Referral specialist work from home jobs - 528 jobs
Maternity Care Authorization Specialist (Hybrid Potential)
Christian Healthcare Ministries 4.1
Remote job
This role plays a key part in ensuring maternity care bills are processed accurately and members receive timely support during an important season of life. The specialist serves as a detail-oriented professional who upholds CHM's commitment to excellence, compassion, and integrity.
WHAT WE OFFER
Compensation based on experience.
Faith and purpose-based career opportunity!
Fully paid health benefits
Retirement and Life Insurance
12 paid holidays PLUS birthday
Lunch is provided DAILY.
Professional Development
Paid Training
ESSENTIAL JOB FUNCTIONS
Compile, verify, and organize information according to priorities to prepare data for entry
Check for duplicate records before processing
Accurately enter medical billing information into the company's software system
Research and correct documents submitted with incomplete or inaccurate details
Verify member information such as enrollment date, participation level, coverage status, and date of service before processing medical bills
Review data for accuracy and completeness
Uphold the values and culture of the organization
Follow company policies, procedures, and guidelines
Verify eligibility in accordance with established policies and definitions
Identify and escalate concerns to leadership as appropriate
Maintain daily productivity standards
Demonstrate eagerness and initiative to learn and take on a variety of tasks
Support the overall mission and culture of the organization
Perform other duties as assigned by management
SKILLS & COMPETENCIES
Core strengths like problem-solving, attention to detail, adaptability, collaboration, and time management.
Soft skills such as empathy (especially important in maternity care), professionalism, and being able to handle sensitive information with care.
EXPERIENCE REQUIREMENTS
Required: High school diploma or passage of a high school equivalency exam
Medical background preferred but not required.
Capacity to maintain confidentiality.
Ability to recognize, research and maintain accuracy.
Excellent communication skills both written and verbal.
Able to operate a PC, including working with information systems/applications.
Previous experience with Microsoft Office programs (I.e., Outlook, Word, Excel & Access)
Experience operating routine office equipment (i.e., faxes, copy machines, printers, multi-line telephones, etc.)
About Christian Healthcare Ministries
Founded in 1981, Christian Healthcare Ministries (CHM) is a health care sharing ministry for Christians. CHM is a nonprofit, voluntary cost-sharing ministry through which participating Christians meet each other's medical bills. The mission of CHM is to glorify God, show Christian love, and experience God's presence as Christians share each other's medical bills.
$31k-35k yearly est. 4d ago
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Patient Scheduling Specialist
Medasource 4.2
Remote job
Medical Support Assistant
Duration: 1 year contract (strong possibility of extension!)
Onsite: Denver, CO
Full Time: M-F, Day Shift
Overview: We are seeking reliable and mission-driven Medical Support Assistants to support Veterans served by a large healthcare system. MSAs provide critical front-line administration support across outpatient clinics and virtual care services.
Responsibilities:
• Customer service, appointment scheduling, and records management
• Answer phones, greet Veteran patients, schedule appointments and consults
• Help determine a clinic's daily needs, and verify and update insurance information
Required Qualifications:
• Minimum 6+ months of customer service experience
• 1+ year of clerical, call center, or healthcare administrative experience
• High school diploma or GED required
• Proficient with medical terminology
• Typing speed of 50 words per minute or more
• Ability to pass a federal background check
• Reliable internet for a remote work environment
$35k-42k yearly est. 1d ago
Cerner Oncology Scheduler
CSI Companies 4.6
Remote job
CSI Companies is seeking a Cerner Oncology Scheduler to work with one of our top healthcare clients!
Training: 2-weeks onsite training in South Bend, IN
Expenses: Travel expenses are reimbursed
Type: 100% Remote after training
Duration: 3+ Month Contract
Pay: $30 - $40/hour W2
Description:
Summary:
The Cerner Oncology Scheduler will provide staff augmentation support to maintain operational volumes across a high-volume outpatient oncology infusion center, medical oncology clinic, and gynecologic oncology center. This role is critical to ensuring continuity of care while the health system completes permanent hiring efforts.
