We have other current jobs related to this field that you can find below

  • Prior Authorization Nurse

    1 month ago

    Atlanta, Georgia, United States A-Line Staffing Solutions Full time

    PRIOR AUTHORIZATION NURSE JOB Summary:Provide processing and communication of specialty medication prior authorization (PA) requests reviewed by the Specialty Medical Prior Authorization department.Work with physician office staff and customer service, admissions and pharmacy operations departments to communicate prior authorization status.Oversee fax...

  • Biologic Prior Authorization Specialist

    2 months ago

    Atlanta, United States SENTA Partners Full time

    DescriptionPosition Summary: Biologic Prior Authorization Specialist is an individual who manages a patient's journey from prescription to drug acquisition. This role navigates the complexities of patient access on behalf of those prescribed biologics. Responsible for communicating with office staff, providers, insurance providers, completing enrollment...

  • Prior Authorization Specialist

    2 weeks ago

    Atlanta, United States Southeastern Rheumatology Alliance Full time

    Job DescriptionJob DescriptionSoutheastern Rheumatology Alliance is seeking a dedicated and customer-oriented Prior Authorization Specialist to join our healthcare team in Atlanta, GA. The Prior Authorization Specialist is responsible for managing and processing requests for prior authorization from healthcare providers to ensure that medical services,...

  • Prior Authorization Specialist

    4 weeks ago

    Atlanta, United States Select Specialty Hospital Full time

    Overview Critical Illness Recovery Hospital Payor Relations Specialist (Precert Nurse) At Select Specialty/Regency Hospitals, a division of Select Medical, we care for chronically and critically ill or post-ICU patients who require extended hospital care. Select Medical employs over 48,000 people across the country and provides quality care to...

  • Prior Authorization Representative

    2 months ago

    Atlanta, United States Warbird Consulting Partners Full time

    Job DescriptionJob DescriptionWarbird Healthcare Advisors seeks experienced Prior Authorization Representatives (PARs) for a remote opportunity with a Durable Medical Equipment client. The Prior Authorization Representatives support the Centralized Business Office by performing all tasks required to obtain referrals/authorizations and verifying patients'...

  • Utilization Review Nurse

    3 weeks ago

    Atlanta, United States Sonder Health Plans, Inc. Full time

    Job Description: The Utilization Review Nurse's role is to ensure that health care services are administered with quality, cost efficiency, and within compliance. By continuously reviewing and auditing member treatment records, the utilization review nurse will ensure members do not receive unnecessary procedures, ineffective treatment, or experience...

  • Utilization Review Nurse

    2 months ago

    Atlanta, Georgia, United States Sonder Health Plans, Inc. Full time

    Job Description:The Utilization Review Nurse's role is to ensure that health care services are administered with quality, cost efficiency, and within compliance. By continuously reviewing and auditing member treatment records, the utilization review nurse will ensure members do not receive unnecessary procedures, ineffective treatment, or experience...

  • Utilization Review Nurse

    3 months ago

    Atlanta, United States Sonder Health Plans Full time

    Job DescriptionJob DescriptionJob Description:The Utilization Review Nurse’s role is to ensure that health care services are administered with quality, cost efficiency, and within compliance. By continuously reviewing and auditing member treatment records, the utilization review nurse will ensure members do not receive unnecessary procedures, ineffective...

  • Surgery Prior Authorization Specialist

    2 weeks ago

    Atlanta, United States PEDIATRIC EAR NOSE & THROAT OF ATLANTA PC Full time

    Job DescriptionJob DescriptionJob Title: Surgery Prior Authorization SpecialistLocation: Atlanta/Sandy Springs, GAJob Type: Full-TimeAbout Us:We are a leading Pediatric Ears, Nose, & Throat practice in Atlanta dedicated to providing exceptional care to our patients. We are currently seeking a skilled and detail-oriented individual to join our team as a...

  • Specialty Medication Authorization Nurse

    6 days ago

    Atlanta, Georgia, United States A-Line Staffing Solutions Full time

    JOB SUMMARY FOR SPECIALTY MEDICATION AUTHORIZATION NURSE: Facilitate the processing and communication of prior authorization (PA) requests for specialty medications as managed by the Specialty Medical Prior Authorization team.Collaborate with healthcare provider office personnel and various departments including customer service, admissions, and pharmacy...

  • Customer Service Representative

    4 weeks ago

    Atlanta, United States ASK Consulting Full time

    Job DescriptionJob Description"All candidates must be directly contracted by ASK Consulting on their payroll and cannot be subcontracted. We are unable to provide sponsorship at this moment".Job Title: Customer Service Representative (Prior Authorization Expertise)Location: Atlanta, GA 30301Duration: 12 months Pay rate: $ 17.50 on W2. Prefer candidates from...

