Patient visits", "Authorization workflows", "Medical billing concepts", "Medical coding concepts", "Sensitive patient information", "Claim issues", "Claim denials", "HIPAA compliance", "Cybersecurity", "HIPAA certification", "Cybersecurity certification", "Charm EHR", "Vonage VoIP" ], "skillCount" : 29, "jobCategory" : "operations", "jobSubcategory" : "general", "seniorityLevel" : "mid", "dataQualityScore" : 0.8888889, "_score" : 186.03369, "daysOld" : 6, "hasLocation" : true, "hasGeo" : false, "llmIndustry" : "Healthcare", "llmIndustryConfidence" : 0.95 }, { "id" : "6a1661d258b93c861ea5abfd", "title" : "Referral & Prior Auth Rep III", "company" : "University of Rochester", "salary" : { "min" : 19.62, "max" : 26.49, "currency" : "USD", "frequency" : "yearly" }, "location" : "United States of America", "locations" : [ "United States of America" ], "timestamp" : "2026-05-27T05:34:48.912", "fingerprint" : "63a16f6b212a04dd258a979a0b349ddd3b634520d92c687fc38c82d0cd88e590", "source" : "workday", "language" : "en", "applyUrl" : "https://rochester.wd5.myworkdayjobs.com/UR_Staff/job/Strong-Memorial-Hospital/Referral---Prior-Auth-Rep-III_R271463", "externalId" : "R271463", "locationPoint" : "51.43667,5.97917", "structuredLocations" : [ { "city" : "Rochester", "state" : "New York", "country" : "United States", "continent" : "na", "source" : "llm", "workMode" : "onsite" } ], "locationText" : "Rochester, New York, United States", "employmentType" : "FULL_TIME", "minimumEducation" : "High School diploma", "experienceMinYears" : 2, "technicalSkills" : "Epic", "professionalSkills" : [ "process management", "cross-functional coordination", "vendor/stakeholder management", "operational metrics", "resource planning", "continuous improvement" ], "hardSkillsList" : [ "Referral Management", "Prior Authorizations" ], "hardSkills" : [ { "name" : "Referral Management", "level" : "intermediate" }, { "name" : "Prior Authorizations", "level" : "intermediate" } ], "majorSkills" : "Referral Management, Prior Authorizations, Epic", "majorSkillsList" : [ "Referral Management", "Prior Authorizations", "Epic" ], "coreResponsibilities" : "Serve as patient referral and prior authorization specialist, Communicate with patients, families, staff, Accountable for planning, execution, appeals, Adhere to approved protocols, Manage Child Neurology Division referrals, Conduct data analyses to track patient compliance, Prioritize referral requests, Acquire insurance authorization, Document all communications, Prepare and provide complex details to insurance carriers, Communicate medical information to insurance carrier, Coordinate peer-to-peer reviews, Resolve obstacles presented by insurance company, Determine relevant information needed for submission, Collaborate with provider to draft letter, Use system tracking mechanisms, Perform needs assessment, Ensure ancillary testing and referrals executed, Investigate failure to receive information, Manage orders for patients, Review complex referral requests, Work with providers to establish care plan, Process outgoing referrals, Discuss options for outside URMC care", "teamCollaboration" : "Communicates regularly with patients, families, clinical and non-clinical staff; Serves as liaison, appointment coordinator, and patient advocate between the referring office, specialists and patient; Collaborates with provider to draft and finalize letter of medical necessity; Works with providers and other clinical staff to establish the best care plan for the patient", "domainKnowledge" : "enterprise standards; referral and prior authorization guidelines; medical protocols; department/division knowledge; insurance policies; International Classification of Diseases (ICD); Current Procedure Technology (CPT); medical terminology; specialty and sub specialty medical office experience; electronic medical record", "domainList" : [ "enterprise-standards", "referral-and-prior-authorization-guidelines", "medical-protocols", "department-division-knowledge", "insurance-policies", "international-classification-of-diseases-icd", "current-procedure-technology-cpt", "medical-terminology", "specialty-and-sub-specialty-medical-office-experience", "electronic-medical-record" ], "domainSpecificKnowledge" : [ "enterprise standards", "referral and prior authorization guidelines", "medical protocols", "department/division knowledge", "insurance policies", "International Classification of Diseases (ICD)", "Current Procedure Technology (CPT)", "medical terminology", "specialty and sub specialty medical office experience", "electronic medical record" ], "toolProficiency" : [ "Epic Referral work queues" ], "communicationSkills" : "Demonstrated customer relations skills required", "documentationSkills" : "Documents all communications pertaining to the referral and/or insurance authorization in the notes section of the Epic referral record", "problemSolvingSkills" : "Resolves obstacles presented by the insurance company", "outcomesObjectives" : "oversight of data and compliance to enterprise standards; tracking all assistance provided; direct, multifaceted impact (quality, financial, patient satisfaction, etc.) on patient scheduling, treatment, care and follow up; track patient compliance with specialty services; reconcile any discrepancies; ensure as many applications are approved as possible; ensuring that accurate patient demographic and current insurance information is adheres to RIM protocols for record verification; Makes decisions that are guided by protocols and practices requiring some maintains an expert level understanding of the department/division", "qualificationsBasic" : "2 years of relevant experience required", "qualificationsPreferred" : "Medical Terminology, experiences with surgical/appointment scheduling software and electronic medical records preferred", "remoteFriendly" : false, "rawDescription" : "As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. _**Job Location (Full Address):**_ 601 Elmwood Ave, Rochester, New York, United States of America, 14642 _**Opening:**_ Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500157 SMH Neurology Pediatrics Work Shift: UR - Day (United States of America) Range: UR URC 205 H Compensation Range: $19.62 - $26.49 _The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job 's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations._ _**Responsibilities:**_ Serves as the patient referral and prior authorization specialist, with oversight of data and compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non-clinical staff, identifying barriers to appointment compliance, insurance company barriers and tracking all assistance provided. Accountable for planning, execution, appeals and efficient follow through on all aspects of the process which has direct, multifaceted impact (quality, financial, patient satisfaction, etc.) on patient scheduling, treatment, care and follow up. Adheres to approved protocols for working referrals and prior authorizations. Makes