Schedulers will work directly within Oracle Health Scheduling Appointment Book to manage complex oncology scheduling workflows, including patient intake, insurance verification, referral review, ICD 10 diagnosis review, treatment authorizations, orders, infusion appointments, provider visits, and coordinated multi-appointment care.
Key Responsibilities:
Interact directly with oncology patients.
Complete all operational patient intake tasks such as insurance verification, management of authorizations, referral management, and patient registrations.
Schedule outpatient oncology appointments using Oracle Health Scheduling Appointment Book, including:
Medical oncology clinic visits
Infusion appointments
Gynecologic oncology visits
Multi-visit and multi-resource appointment coordination
Accurately manage provider templates, infusion chair availability, and resource constraints
Coordinate care across clinics, infusion services, and ancillary departments
Apply oncology-specific scheduling rules, sequencing, and timing requirements
Communicate effectively with clinical teams, patients, and leadership regarding scheduling needs
Support operational throughput and access goals during staffing shortages
Adhere to organizational scheduling policies, workflows, and escalation paths
Required Qualifications
Minimum 2 years of hands-on experience scheduling oncology patients in Cerner
Demonstrated proficiency with Oracle Health CPM ambulatory specialist scheduling & Scheduling Appointment Book oncology infusion center scheduling.
Experience supporting outpatient oncology environments (medical oncology, infusion, and/or gynecologic oncology)
Strong understanding of the complexities and sequencing of oncology appointments
Ability to work independently with minimal ramp-up after onboarding
Willingness to travel onsite to Indiana for initial onboarding period
Preferred Qualifications
Experience in high-volume oncology infusion centers
Familiarity with oncology operational metrics (access, utilization, chair time optimization)
Prior contract or staff augmentation experience in healthcare settings
$30-40 hourly 5d ago
Scheduling Coordinator - Healthcare (Remote)
Access Telecare
Remote job
Who We Are:
Access TeleCare is the largest national provider of telemedicine technology and solutions to hospitals and health systems. The Access TeleCare technology platform, Telemed IQ, enables life-saving patient care through telemedicine and empowers healthcare organizations to build telemedicine programs in any clinical specialty. We provide healthcare teams with industry-leading solutions that drive improved clinical care, patient outcomes, and organizational health. We are proud to be the first provider of acute clinical telemedicine services to earn The Joint Commission's Gold Seal of Approval and has maintained that accreditation every year since inception.
We love what we do and if you want to know more about our vision, mission and values go to accesstelecare.com to check us out.
The Opportunity
We are seeking a detail-oriented and organized Scheduling Coordinator to join our Neurology Clinical Operations team. As a Scheduling Coordinator, you will support daily operational tasks related to our Neurology providers and assist with the management, development, and implementation of physician schedules in alignment with defined metrics and operational goals. Success in this position requires strong communication and organization skills, as you'll collaborate daily with clinicians, operations leaders, and internal teams to ensure schedule accuracy, efficiency, and seamless coordination across departments.
What You'll Work On
Collect, analyze, and interpret data from multiple sources to identify opportunities to optimize clinician schedules
Quickly get up to speed on Access Telecare's scheduling tool to support the analyses above
Generate & post Physician Schedules on a monthly basis utilizing predetermined availability to strategically maximize efficiency and meet/exceed target goal parameters.
Maintain real-time schedule changes.
Assist with the formation of facility specific physician panels as part of implementation process, depending upon existing & future State licensure/privileges.
