Clinical Authorization Specialist

2 weeks ago

Fairfield, United States Actalent Full time
Job DescriptionJob DescriptionJob Title: Clinical Authorization Specialist - IMMEDIATE NEED

Job Description

We are seeking a Clinical Authorization Specialist to join our client with a dynamic intake team

Responsibilities
  • Retrieve, count, pour, and weigh prescriptions per written instruction.
  • Pre-pack medicines, bottle, and label as requested by pharmacy staff.
  • Utilize prior authorization and insurance knowledge to support the intake team for the pharmacy.
  • Conduct benefits investigations and manage prior authorizations for patients.
  • Validate insurance information before medication shipments
  • Use computer systems and make phone calls to verify patient and insurance information.
  • Handle dozens of outbound calls, often with significant hold times.
  • Prepare and manage lists of patients, coordinating with insurance companies for multiple patients simultaneously.
  • Maintain patience and professionalism while on hold with insurance companies.
  • Develop daily lists of high-priority patients based on upcoming infusion dates, in coordination with the intake manager and pharmacy team.
  • Make general assignments for patient and payer coordination each day.
  • Ensure efficient use of time during phone calls, with an expected talking time of 25% during peak periods.
  • Potentially receive special assignments from the intake manager.
Essential Skills
  • Experience in prior authorization review.
  • Knowledge of insurance verification and benefits.
  • Understanding of medical terminology.
  • Patient care experience.
  • Pharmacy technician license or medical assistant certification.
  • Experience in healthcare, medical billing, and using Epic systems.
Additional Skills & Qualifications
  • Dedicated worker with reliable transportation.
  • Committed to schedule with no PTO requests during the contract period.
  • Kind personality and good customer service skills.
  • Patience and professionalism.
Work Environment
  • The position offers a unique closed-door environment, so there is no face-to-face interaction with patients.
  • The work shift is Monday to Friday from 9:00 AM to 5:30 PM with a 30-minute break each day.
  • Expect to work at least 8 hours a day during the first weeks of January due to high demand.
About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

Diversity, Equity & Inclusion

At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

  • Hiring diverse talent
  • Maintaining an inclusive environment through persistent self-reflection
  • Building a culture of care, engagement, and recognition with clear outcomes
  • Ensuring growth opportunities for our people

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.

  • Clinical Authorization Specialist

    4 weeks ago

    Fairfield, California, United States Actalent Full time

    Job Title:Clinical Authorization SpecialistWe are seeking a Clinical Authorization Specialist who will be responsible for retrieving, counting, pouring, and weighing prescriptions per written instruction.The role involves pre-packing medicines, bottling, and labeling as requested by pharmacy staff. You will utilize your prior authorization and insurance...

  • Clinical Authorization Specialist

    4 weeks ago

    Fairfield, New Jersey, United States Actalent Full time

    Job DescriptionWe are seeking a highly skilled Clinical Authorization Specialist to join our team at Actalent. As a Clinical Authorization Specialist, you will be responsible for retrieving, counting, pouring, and weighing prescriptions per written instruction. You will also pre-pack medicines, bottle, and label as requested by pharmacy staff.Key...

  • Clinical Authorization Specialist

    1 month ago

    Fairfield, United States Actalent Full time

    Job DescriptionJob DescriptionJob Title: Clinical Authorization SpecialistJob Description:We are seeking a Clinical Authorization Specialist who will be responsible for:Retrieving, counting, pouring, and weighing prescriptions per written instruction.Pre-packing medicines, bottling, and labeling as requested by pharmacy staff.Utilizing prior authorization...

  • Clinical Authorization Specialist

    1 week ago

    Fairfield, United States Actalent Full time

    Job DescriptionJob DescriptionClinical Authorization Specialist - IMMEDIATE NEED!*** 13 WEEK CONTRACT ***Job DescriptionWe are seeking a Clinical Authorization Specialist to join our client with a dynamic intake team!ResponsibilitiesRetrieve, count, pour, and weigh prescriptions per written instruction.Pre-pack medicines, bottle, and label as requested by...

  • Clinical Authorization Specialist

    4 weeks ago

    Fairfield, United States Actalent Full time

    Job DescriptionJob DescriptionJob Title: Clinical Authorization SpecialistJob DescriptionWe are seeking a Clinical Authorization Specialist to join our dynamic intake team. The ideal candidate will have a strong knowledge in prior authorizations and insurance verification, with the ability to support our pharmacy staff by conducting benefits investigations...

  • Clinical Authorization Specialist

    2 weeks ago

    Fairfield, United States Actalent Full time

    Job DescriptionJob DescriptionJob Title: Clinical Authorization SpecialistJob DescriptionWe are seeking a Clinical Authorization Specialist to assist our pharmacy team with various tasks related to prescription management, insurance verification, and patient care coordination. The role involves conducting benefits investigations, managing prior...

  • Clinical Authorization Specialist

    2 weeks ago

    Fairfield, United States Actalent Full time

    Job DescriptionJob DescriptionJob Title: Clinical Authorization Specialist - IMMEDIATE NEED!**13 week assignment** The contract is expected to start before Thanksgiving and last until late February or early March 2025. Job DescriptionWe are seeking a Clinical Authorization Specialist to join our client with a dynamic intake team!ResponsibilitiesRetrieve,...