decisions that are guided by protocols and practices requiring some interpretation; maintains an expert level understanding of the department/division. May train new staff members. **ESSENTIAL FUNCTIONS** **Referral Management** * Responsible for managing Child Neurology Division referrals. Serves as liaison, appointment coordinator, and patient advocate between the referring office, specialists and patient to assist in the coordination of scheduled visits and procedures incorporating all incoming referrals to the department using Epic Referral work queues. Conducts data analyses to track patient compliance with specialty services, consistently monitors the work queues and communicates with referring and referred to departments to reconcile any discrepancies and/or answer any questions. Prioritizes referral requests using medical protocols, responding immediately and expediting most urgent requests. Acquire insurance authorization for the visit and, if applicable, any testing; insurance authorization information will be entered in the Epic referral record for the patient, and attaches referral records to any visits in which they are missing. Documents all communications pertaining to the referral and/or insurance authorization in the notes section of the Epic referral record. **Prior Authorizations:** * Prior authorization functionality required for testing and services ordered by referred to specialist includes, preparing and providing multiple, complex details to insurance or worker’s compensation carrier to obtain prior authorizations for both standard and complex requests such as imaging, non-invasive procedures, sleep studies etc., communicating medical information to the insurance carrier, and coordinating peer-to-peer reviews for denied services. * Anticipates insurer’s various questions and prepares request by applying prior insurer decisions and specialty/sub-specialty knowledge of general medical experience and terminology, specialty and sub specialty medical office experience, International Classification of Diseases (ICD) and Current Procedure Technology (CPT), insurance policies, permissible and non-permissible requests, necessary and appropriate medical terminology to use in order for claim to be approved, previous treatments that are necessary to report, appropriate verbiage for treatments that have been tried and not successful (i.e., medication could not be utilized due to heart condition). Applies knowledge and protocols to varying degrees based on how complexities of the situation deviate from the norm. Resolves obstacles presented by the insurance company by applying knowledge and experience of previous authorization requests, denials and approvals. On behalf of the provider and the University, perseveres with the process to ensure as many applications are approved as possible without provider intervention. * Determines relevant information needed, based on previous authorization request experience for submission to carrier if first or second request is denied. Collaborates with provider to draft and finalize letter of medical necessity. Uses system tracking mechanisms to ensure all renewals/approvals are obtained prior to patient arrival. * Performs a needs assessment using information from the electronic medical record to assure the appropriate appointment/procedure is schedule with the appropriate provider; ensuring that accurate patient demographic and current insurance information is captured; adheres to RIM protocols for record verification. May perform complex appointment scheduling, linking referrals and ancillary services for the assigned specialty service. Provides patients with appointment and provider information, directions to the office location and any educational materials if appropriate. * Ensures ancillary testing and other specialty referrals have been executed and results received and acted upon as needed. Investigates failure to receive such information, troubleshoots, resolves, and/or makes recommendations to insure delivery/receipt. Manages orders for patients being seen in ED/ Urgent Care. Demonstrates expert medical knowledge base with ability to recognize urgent clinical situations. Prioritizes referral requests, responding immediately and expediting most urgent requests. Reviews complex referral requests, evaluates and schedules to the appropriate provider. Works with providers and other clinical staff to establish the best care plan for the patient. * Processes outgoing referrals. Discusses with patient options for outside URMC options for care. * Other job duties as assigned. **MINIMUM EDUCATION & EXPERIENCE** * High School diploma required * 2 years of relevant experience required * or equivalent combination of education and experience **KNOWLEDGE, SKILLS AND ABILITIES** * Medical Terminology, experiences with surgical/appointment scheduling software and electronic medical records preferred * Demonstrated customer relations skills required. The University of Rochester is committed to fostering, cultivating, and preserving an inclusive and welcoming culture to advance the University’s Mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion, creed, sex, sexual orientation, citizenship status, or any other characteristic protected by federal, state, or local law (Protected Characteristics). This commitment extends to non-discrimination in the administration of our policies, admissions, employment, access, and recruitment of candidates, for all persons consistent with our values and based on applicable law.", "summaryDescription" : "Referral & Prior Auth Rep III at University of Rochester. Skills: Referral Management, Prior Authorizations, Epic. Serve as patient referral and prior authorization specialist. 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Completes referrals and/or authorizations accurately and consistently with minimal supervision. In Managed Care, processes authorization and referral requests for members in coordination with health plans and contracted providers. Provides support to the Case Management staff. Serves as a resource to providers regarding the authorization process. **Onsite Position** **Job Description** : **EDUCATION:** * HS Diploma or GED **TYPICAL EXPERIENCE:** * 2 years recent relevant experience. **SKILLS AND KNOWLEDGE:** * Medical terminology, Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS)/International Classification of Diseases (ICD)-9 coding knowledge. * Knowledge of medical terminology/anatomy. * Ability to exercise discretion and make independent judgements, seeking review when decisions represent significant departure from established guidelines. * Knowledge of Microsoft Office programs including Excel, Word or similar programs. * Ability to maintain composure during challenging interpersonal interactions. * Active listening skills; including interpersonal skills and telephone communication. * Organizational skills with attention to detail and follow-up. **Job Shift:** Days **Schedule:** Full Time **Shift Hours:** 8 **Days of the Week:** Monday - Friday **Weekend Requirements:** None **Benefits:** Yes **Unions:** No **Position Status:** Non-Exempt **Weekly Hours:** 40 **Employee Status:** Regular Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $31.87 to $39.83 / hour _The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate’s experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health’s comprehensive total rewards program. Eligible positions also include a comprehensive benefits package._", "summaryDescription" : "Authorization Coordinator III at Sutter Health. Skills: Prior authorizations, Referral processing. Obtain referral or prior authorizations. Complete referrals and/or authorizations", "postedDate" : "2026-06-01T11:16:43.730", "createdAt" : "2026-06-11T11:16:42.927", "lastUpdated" : "2026-06-12T08:32:39.250", "ingestTimestamp" : "2026-06-11T11:16:42.927", "mongoId" : "6a25c97a74d8ee00a01cf6f5", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "sourceUrl" : "https://wd1.myworkdaysite.com/recruiting/sutterhealth/SH/job/Santa-Rosa/Authorization-Coordinator-III_R-130037-1", "salaryAnnualMin" : 66289, "salaryAnnualMax" : 66289, "salaryBand" : "50k-75k", "hasSalary" : true, "allSkills" : [ "CPT coding", "HCPCS coding", "ICD-9 coding", "Active listening", "Interpersonal skills", "Telephone communication", "Prior authorizations", "Referral processing", "Medical terminology", "Coding knowledge", "Managed Care", "Microsoft Office" ], "skillCount" : 12, "jobCategory" : "other", "seniorityLevel" : "executive", "dataQualityScore" : 0.8888889, "_score" : 185.39767, "daysOld" : 10, "hasLocation" : true, "hasGeo" : false, "llmIndustry" : "Healthcare" }, { "id" : "6a2ccd1574d8ee00a0a28e10", "title" : "ML / CV Engineer (Thermal Detection & Tracking)", "company" : "Everstar", "industry" : "Manufacturing", "salary" : { "min" : 960000.0, "max" : 1560000.0, "currency" : "UAH", "frequency" : "yearly", "is_estimated" : true, "estimation_basis" : "Market baseline for ML/CV Engineer in Kyiv, Ukraine, adjusted for mid-seniority and technology industry." }, "location" : "Kyiv | Київ, UA", "locations" : [ "Kyiv | Київ", "UA" ], "timestamp" : "2026-06-16T01:26:08.345", "fingerprint" : "641a27a116da5a26b12d12143e69a36b5ef81672424c6e9d14c8c54aba120dc7", "source" : "breezyhr", "language" : "uk", "applyUrl" : "https://everstar.breezy.hr/p/30141458192a-ml-cv-engineer-thermal-detection-tracking", "externalId" : "30141458192a", "industryFunction" : { }, "structuredLocations" : [ { "city" : "Kyiv", "country" : "Ukraine", "continent" : "eu", "source" : "llm", "workMode" : "onsite", "geo" : "50.4500336,30.5241361" } ], "locationText" : "Kyiv, Ukraine", "employmentType" : "FULL_TIME", "coreResponsibilities" : "Develop and produce technical equipment, Develop and produce electronic solutions", "domainKnowledge" : "Thermal detection; Tracking systems", "domainList" : [ "thermal-detection", "tracking-systems" ], "domainSpecificKnowledge" : [ "Thermal detection", "Tracking systems" ], "innovationCreativity" : "R&D projects", "rawDescription" : "Ми — EVERSTAR, перша рекрутингова агенція в MilTech для тих, хто готовий створювати технологічне майбутнє. Але досить про нас, розказуємо про головну роль. Ця вакансія у R&D-команду, що розробляє та виробляє техніку й електронні рішення, які працюють на реальному полі бою, а не в красивих пр", "summaryDescription" : "ML / CV Engineer (Thermal Detection & Tracking) at Everstar. Develop and produce technical equipment. 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International teams", "projectManagementSkills" : [ "Project implementation", "Improvement projects" ], "domainKnowledge" : "Supply Chain; Fulfillment Center Operations; Logistics", "domainList" : [ "supply-chain", "fulfillment-center-operations", "logistics" ], "domainSpecificKnowledge" : [ "Supply Chain", "Fulfillment Center Operations", "Logistics" ], "continuousLearning" : "Internal learning opportunities; Workshops; Bootcamps", "innovationCreativity" : "Test new ideas", "problemSolvingSkills" : "Identify problems; Solve problems", "specialRequirements" : "Shift work, Office and warehouse environment", "outcomesObjectives" : "Increase productivity; Simplify processes; Solve bottlenecks; Elevate supply chain", "qualificationsBasic" : "Master's degree in Logistics, Master's degree in Supply Chain Management, Master's degree in Industrial Engineering, Master's degree in comparable field, First practical experience in supply chain, Fluent German, Very good English skills", "qualificationsPreferred" : "Experience in operations supervisor role, Experience in operations manager role", "remoteFriendly" : true, "workSiteFlexibility" : "Flexible", "rawDescription" : "Kurz und knapp Du stehst kurz vor deinem Masterabschluss und willst als Graduate mehr als nur einen klassischen Berufseinstieg? Du suchst Verantwortung, Tempo und echte Wirkung in deinem Alltag? Als Fast Track to Leadership Trainee im Bereich Supply Chain und Operations startest du bei Picnic durch: In nur zwei Jahren entwickelst du dich vom Graduate in die Führungsposition als Operations Manager und übernimmst die Verantwortung für Teams, Prozesse und strategische Projekte entlang unserer Supply Chain im Fulfillment. Hands-on, datengetrieben und mit echtem Impact. Das erwartet dich Jahr 1: Operative Grundlagen & Leadership als Operations Supervisor Onboarding & Einstieg: Du startest mit einem strukturierten Onboarding, baust dir ein starkes Netzwerk auf und lernst unser Fulfillment Center (FC) von Grund auf kennen. Schichtleitung im FC: An ca. 3-4 Tagen pro Woche übernimmst du als Operations Supervisor die Verantwortung einer Schicht. Du planst, koordinierst und führst dein Team - und erlebst vom ersten Tag an, wie operative Entscheidungen direkten Einfluss auf unsere Teams und Performance haben. Führung & Coaching: Durch Mentoring, Trainings zu Leadership, Feedback und Motivation lernst du, wie du Menschen entwickelst, Klarheit schaffst und herausfordernde Situationen meisterst. Eigene Projekte mit Impact: Du identifizierst Optimierungspotenziale im operativen Alltag und setzt an deinen 1-2 Projekttagen eigenständig Verbesserungsprojekte um, die Produktivität steigern, Prozesse vereinfachen und Engpässe nachhaltig lösen. Jahr 2: Führung mit Wirkung über Standorte hinweg als Operations Manager (Inter)nationale Perspektive: Ergreife die Chance und bring dein Wissen an anderen Picnic Standorten - national oder international - oder lerne eine andere Abteilung entlang unserer Supply Chain kennen. Du übernimmst Verantwortung in einem neuen Umfeld mit neuen Teams und wächst über dich hinaus. Fokus auf Projekte: Neben deinen ca. 1-2 Schichttagen pro Woche arbeitest du an ca. 3-4 Tagen an standortübergreifenden Initiativen, z. B. bei der Optimierung unserer Bestellprozesse oder bei der Unterstützung neuer (automatisierter) FCs. Mit deinem operativen Know-How und deinem analytischen Blick hebst du unsere Supply Chain auf das nächste Level. Dein nächster