Create summaries of coverage progress and remaining deficiencies
Compile capacity/coverage needs by service line, by physician group, or other criteria
Conduct outreach to clinicians to resolve capacity/coverage needs
Process shifts changes (extensions, change in start/end time, trades, etc.) in line with parameters set with service line leadership
Compile regular reporting on schedule performance
Enter monthly scheduling data into the scheduling software
Perform other duties and special projects as assigned
What You'll Bring
Bachelor's degree
Minimum of two years physician scheduling/workforce management or related experience preferred
Experience with quantitative analysis using tools like Microsoft Excel
Highly effective communication skills (written and oral)
Excellent organizational and project management skills, with an emphasis on hitting key deliverables/dates
Detail-oriented
Ability to collaborate across multiple cross-functional teams
Proficiency with Microsoft Office Suite and general computer skills
Company Perks
Remote Work
Health Insurance (Medical, Dental, Vision)
Health Savings Account
Flexible Spending (Medical and Dependent Care)
Employer Paid Life and AD&D (Supplemental available)
Flexible Vacation, Wellness Days, and Paid Holidays
About our recruitment process:
We don't expect a perfect fit for every requirement we've outlined. If you can see yourself contributing to the team, we would like to speak with you. You can expect up to 3 interviews via Zoom.
Access TeleCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration without regard to race, age, religion, color, marital status, national origin, gender, gender identity or expression, sexual orientation, disability, or veteran status.
$30k-39k yearly est. 2d ago
Authorizations & Referrals Specialist - Per Diem / Variable
Island Health Careers
Remote job
Island Health is searching for an experienced Authorizations & ReferralsSpecialist for our Patient Access department at our hospital in Anacortes, WA.
Work Schedule:
Per Diem / Variable
For Information on Employee Benefits
Location:
Onsite / Anacortes, WA
Salary Ranges: $20.41 - $30.61
Why Choose Island Health?
Whether you're a new grad or experienced in your field and considering a change, we invite you to explore a wide range of careers at Island Health with exceptional benefits including:
Medical, Vision, & Dental Insurance
Paid Time Off
Extended Illness Benefit
Life Insurance
Long-Term Disability
Vested Retirement Contribution
Flexible Spending Account
Tuition Reimbursement
Employee Assistance Program
Employee Recognition Events
And More!
Authorization & ReferralsSpecialist Job Requirements:
Completes referral and authorization processes with ICD-10 and CPT codes, pertinent documentation and Diagnostic information.
Verifies active primary insurance coverage in electronic worklists
Documents chart notes and confirmation of service in EMR.
Facilitates routing and release of patient record and other information to Scheduler in order to assist the patient with their appointment.
Discusses and clarifies insurance coverage and problems with referrals with patients.
Verifies ordered services meet CMS Medical Necessity requirements
Sends patients notes of approval/denial of referral or authorization when applicable.
Work patient electronic worklists daily
Works collaboratively with team to assure referrals are processed timely
Keeps abreast of new insurance and payer information, contractual updates, or developments as provided.
Must have demonstrated ability to interact positively with Administration, Director, Managers, Supervisors, peers, co-workers, subordinates, patients and visitors.
Must meet regular attendance standard and must stay at or below average sick leave utilization levels.
Employee will function at all times within guidelines established in the Island Hospital HIPAA Compliance Policy and Confidentiality agreements.
Job Requirements:
High School diploma or GED required.
Must maintain expectations outlined in work from home agreement.
Additional education or training in ICD-10 Coding encouraged.
Work Environment and Physical Demands: While performing the duties of this position, the employee is exposed to inside environmental conditions, protected from weather conditions but not necessarily from temperature changes. The employee may be exposed to dust, pollens, pollutants, fumes and communicable diseases as related to a health care environment. The noise level in the work environment is usually moderate.
While performing the responsibilities of this position, the employee is regularly required to talk, and have hearing sufficient to understand conversations, both in person and on the telephone. The employee is often required to sit for potentially long periods of time throughout the workday. Manual dexterity of hands and fingers, to handle or feel and to manipulate keys on a keyboard. The employee is occasionally required to stand; walk, climb or balance; stoop, kneel, or crouch; lift and/or move up to 25 pounds and use hands to finger, handle, or feel objects, tools, or controls, and reach with hands and arm. Vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception, and ability to adjust focus sufficient to operate computer systems. Reasonable accommodation can be made to enable people with disabilities to perform essential functions of this position in relation to the physical demands detailed above.