  • Prior Authorization Pharmacy Tech II

    3 days ago

    Atlanta, United States US Tech Solutions, Inc. Full time

    Duration: 06 Months Summary: This position takes in-coming calls from members, providers, etc providing professional phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of all approvals and denials, and transfers all clinical questions and...

  • Utilization Review Nurse

    1 month ago

    Atlanta, United States GHR Healthcare Full time

    Are you a detail-oriented RN with a knack for navigating complex medical cases? Do you thrive on making critical decisions that impact patient care? Join us as a Care Management Coordinator and play a key role in evaluating and authorizing essential healthcare services. Shift: Monday – Friday (8am – 5pm Normal business hours) Type: Temp to...

  • Utilization Review Nurse

    1 month ago

    Atlanta, United States GHR Healthcare Full time

    Are you a detail-oriented RN with a knack for navigating complex medical cases? Do you thrive on making critical decisions that impact patient care? Join us as a Care Management Coordinator and play a key role in evaluating and authorizing essential healthcare services. Shift: Monday – Friday (8am – 5pm Normal business hours) Type: Temp to...

  • Utilization Review Nurse

    3 weeks ago

    Atlanta, United States GHR Healthcare Full time

    Are you a detail-oriented RN with a knack for navigating complex medical cases? Do you thrive on making critical decisions that impact patient care? Join us as a Care Management Coordinator and play a key role in evaluating and authorizing essential healthcare services. Shift: Monday - Friday (8am - 5pm Normal business hours) Type: Temp to Hire...

  • Prior Auth

    12 hours ago

    Atlanta, United States Prestige Staffing Full time

    Onsite Prior Authorization Specialist Job Overview Position requires utilization of clinical knowledge and excellent customer service skills to schedule appropriate procedures/surgeries per provider???s orders in the hospital, ambulatory surgery center or in office places of service. Location: Smyrna, GA Hours: Normal Business Hours   3 month contract to...

  • Clinical Authorization Supervisor

    5 days ago

    Atlanta, United States Alliant Health Solutions, Inc. Full time

    Position OverviewAlliant Health Solutions, Inc. is a collective of organizations dedicated to enhancing the administration of healthcare programs and initiatives aimed at improving health outcomes. Our mission is to provide governmental entities with essential services, expertise, and information systems that elevate the quality, accessibility, and value of...

  • Clinical Services Authorization Specialist

    6 days ago

    Atlanta, Georgia, United States US Tech Solutions Full time

    Job Title: Clinical Services Authorization Specialist Location: Fully remote Duration: 10 months contract Job Overview: The Clinical Services Authorization Specialist will play a vital role in supporting various operational tasks, including but not limited to: making outbound calls, reviewing and processing authorization requests received through...

  • Authorization Coordinator

    5 days ago

    Atlanta, Georgia, United States Select Specialty Hospital Full time

    OverviewCritical Illness Recovery HospitalAuthorization CoordinatorAt Select Specialty Hospitals, a part of Select Medical, we specialize in the care of patients who are chronically and critically ill or those recovering from intensive care. Our organization employs over 48,000 professionals nationwide, delivering quality healthcare to approximately 70,000...

  • Oncology Drug Authorization Specialist

    1 day ago

    Atlanta, Georgia, United States Medical Practice Full time

    Job SummaryWe are seeking a highly skilled and experienced Prior Authorization Specialist to join our Medical Practice team. As a Prior Authorization Specialist, you will play a critical role in ensuring that our patients receive the necessary coverage for their chemotherapy treatments.ResponsibilitiesObtain insurance authorization and pre-certification for...

Utilization Review/Prior Authorization LPN

2 months ago

Atlanta, United States A-Line Staffing Solutions Full time

A-Line Staffing is now hiring a Fully Remote Utilization Review/Prior Authorization LPN This would be full time / 40+ hours per week.

***Scheduled Start Date: August 12th 2024***


*MUST HAVE PRIOR AUTHOIZATION EXPERIENCE WITH A HEALTH PLAN/MANAGED CARE COMPANY*


Fully Remote PBM LPN Hours

  • Training: Mon - Fri 8:00 AM - 4: 30 PM CST.
  • 8-hour shifts – 40-hour work week – must be flexible any day of week
  • Sun - Sat 8:00 AM - 6:00 PM CST

Fully Remote PBM LPN Compensation

  • The pay for this position is between $37.17 an hour
  • Benefits are available to full-time employees after 90 days of employment
  • A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates

Fully Remote PBM LPN Requirements

  • LPN License in state candidate lives in required
  • Must have 3 to 5 years Prior Authorization experience as an LPN/LVN with a Health Plan Candidates without this experience will not be considered.
  • Experience using MS Office, other Windows-based computer applications, and phone use.