Schritt: Nach dem Fast Track stehen dir viele Türen offen: als erfahrener Operations Manager oder in weiteren Positionen innerhalb von Picnic. Das bringst du mit Ein (bald) abgeschlossenes Masterstudium in Logistik, Supply Chain Management, Wirtschaftsingenieurwesen oder einem vergleichbaren Masterstudiengang Erste praktische Erfahrungen im Supply-Chain-Umfeld (z. B. durch Praktika oder Werkstudententätigkeiten) Fließende Deutsch- und sehr gute Englischkenntnisse Freude daran, als Trainee direkt Verantwortung für ein Team zu übernehmen und Menschen zu motivieren und entwickeln Du setzt Ideen mit deiner Hands-on-Mentalität in erfolgreiche Projekte um und gehst als Vorbild voran Ein starkes Zahlenverständnis und die Fähigkeit, Probleme frühzeitig zu erkennen Flexibilität und Begeisterung für eine Rolle, die sowohl im Büro als auch im operativen Lagerumfeld stattfindet, inklusive Schichtarbeit Darauf kannst du dich freuen Starte durch - mit uns: Werde Teil unseres internationalen Teams in einem Umfeld, das echtes Wachstum und eine „Act like an Owner“-Mentalität fördert. Bei uns hast du die Chance, Projekte eigenverantwortlich voranzutreiben, neue Ideen zu testen und direkt miterleben zu können, wie deine Arbeit in unserem schnell wachsenden Unternehmen Wirkung zeigt. Nachhaltigkeit als Kern: Werde Teil der Revolution. Du trägst zu einer grüneren Zukunft bei – durch unsere 100 % elektrische Flotte und eine Lieferkette, die Lebensmittelverschwendung reduziert. Die Basics: Wir stellen dir alles für deinen Erfolg bereit – inklusive Laptop und Handy sowie Zugang zu exklusiven Mitarbeiter-Rabatten (Corporate Benefits) für Reisen, Technik und vieles mehr. Zeit zum Auftanken: Mit 30 Urlaubstagen pro Jahr (bei einer 40-Stunden-Woche) sorgst du für den perfekten Ausgleich zwischen Arbeit und Erholung. Verpflegung für Gewinner: Wir kümmern uns um dich. Genieße jeden Tag ein frisches, kostenloses Frühstück und Mittag- oder Abendessen in unserem Fulfilment Center, dazu gibt es reichlich Snacks, Getränke und Obst für den Energiekick zwischendurch. Unvergessliche Momente: Wir sind mehr als nur ein Team. Von unserem legendären jährlichen Ski-Trip über Weihnachtsfeiern bis hin zu Auftritten unserer eigenen Picnic-Band: Wir feiern unsere Erfolge gemeinsam. Wohlbefinden & Gleichgewicht: Wir bieten dir professionelle Unterstützung für deine mentale Gesundheit mit OpenUp. Individuelle Mobilität:Du erhältst einen Firmenwagen (auch zur privaten Nutzung) und kannst zusätzlich unser „Lease-a-Bike“-Programm nutzen. Lebensmittelretter: Hol dir unsere exklusiven \"Too-Good-To-Go\"-Tüten und rette leckere Lebensmittel – nur für unsere Mitarbeitenden! Lerne & wachse: Profitiere von internen Lern- & Entwicklungsmöglichkeiten durch spannende Workshops und intensive Bootcamps, um deine Skills ständig zu erweitern Bist du neugierig?", "summaryDescription" : "Fast Track to Leadership Trainee at Picnic. Skills: Supply Chain Management, Operations Management, Team Leadership. Plan shifts. Coordinate shifts", "postedDate" : "2026-06-14T21:36:50.105", "createdAt" : "2026-06-14T21:36:50.105", "lastUpdated" : "2026-06-16T01:07:42.722", "ingestTimestamp" : "2026-06-14T21:36:50.105", "mongoId" : "6a2ca43874d8ee00a09b0c0a", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "salaryBand" : "30k-50k", "hasSalary" : false, "allSkills" : [ "Operational decision making", "Process optimization", "Data analysis", "Leadership", "Mentoring", "Motivation", "Coaching", "Supply Chain Management", "Operations Management", "Team Leadership", "Process management", "Resource planning", "Continuous improvement", "Project implementation", "Improvement projects", "Supply Chain", "Fulfillment Center Operations", "Logistics" ], "skillCount" : 18, "jobCategory" : "operations", "jobSubcategory" : "general", "seniorityLevel" : "Entry", "dataQualityScore" : 1.0, "_score" : 182.5642, "daysOld" : 1, "hasLocation" : true, "hasGeo" : false, "llmIndustry" : "E-Commerce", "llmIndustryConfidence" : 0.95 }, { "id" : "6a2c9a2274d8ee00a0996abb", "title" : "Marketing Tracking Specialist", "company" : "UPROSPECT", "industry" : "Computer Software", "salary" : { "min" : 3.8E7, "max" : 5.8E7, "currency" : "COP", "frequency" : "yearly", "is_estimated" : true, "estimation_basis" : "The estimation is based on the market baseline for a Mid-level Marketing Tracking Specialist in Medellín, Colombia within the Technology industry, adjusted for company size and onsite work mode." }, "location" : "Medellín, Antioquia, CO", "locations" : [ "Medellín", "Antioquia", "CO" ], "timestamp" : "2026-06-15T07:45:37.202", "fingerprint" : "a329cbb2677810bfffc88268a3698610c26872bbc1ecdc3a8f117b883daed229", "source" : "smartrecruiters", "language" : "en", "applyUrl" : "https://jobs.smartrecruiters.com/UPROSPECT/744000131810739-marketing-tracking-specialist-hybrid-role-industry-leading-global-language-tech-company", "externalId" : "744000131810739", "industryFunction" : { }, "structuredLocations" : [ { "city" : "Medellín", "state" : "Antioquia", "country" : "Colombia", "continent" : "sa", "source" : "llm", "workMode" : "hybrid", "geo" : "6.2697324,-75.6025597" }, { "city" : "Cape Town", "country" : "South Africa", "continent" : "af", "source" : "llm", "workMode" : "hybrid", "geo" : "-33.9288301,18.4172197" }, { "city" : "Pune", "country" : "India", "continent" : "as", "source" : "llm", "workMode" : "hybrid", "geo" : "18.5213738,73.8545071" } ], "locationText" : "Medellín, Antioquia, Colombia; Cape Town, South Africa; Pune, India", "employmentType" : "FULL_TIME", "experienceMinYears" : 5, "experienceMaxYears" : 10, "experienceLevel" : "mid", "technicalSkills" : "Google Tag Manager, GA4, Google Ads, HTML, JavaScript", "professionalSkills" : [ "Tag implementation", "Tracking infrastructure", "Digital marketing analytics" ], "hardSkillsList" : [ "Attribution models", "UTM governance", "Event frameworks", "Enhanced conversions" ], "hardSkills" : [ { "name" : "Attribution models", "level" : "intermediate" }, { "name" : "UTM governance", "level" : "intermediate" }, { "name" : "Event frameworks", "level" : "intermediate" }, { "name" : "Enhanced conversions", "level" : "intermediate" } ], "majorSkills" : "Tracking, Measurement, Analytics", "majorSkillsList" : [ "Tracking", "Measurement", "Analytics" ], "coreResponsibilities" : "Own end-to-end tag implementation, Configure GA4 properties, Maintain GA4 events, Implement tracking using GTM, Implement hard-coded website tags, Troubleshoot tracking issues, Resolve tracking issues, Support integrations, Maintain UTM governance, Ensure attribution consistency, Support dashboard creation, Support reporting workflows, Ensure tracking frameworks comply", "teamCollaboration" : "Cross-functional stakeholders; Marketing teams; Development teams; CRM teams; SEO teams; Paid media teams; Analytics teams", "domainKnowledge" : "Data protection regulations; GDPR; ePrivacy", "domainList" : [ "data-protection-regulations", "gdpr", "eprivacy" ], "domainSpecificKnowledge" : [ "Data