Join our award-winning team and apply today!
$20.4-30.6 hourly 7d ago
Referrals Specialist I #Full Time #Remote
61St. Street Service Corp
Remote job
Top Healthcare Provider Network
The 61st Street Service Corporation, provides administrative and clinical support staff for
ColumbiaDoctors
. This position will support ColumbiaDoctors, one of the largest multi-specialty practices in the Northeast. ColumbiaDoctors practices comprise an experienced group of more than 2,800 physicians, surgeons, dentists, and nurses, offering more than 240 specialties and subspecialties.
This position is primarily remote, candidates must reside in the Tri-State area.
Note: There may be occasional requirements to visit the office for training, meetings, and other business needs.
Opportunity to grow as part of the Revenue Cycle Career Ladder!
Job Summary:
The ReferralsSpecialist I is responsible for verifying insurance policy benefit information, and securing payer required referrals. This position is responsible for obtaining accurate and timely insurance referrals for professional services prior to the patient s visit. This position may also be required to obtain prior authorizations for scheduled services, as needed.
Job Responsibilities:
Verifies insurance coverage via system tools, payer portals (Electronic Query (Real-Time-Eligibility [RTE]/Insurance Payer Portal/Phone).
Upon verification of patient's insurance coverage, update changes in the billing system.
Confirms provider s participation status with patient s insurance plan/network.
Determines payer referral and authorization requirements for professional services.
Contacts patient and PCP to secure payer required referral for planned services.
Documents referral in practice management system.
Research system notes to obtain missing or corrected insurance or demographic information.
Initiates authorization and submits clinical documentation as requested by insurance companies.
Manage faxes, emails, and phone calls in a timely manner. Responds to voicemails and emails within same business day of receipt.
Serves as primary liaison between faculty practice/department, insurance companies and patient to verify eligibility and coordination of benefits and resolve any insurance complications.
Performs other job duties as assigned.
Job Qualifications:
High school graduate or GED certificate is required.
A minimum of 6 months experience in a physician s billing or third payer environment.
Candidate must demonstrate the ability to understand and navigate managed care eligibility, insurance billing requirements, and obtaining pre-authorizations.
Candidate must demonstrate strong customer service and patient focused orientation and the ability to communicate, adapt, and respond to complex situations. Including the ability to diffuse complex situations in a calm and professional manner.
Must demonstrate effective communication skills both verbally and written.
Ability to multi-task, prioritize, document, and manage time effectively.
Functional proficiency in computer software skills (e.g. Microsoft Word, Excel and Outlook, E-mail, etc.)
Functional proficiency and comprehension of medical terminology.
Ability to work independently and collaborate in teams.
The ideal candidate is a motivated individual with a positive attitude and exceptional work ethic.
Experience in Epic and or other electronic billing systems is preferred.
Knowledge of medical terminology, diagnosis and procedure coding is preferred.
Previous experience in an academic healthcare setting is preferred.
Hourly Rate Ranges: $22.39 - $28.29
Note: Our salary offers will fall within these ranges based on a variety of factors, including but not limited to experience, skill set, training and education.
61st Street Service Corporation
At 61st Street Service Corporation we are committed to providing our client with excellent customer service while maintaining a productive environment for all employees. The Service Corporation offers a competitive comprehensive Benefit package to eligible employees; including Healthcare and various other benefits including Paid Time off to promote a healthy lifestyle.
We are an equal employment opportunity employer and we adhere to all requirements of all applicable federal, state, and local civil rights laws.
$22.4-28.3 hourly 41d ago
FIELD REFERRAL PROGRAM
Marek 4.5
Remote job
Hello, You have been referred by an employee of MAREK to apply for a full-time field position with MAREK. Please click View & Apply to complete the application.