  • Clinical Authorization Specialist

    2 weeks ago

    Fairfield, United States Actalent Full time

    Job DescriptionJob DescriptionJob Title: Clinical Authorization Specialist - IMMEDIATE NEED!**13 week assignment** The contract is expected to start before Thanksgiving and last until late February or early March 2025. Job DescriptionWe are seeking a Clinical Authorization Specialist to join our client with a dynamic intake team!ResponsibilitiesRetrieve,...

  • Insurance Authorization Specialist

    2 weeks ago

    Fairfield, United States Actalent Full time

    Job DescriptionJob DescriptionJob Title: Clinical Authorization Specialist - IMMEDIATE NEED!Job DescriptionWe are seeking a Clinical Authorization Specialist to join our client with a dynamic intake team!ResponsibilitiesRetrieve, count, pour, and weigh prescriptions per written instruction.Pre-pack medicines, bottle, and label as requested by pharmacy...

  • Clinical Care Specialist

    3 weeks ago

    Fairfield, California, United States Pride Health Full time

    Job Title: Clinical Care SpecialistJob Summary: Pride Health is seeking a skilled Clinical Care Specialist to join our team. As a Nurse Practitioner, you will provide high-quality patient care in a long-term care setting.Responsibilities:Provide clinical care to patients in a long-term care settingDevelop and implement individualized care plansCollaborate...

  • Clinical Nurse Specialist Coordinator NICU

    4 weeks ago

    Fairfield, California, United States NorthBay Health Full time

    Job Title: Clinical Nurse Specialist Coordinator NICUJob Summary:We are seeking a highly skilled Clinical Nurse Specialist Coordinator to join our team at NorthBay Health. The successful candidate will be responsible for coordinating clinical and educational resources and care standards for the neonatal and pediatric critical care level patient...

  • Clinical Nurse Specialist

    4 weeks ago

    Fairfield, California, United States Jefferson County Health Center Full time

    POSITION SUMMARY:As a skilled Clinical Nurse Specialist at Jefferson County Health Center, you will play a vital role in delivering exceptional patient care and supporting our medical providers in their daily tasks.Key responsibilities include creating a professional office image, providing superior customer service, and working collaboratively with other...

  • Clinical Dietitian

    4 weeks ago

    Fairfield, California, United States Bon Secours Mercy Health Full time

    Job Summary:Clinical Dietitian - Nutrition SpecialistBon Secours Mercy Health is seeking a skilled Clinical Dietitian - Nutrition Specialist to join our team. As a key member of our healthcare team, you will provide nutritional assessments, diet plans, and ongoing dietary education to patients of Mercy Health Physicians.Responsibilities:Conduct nutritional...

  • Clinical Dietitian

    4 weeks ago

    Fairfield, California, United States Bahama Consulting Full time

    Nutrition Care SpecialistThe Clinical Dietitian is responsible for delivering high-quality nutrition care to patients in an acute care hospital setting. This role involves assessing, planning, implementing, and evaluating nutritional processes to ensure optimal patient outcomes. The ideal candidate will have a strong background in clinical nutrition and...

  • Clinical Psychologist

    4 weeks ago

    Fairfield, California, United States Kaiser Permanente Full time

    Job Summary:Kaiser Permanente is seeking a highly skilled Clinical Psychologist to join our team as a Crisis Stabilization Specialist. As a member of our multidisciplinary team, you will provide mental health assessment, diagnosis, treatment, and crisis intervention services to adult and child members. Your expertise will be invaluable in developing and...

  • Clinical Mental Health Specialist

    3 weeks ago

    Fairfield, California, United States Kaiser Full time

    Job Summary:As a Clinical Mental Health Specialist at Kaiser Permanente, you will work under the supervision of a licensed Psychologist or board certified Psychiatrist to provide mental health assessment, diagnosis, treatment, and crisis intervention services for adult and/or child members. You will collaborate with treating primary care providers and with...

  • Imaging Support Specialist

    4 weeks ago

    Fairfield, California, United States NorthBay Health Full time

    Job SummaryWe are seeking a highly organized and detail-oriented Imaging Support Specialist to join our team at NorthBay Health. In this role, you will be responsible for obtaining billing documentation and authorizations for patient imaging exams, verifying patient eligibility and benefits, and scheduling exams for multiple diagnostic modalities.Key...

  • Nurse Practitioner/Physician Assistant

    4 weeks ago

    Fairfield, Maine, United States Matrix Medical Network Full time

    About the RoleMatrix Medical Network is seeking a skilled Nurse Practitioner/Physician Assistant to join our team as a Home Risk Assessment Specialist. In this role, you will conduct comprehensive health assessments in the comfort of patients' homes, providing unmatched insight into their overall health and well-being.As a Home Risk Assessment Specialist,...

  • Patient Service Specialist

    1 month ago

    Fairfield, United States Bon Secours Mercy Health Full time

    At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. This position will focus on prior authorizations and insurance benefit checks for all Cincinnati Market Locations for Audiology and Speech...

  • Clinical Nutrition Specialist

    1 month ago

    Fairfield, California, United States NorthBay Health Medical Center Full time

    Job Title: Clinical DietitianJob Specialty: Clinical NutritionJob Duration: 8 weeksShift: Saturday, Sunday, and Monday (potentially Fridays); Weekend shifts: 7 am to 3:30 pm or 8 am to 4:30 pm; Monday: 8 am to 4:30 pmGuaranteed Hours: 24.00 hours per weekRequirements:Minimum 1 year of clinical experience in an acute care hospital; 2 years preferredRegistered...