protection regulations", "GDPR", "ePrivacy" ], "toolProficiency" : [ "Google Tag Manager", "Salesforce", "Pardot", "HubSpot", "Tableau" ], "continuousLearning" : "Growth opportunities", "problemSolvingSkills" : "Analytical thinking; Problem-solving abilities", "qualificationsBasic" : "3-6+ years experience, C1 English level", "qualificationsPreferred" : "Experience with Adobe Analytics, Experience with Snowplow, Experience with Mixpanel", "remoteFriendly" : true, "workSiteFlexibility" : "Hybrid", "rawDescription" : "This is a HYBRID role available in Medellin,Colombia - Cape Town, South Africa or Pune, India. You must have a strong C1 English level. If this isn’t you, please DO NOT apply. This is an exciting opportunity at an industry leading US $1B+ Global Language Tech Company. Note that your final salary will be confirmed at the end of the hiring process, based on your professional background and skills/experience noted during the interviews. Our client is an industry leader and one of the world’s largest privately held language and business services companies. Their products and solutions have streamlined international operations with advanced automation, AI, and enterprise level integrations for translation & language services. They’ve helped more than 6000+ companies through professional services, technology platforms, and strategic support in more than 200+ languages. This an exciting opportunity to join an award winning industry leader that has won multiple awards for their fast growth most notably Inc. 5000 fastest growing companies. You'll not only become a part of their amazing growth story, but you'll also gain exposure to various industries such as tech, legal, life sciences, and AI. Company Culture Our client believes great products are built by empowered teams. Our culture values ownership, collaboration, transparency, and continuous improvement. You will work closely with cross-functional stakeholders and have a direct influence on architectural decisions and long-term platform strategy. Benefits * Home-office flexibility * Hybrid work model * PTOs * Weekends Off * Growth opportunities * Schedule flexibility We are looking for a Tracking Specialist SEO/SEM to own and optimize the company’s global tracking and measurement infrastructure across websites, campaigns, analytics platforms, and CRM systems. This is a highly technical role focused on ensuring accurate, privacy-compliant tracking across all digital touchpoints while strengthening attribution between marketing activity and CRM performance. You will work closely with marketing, development, CRM, SEO, paid media, and analytics teams worldwide to build scalable tracking frameworks and ensure data integrity across the organization. Responsibilities: * Own end-to-end tag implementation through Google Tag Manager (GTM). * Configure and maintain GA4 properties, events, conversions, and tracking frameworks. * Implement tracking using GTM and hard-coded website tags when required. * Troubleshoot and resolve tracking issues across websites and landing pages * Support integrations between analytics platforms and CRM systems such as Salesforce (Pardot) or HubSpot. * Maintain UTM governance and attribution consistency across campaigns. * Support dashboard creation and reporting workflows using tools such as Tableau. * Ensure tracking frameworks comply with GDPR, ePrivacy, and data protection regulations. * Partner closely with paid media, SEO, CRM, web development , and marketing operations teams. ## Qualifications * 3-6+ years of experience in tag implementation, tracking infrastructure, or digital marketing. analytics. * Advanced expertise in: Google Tag Manager (GTM), GA4, Google Ads conversion tracking, Enhanced conversions, Event frameworks, Attribution models, UTM governance. * Experience with: Adobe Analytics, Snowplow, Mixpanel. * Hands-on experience integrating CRM systems such as Salesforce (Pardot) or HubSpot with analytics platforms. * Ability to work with HTML and JavaScript for custom tagging solutions. * Experience troubleshooting complex tracking issues across multiple websites and systems. * Strong analytical thinking and problem-solving abilities. ## Additional Information About SaaS Talent SaaS Talent is more than just a recruiting company. We're your hiring, business development and growth partner with 20+ years of experience in SaaS and Hi-Tech that helps you scale and transform your business. We've worked with 100+ companies and helped them achieve their goals. From streamlining sales, marketing, and operations to hiring ideal talent and getting funding, if you're struggling to grow, we're an ideal choice. Reach out to us at www.saas-talent.com to learn more about how we can help you. SMS Communication Consent Disclaimer By applying for this position, you agree to receive text message updates from SaaS Talent related to job opportunities. Standard message and data rates may apply, and messaging frequency varies. Text HELP for help and STOP to cancel.Learn more about our opt-in SMS Communication consent policy here: https://www.saas-talent.com/opt-in-sms-communication-consent", "summaryDescription" : "Marketing Tracking Specialist at UPROSPECT. Skills: Tracking, Measurement, Analytics. Own end-to-end tag implementation. Configure GA4 properties", "postedDate" : "2026-06-12T04:03:47.000", "createdAt" : "2026-06-13T22:16:44.440", "lastUpdated" : "2026-06-15T07:45:37.202", "ingestTimestamp" : "2026-06-13T22:16:44.440", "mongoId" : "6a2c9a2274d8ee00a0996abb", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "salaryBand" : "200k+", "hasSalary" : false, "allSkills" : [ "Attribution models", "UTM governance", "Event frameworks", "Enhanced conversions", "Tracking", "Measurement", "Analytics", "Tag implementation", "Tracking infrastructure", "Digital marketing analytics", "Data protection regulations", "GDPR", "ePrivacy", "Google Tag Manager", "Salesforce", "Pardot", "HubSpot", "Tableau" ], "skillCount" : 18, "jobCategory" : "marketing", "jobSubcategory" : "growth", "seniorityLevel" : "Mid", "dataQualityScore" : 1.0, "_score" : 181.609, "daysOld" : 3, "hasLocation" : true, "hasGeo" : true, "llmIndustry" : "Technology", "llmIndustryConfidence" : 0.95 }, { "id" : "6a0d97ca58b93c861e9f28cb", "title" : "Authorizations Coordinator", "company" : "Skilled Wound Care", "salary" : { "min" : 5.0, "max" : 5.0, "currency" : "USD", "frequency" : "yearly" }, "location" : "Contractors", "locations" : [ "Contractors" ], "timestamp" : "2026-05-20T14:35:41.098", "fingerprint" : "3ae72d40a0894ca0947176fa0f063df1c93d6ba4c13abe0f70ea694cfa84013c", "source" : "greenhouse", "language" : "en", "applyUrl" : "https://job-boards.greenhouse.io/skilledwoundcare/jobs/7737982003", "externalId" : "7737982003", "structuredLocations" : [ { "workMode" : "remote" } ], "locationText" : "", "employmentType" : "CONTRACT", "experienceMinYears" : 1, "professionalSkills" : [ "process management", "cross-functional coordination", "vendor/stakeholder management", "operational metrics", "resource planning", "continuous improvement" ], "hardSkillsList" : [ "Request for prior authorizations for services requested by MD", "Request Authorizations for continuation of care for services being rendered by MD", "Communicate with MD regarding services not approved", "Knowledge of Medicare, Medicaid, and Managed Care reimbursement guidelines" ], "softSkillsList" : [ "Ability to effectively handle multiple priorities within dept", "Ability to pay attention to detail, prioritize needs, multi-task and manage needs is essential" ], "hardSkills" : [ { "name" : "Request for prior authorizations for services requested by MD", "level" : "intermediate" }, { "name" : "Request Authorizations for continuation of care for services being rendered by MD", "level" : "intermediate" }, { "name" : "Communicate with MD regarding services not approved", "level" : "intermediate" }, { "name" : "Knowledge of Medicare, Medicaid, and Managed Care reimbursement guidelines", "level" : "intermediate" } ], "softSkills" : [ { "name" : "Ability to effectively handle multiple priorities within dept" }, { "name" : "Ability to pay attention to detail, prioritize needs, multi-task and manage needs is essential" } ], "majorSkills" : "Authorizations Coordinator, Request for prior authorizations for services requested by MD, Request Authorizations for continuation of care for services being rendered by MD, Communicate with MD regarding services not approved", "majorSkillsList" : [ "Authorizations Coordinator", "Request for prior authorizations for services requested by MD", "Request Authorizations for continuation of care for services being rendered by MD", "Communicate with MD regarding services not approved" ], "coreResponsibilities" : "Request for prior authorizations for services requested by MD, Request Authorizations for continuation of care for services being rendered by MD, Communicate with MD regarding services not approved", "domainKnowledge" : "Medicare; Medicaid; Managed Care reimbursement guidelines", "domainList" : [ "medicare", "medicaid", "managed-care-reimbursement-guidelines" ], "domainSpecificKnowledge" : [ "Medicare", "Medicaid", "Managed Care reimbursement guidelines" ], "communicationSkills" : "Communicate with MD regarding services not approved", "specialRequirements" : "Must be willing to work the graveyard Shift - Will be working US hours, Independent contractor role, Will be working US hours, perform pre-employment confidential DiSC testing and appropriate relevant skills testing prior to hiring", "qualificationsBasic" : "At least 1 year experience in authorizations is required, 1+ years’ experience working in a healthcare setting (i. e. hospital, medical/dental office, nursing facilities, etc. ), At least 1 year of experience applying knowledge of Medicare, Medicaid, and Managed Care reimbursement guidelines, Ability to effectively handle multiple priorities within dept, Ability to pay attention to detail, prioritize needs, multi-task and manage needs is essential, Must be willing to work the graveyard Shift - Will be working US hours", "remoteFriendly" : true, "workSiteFlexibility" : "Full time work from home position", "rawDescription" : "Job description Come and join Skilled Wound Care where an exciting career awaits you! Our company is looking for an experienced and motivated Authorizations Coordinator to join our Skilled Wound Care team! Essential Job Duties: Request for prior authorizations for services requested by MD Request Authorizations for continuation of care for services being rendered by MD Communicate with MD regarding services not approved Must be willing to work the graveyard Shift - Will be working US hours Compensation $5/hr Requirements: At least 1 year experience in authorizations is required 1+ years’ experience working in a healthcare setting (i. e. hospital, medical/dental office, nursing facilities, etc.) At least 1 year of experience applying knowledge of Medicare, Medicaid, and Managed Care reimbursement guidelines Ability to effectively handle multiple priorities within dept Ability to pay attention to detail, prioritize needs, multi-task and manage needs is essential. Full time work from home position Must be willing to work the graveyard Shift - Will be working US hours This is an Independent contractor role Great Place to Work® Certified! Skilled Wound Care is proud to be Certified™ by Great Place to Work® for the 3rd year in a row. The prestigious award is based entirely on what current employees say about their experience working at Skilled Wound Care. This year, 95% of employees said it’s a great place to work – 39% higher than the average U. S. company. Skilled Wound Care will ask all candidates to perform pre-employment confidential DiSC testing and appropriate relevant skills testing prior to hiring. Skilled Wound Care is an equal opportunity employer and does not discriminate on the basis of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age (40 or older), disability or genetic information.", "summaryDescription" : "Authorizations Coordinator at Skilled Wound Care. Skills: Authorizations Coordinator, Request for prior authorizations for services requested by MD, Request Authorizations for continuation of care for services being rendered by MD, Communicate with MD regarding services not approved. Request for prior authorizations for services requested by MD. Request Authorizations for continuation of care for services being rendered by MD", "postedDate" : "2026-05-20T14:34:28.153", "createdAt" : "2026-05-20T14:34:28.153", "lastUpdated" : "2026-05-20T14:35:41.098", "ingestTimestamp" : "2026-05-20T14:34:28.153", "mongoId" : "6a0d97ca58b93c861e9f28cb", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "salaryAnnualMin" : 10400, "salaryAnnualMax" : 10400, "salaryBand" : "<30k", "hasSalary" : true, "allSkills" : [ "Request for prior authorizations for services requested by MD", "Request Authorizations for continuation of care for services being rendered by MD", "Communicate with MD regarding services not approved", "Knowledge of Medicare, Medicaid, and Managed Care reimbursement guidelines", "Ability to effectively handle multiple priorities within dept", "Ability to pay attention to detail, prioritize needs, multi-task and manage needs is essential", "Authorizations Coordinator", "process management", "cross-functional coordination", "vendor/stakeholder management", "operational metrics", "resource planning", "continuous improvement", "Medicare", "Medicaid", "Managed Care reimbursement guidelines" ], "skillCount" : 16, "jobCategory" : "other", "jobSubcategory" : "billing", "dataQualityScore" : 0.8888889, "_score" : 180.66895, "daysOld" : 0, "hasLocation" : true, "hasGeo" : false }, { "id" : "6a3058c7f292fd229cf44134", "title" : "Youth Track and Field Instructor", "industry" : "Sports & Fitness", "salary" : { "min" : 42000.0, "max" : 58000.0, "currency" : "USD", "frequency" : "yearly", "is_estimated" : true, "estimation_basis" : "Market baseline for an Entry-level Youth Track and Field Instructor in New York, United States, adjusted for the Education industry." }, "location" : "New York, NY", "locations" : [ "New York, NY" ], "timestamp" : "2026-06-16T08:28:10.500", "fingerprint" : "bec6727bf178588b49e3428e759e9678e7f1169d0c12baa44c3a93dbaf61c31e", "source" : "jazzhr", "language" : "en", "externalId" : "lWirqSK0lT", "industryFunction" : { }, "structuredLocations" : [ { "city" : "New York", "state" : "New York", "country" : "United States", "continent" : "na", "source" : "llm", "workMode" : "onsite", "geo" : "40.7127281,-74.0060152" } ], "locationText" : "New York, New York, United States", "coreResponsibilities" : "Instruct youth in track and field, Develop training plans, Ensure athlete safety, Foster a positive environment, Organize and lead practices, Provide feedback to athletes, Communicate with parents", "domainKnowledge" : "Track and field; Youth sports", "domainList" : [ "track-and-field", "youth-sports" ], "domainSpecificKnowledge" : [ "Track and field", "Youth sports" ], "workSiteFlexibility" : "Onsite", "summaryDescription" : "Youth Track and Field Instructor. Instruct youth in track and field. Develop training plans", "createdAt" : "2026-06-15T22:17:05.054", "lastUpdated" : "2026-06-16T08:28:10.500", "ingestTimestamp" : "2026-06-15T22:17:05.054", "mongoId" : "6a3058c7f292fd229cf44134", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "salaryAnnualMin" : 42000, "salaryAnnualMax" : 58000, "salaryBand" : "30k-50k", "hasSalary" : true, "allSkills" : [ "Track and field", "Youth sports" ], "skillCount" : 2, "jobCategory" : "general", "jobSubcategory" : "general", "seniorityLevel" : "Entry", "dataQualityScore" : 0.44444445, "_score" : 179.59703, "hasLocation" : true, "hasGeo" : true, "llmIndustry" : "Education", "llmIndustryConfidence" : 0.85 }, { "id" : "6a2ca43874d8ee00a09b0c0d", "title" : "Fast Track to Leadership Trainee", "company" : "Picnic", "industry" : "Logistics", "salary" : { "min" : 45000.0, "max" : 55000.0, "currency" : "EUR", "frequency" : "yearly", "is_estimated" : true, "estimation_basis" : "Market baseline for an entry-level E-commerce trainee in Germany, adjusted for company size and industry." }, "location" : "Germany ", "locations" : [ "Germany" ], "timestamp" : "2026-06-15T21:59:18.600", "fingerprint" : "3b5c4e891d55a70b82119dbd67867fb685b0281cac681095949d896ec967b152", "source" : "greenhouse", "language" : "de", "applyUrl" : "https://jobs.picnic.app/nl/vacancies?gh_jid=7730885", "externalId" : "7730885", "industryFunction" : { }, "structuredLocations" : [ { "country" : "Germany", "continent" : "eu", "workMode" : "onsite" } ], "locationText" : "Germany", "employmentType" : "FULL_TIME", "minimumEducation" : "Master's", "experienceMinYears" : 0, "experienceMaxYears" : 2, "experienceLevel" : "Entry", "professionalSkills" : [ "Supply chain management", "Operations management", "Process optimization", "Data analysis" ], "hardSkillsList" : [ "Process simplification", "Bottleneck resolution", "Order process optimization", "Team leadership", "People development" ], "softSkillsList" : [ "Leadership", "Mentoring", "Motivation", "Team development" ], "hardSkills" : [ { "name" : "Process simplification", "level" : "intermediate" }, { "name" : "Bottleneck resolution", "level" : "intermediate" }, { "name" : "Order process optimization", "level" : "intermediate" }, { "name" : "Team leadership", "level" : "intermediate" }, { "name" : "People development", "level" : "intermediate" } ], "softSkills" : [ { "name" : "Leadership" }, { "name" : "Mentoring" }, { "name" : "Motivation" }, { "name" : "Team development" } ], "majorSkills" : "Operations Management, Team Leadership, Process Improvement", "majorSkillsList" : [ "Operations Management", "Team Leadership", "Process Improvement" ], "coreResponsibilities" : "Onboard and learn fulfillment center, Lead a shift in fulfillment center, Plan shift operations, Coordinate shift operations, Lead shift team, Identify optimization potential, Implement improvement projects, Take responsibility for teams, Take responsibility for processes, Take responsibility for strategic projects, Contribute to international perspective, Work on cross-site initiatives, Support new fulfillment centers, Optimize ordering processes, Support automated fulfillment centers", "teamCollaboration" : "Cross-functional teams; International teams", "projectManagementSkills" : [ "Project management" ], "domainKnowledge" : "Supply chain; Fulfillment center operations; Logistics; Food waste reduction", "domainList" : [ "supply-chain", "fulfillment-center-operations", "logistics", "food-waste-reduction" ], "domainSpecificKnowledge" : [ "Supply chain", "Fulfillment center operations", "Logistics", "Food waste reduction" ], "continuousLearning" : "Mentoring; Training; Workshops; Bootcamps; Learning opportunities", "innovationCreativity" : "Test new ideas", "problemSolvingSkills" : "Problem identification; Root cause analysis; Analytical thinking", "specialRequirements" : "Shift work, Office and warehouse environment, Company car, Private car use", "outcomesObjectives" : "Increase productivity; Simplify processes; Solve bottlenecks; Develop people; Create clarity; Master challenging situations; Grow beyond oneself; Elevate supply chain", "qualificationsBasic" : "Master's degree in Logistics, Master's degree in Supply Chain Management, Master's degree in Industrial Engineering, Master's degree in comparable field, Practical experience in supply chain, Fluent German, Very good English skills", "qualificationsPreferred" : "Experience through internships, Experience through working student roles", "remoteFriendly" : true, "workSiteFlexibility" : "Flexible", "rawDescription" : "Kurz und knapp Du stehst kurz vor deinem Masterabschluss und willst als Graduate mehr als nur einen klassischen Berufseinstieg? Du suchst Verantwortung, Tempo und echte Wirkung in deinem Alltag? Als Fast Track to Leadership Trainee im Bereich Supply Chain und Operations startest du bei Picnic durch: In nur zwei Jahren entwickelst du dich vom Graduate in die Führungsposition als Operations Manager und übernimmst die Verantwortung für Teams, Prozesse und strategische Projekte entlang unserer Supply Chain im Fulfillment. Hands-on, datengetrieben und mit echtem Impact. Das erwartet dich Jahr 1: Operative Grundlagen & Leadership als Operations Supervisor Onboarding & Einstieg: Du startest mit einem strukturierten Onboarding, baust dir ein starkes Netzwerk auf und lernst unser Fulfillment Center (FC) von Grund auf kennen. Schichtleitung im FC: An ca. 3-4 Tagen pro Woche übernimmst du als Operations Supervisor die Verantwortung einer Schicht. Du planst, koordinierst und führst dein Team - und erlebst vom ersten Tag an, wie operative Entscheidungen direkten Einfluss auf unsere Teams und Performance haben. Führung & Coaching: Durch Mentoring, Trainings zu Leadership, Feedback und Motivation lernst du, wie du Menschen entwickelst, Klarheit schaffst und herausfordernde Situationen meisterst. Eigene Projekte mit Impact: Du identifizierst Optimierungspotenziale im operativen Alltag und setzt an deinen 1-2 Projekttagen eigenständig Verbesserungsprojekte um, die Produktivität steigern, Prozesse vereinfachen und Engpässe nachhaltig lösen. Jahr 2: Führung mit Wirkung über Standorte hinweg als Operations Manager (Inter)nationale Perspektive: Ergreife die Chance und bring dein Wissen an anderen Picnic Standorten - national oder international - oder lerne eine andere Abteilung entlang unserer Supply Chain kennen. Du übernimmst Verantwortung in einem neuen Umfeld mit neuen Teams und wächst über dich hinaus. Fokus auf Projekte: Neben deinen ca. 1-2 Schichttagen pro Woche arbeitest du an ca. 3-4 Tagen an standortübergreifenden Initiativen, z. B. bei der Optimierung unserer Bestellprozesse oder bei der Unterstützung neuer (automatisierter) FCs. Mit deinem operativen Know-How und deinem analytischen Blick hebst du unsere Supply Chain auf das nächste Level. Dein nächster Schritt: Nach dem Fast Track stehen dir viele Türen offen: als erfahrener Operations Manager oder in weiteren Positionen innerhalb von Picnic. Das bringst du mit Ein (bald) abgeschlossenes Masterstudium in Logistik, Supply Chain Management, Wirtschaftsingenieurwesen oder einem vergleichbaren Masterstudiengang Erste praktische Erfahrungen im Supply-Chain-Umfeld (z. B. durch Praktika oder Werkstudententätigkeiten) Fließende Deutsch- und sehr gute Englischkenntnisse Freude daran, als Trainee direkt Verantwortung für ein Team zu übernehmen und Menschen zu motivieren und entwickeln Du setzt Ideen mit deiner Hands-on-Mentalität in erfolgreiche Projekte um und gehst als Vorbild voran Ein starkes Zahlenverständnis und die Fähigkeit, Probleme frühzeitig zu erkennen Flexibilität und Begeisterung für eine Rolle, die sowohl im Büro als auch im operativen Lagerumfeld stattfindet, inklusive Schichtarbeit Darauf kannst du dich freuen Starte durch - mit uns: Werde Teil unseres internationalen Teams in einem Umfeld, das echtes Wachstum und eine „Act like an Owner“-Mentalität fördert. Bei uns hast du die Chance, Projekte eigenverantwortlich voranzutreiben, neue Ideen zu testen und direkt miterleben zu können, wie deine Arbeit in unserem schnell wachsenden Unternehmen Wirkung zeigt. Nachhaltigkeit als Kern: Werde Teil der Revolution. Du trägst zu einer grüneren Zukunft bei – durch unsere 100 % elektrische Flotte und eine Lieferkette, die Lebensmittelverschwendung reduziert. Die Basics: Wir stellen dir alles für deinen Erfolg bereit – inklusive Laptop und Handy sowie Zugang zu exklusiven Mitarbeiter-Rabatten (Corporate Benefits) für Reisen, Technik und vieles mehr. Zeit zum Auftanken: Mit 30 Urlaubstagen pro Jahr (bei einer 40-Stunden-Woche) sorgst du für den perfekten Ausgleich zwischen Arbeit und Erholung. Verpflegung für Gewinner: Wir kümmern uns um dich. Genieße jeden Tag ein frisches, kostenloses Frühstück und Mittag- oder Abendessen in unserem Fulfilment Center, dazu gibt es reichlich Snacks, Getränke und Obst für den Energiekick zwischendurch. Unvergessliche Momente: Wir sind mehr als nur ein Team. Von unserem legendären jährlichen Ski-Trip über Weihnachtsfeiern bis hin zu Auftritten unserer eigenen Picnic-Band: Wir feiern unsere Erfolge gemeinsam. Wohlbefinden & Gleichgewicht: Wir bieten dir professionelle Unterstützung für deine mentale Gesundheit mit OpenUp. Individuelle Mobilität:Du erhältst einen Firmenwagen (auch zur privaten Nutzung) und kannst zusätzlich unser „Lease-a-Bike“-Programm nutzen. Lebensmittelretter: Hol dir unsere exklusiven \"Too-Good-To-Go\"-Tüten und rette leckere Lebensmittel – nur für unsere Mitarbeitenden! Lerne & wachse: Profitiere von internen Lern- & Entwicklungsmöglichkeiten durch spannende Workshops und intensive Bootcamps, um deine Skills ständig zu erweitern Bist du neugierig?", "summaryDescription" : "Fast Track to Leadership Trainee at Picnic. Skills: Operations Management, Team Leadership, Process Improvement. Onboard and learn fulfillment center. Lead a shift in fulfillment center", "postedDate" : "2026-06-14T19:24:26.439", "createdAt" : "2026-06-14T19:24:26.439", "lastUpdated" : "2026-06-15T21:59:18.600", "ingestTimestamp" : "2026-06-14T19:24:26.439", "mongoId" : "6a2ca43874d8ee00a09b0c0d", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "salaryBand" : "30k-50k", "hasSalary" : false, "allSkills" : [ "Process simplification", "Bottleneck resolution", "Order process optimization", "Team leadership", "People development", "Leadership", "Mentoring", "Motivation", "Team development", "Operations Management", "Team Leadership", "Process Improvement", "Supply chain management", "Operations management", "Process optimization", "Data analysis", "Project management", "Supply chain", "Fulfillment center operations", "Logistics", "Food waste reduction" ], "skillCount" : 21, "jobCategory" : "operations", "jobSubcategory" : "general", "seniorityLevel" : "Entry", "dataQualityScore" : 1.0, "_score" : 179.48235, "daysOld" : 1, "hasLocation" : true, "hasGeo" : false, "llmIndustry" : "E-Commerce", "llmIndustryConfidence" : 0.95 }, { "id" : "6a305924f292fd229cf454c1", "title" : "Part Time Authorization and Appeals Specialist", "salary" : { "min" : 31000.0, "max" : 45000.0, "currency" : "USD", "frequency" : "yearly", "is_estimated" : true, "estimation_basis" : "Market baseline data for an Entry-level Part-time Authorization and Appeals Specialist in St. Louis, MO, adjusted for the healthcare industry." }, "location" : "St. Louis, MO", "locations" : [ "St. Louis, MO" ], "timestamp" : "2026-06-16T06:50:21.175", "fingerprint" : "88d3d7b11330d750138fe0b9c89e3f4520330798db71421ed4ba4ffa1eb6277a", "source" : "jazzhr", "language" : "en", "externalId" : "1dkyvdU3Y2", "industryFunction" : { }, "structuredLocations" : [ { "city" : "St. Louis", "state" : "Missouri", "country" : "United States", "continent" : "na", "source" : "llm", "workMode" : "onsite", "geo" : "38.6254063,-90.1900090" } ], "locationText" : "St. Louis, Missouri, United States", "employmentType" : "PART_TIME", "workSiteFlexibility" : "Onsite", "summaryDescription" : "Part Time Authorization and Appeals Specialist", "createdAt" : "2026-06-15T22:16:33.023", "lastUpdated" : "2026-06-16T06:50:21.175", "ingestTimestamp" : "2026-06-15T22:16:33.023", "mongoId" : "6a305924f292fd229cf454c1", "processingStatus" : "llm_updated", "llmProcessingStatus" : true, "salaryAnnualMin" : 31000, "salaryAnnualMax" : 45000, "salaryBand" : "30k-50k", "hasSalary" : true, "allSkills" : [ ], "skillCount" : 0, "jobCategory" : "operations", "jobSubcategory" : "general", "seniorityLevel" : "Entry", "dataQualityScore" : 0.44444445, "_score" : 179.17459, "hasLocation" : true, "hasGeo" : true, "llmIndustry" : "Healthcare", "llmIndustryConfidence" : 0.85 } ], "status" : 200, "message" : "OK", "pagination" : { "page" : 0, "limit" : 50, "totalCount" : 19313, "totalPages" : 387, "hasNext" : true, "hasPrevious" : false } }

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