Please make sure you select which Location(s) you are applying to work at , and which Job(s) you are applying for.
A resume is not required, but please include any skills and experience you would like to share.
A member of the HR team will reach out once your application has been received. Thank you for your interest!
*We are an Equal Opportunity Employer*
Hola, Un empleado de MAREK lo ha recomendado para un puesto de campo a tiempo completo en MAREK. Haga clic en Ver y aplicar para completar la solicitud.
Por favor, asegúrese de seleccionar en qué Ubicación(es) está solicitando trabajar y qué Trabajo(s) está solicitando.
No se requiere un currículum, pero incluya las habilidades y experiencias que le gustaría compartir.
Un miembro del equipo de recursos humanos se pondrá en contacto usted una vez que se haya recibido tu solicitud. ¡Gracias por su interés!
*Somos un empleador que ofrece igualdad de oportunidades*
$38k-46k yearly est. Auto-Apply 60d+ ago
Referral Specialist Manager
Pomelo Care
Remote job
About us Pomelo Care is the national leader in evidence-based healthcare for women and children. We deliver personalized, high-quality clinical interventions from reproductive care and pregnancy, infant care and pediatrics, to hormonal health through perimenopause and menopause, with long-term preventive care and condition management. Our model delivers 24/7 multispecialty care to address the medical, behavioral, and social factors that most significantly impact outcomes for women and children. We partner with payers, employers, and providers to expand access to quality healthcare across the system.
Role Description
Your North Star: Ensure every referred client is seamlessly enrolled and matched quickly with doula care by driving team performance, operational excellence, and directly matching a limited number of referred clients.
As the ReferralSpecialist Manager, you will supervise a team of three ReferralSpecialists, ensuring the team hits enrollment and doula matching targets while maintaining the highest standards of member experience. You will serve as the subject matter expert for the Pomelo doula care enrollment pipeline, managing the team as well as a high-priority portfolio of client referrals. You will own, refine, and train on the workflows that allow our enrollment and matching efforts to scale. You will be the primary bridge between the frontline referralspecialist team and the broader operations leadership team.
What you'll do
* Team Supervision & Operations
* Direct Supervision: Manage a team of three ReferralSpecialists, providing daily guidance and coaching, conducting weekly 1:1s, and fostering a culture of accountability.
* Performance Management: Monitor team KPIs-including outreach volume, enrollment conversion rates, and doula matches-to ensure the team meets or exceeds targets.
* Workflow Optimization: Continuously evaluate the referral-to-match pipeline to identify bottlenecks and implement process improvements that increase efficiency.
* Complex Case Resolution: Act as the first point of escalation for difficult enrollments, eligibility discrepancies, or sensitive health plan partner inquiries.
Expert Enrollment & Outreach
* Strategic Enrollment: Directly manage outreach and enrollment for high-priority or complex referrals, utilizing phone, SMS, and email to drive conversions.
* System Integrity: Maintain expert-level accuracy in our systems of record, ensuring all member interactions and doula matches are documented in real-time.
* Stakeholder Relations: Coordinate with health plan case managers and external providers to share updates on referral status and ensure a seamless handoff for the member.
* Quality Assurance: Regularly audit team quality to ensure compliance with health plan partners' and Pomelo's high standards.
Who you are
* Proven Lead: 1-2+ years of experience in a lead or supervisory role within healthcare, patient navigation, or high-volume enrollment operations. Demonstrated success in a similar role as an individual contributor, with willingness to roll up your sleeves.
* Process-oriented: Experience taking ambiguous challenges and turning them into clear, repeatable workflows for a team. Demonstrated ability to translate workflows into clear, simple documentation and guidelines for a frontline team.
* Metrics-obsessed: Experience managing a team to hit ambitious goals by managing team members to daily metrics, providing tactical coaching, and supporting the team to meet goals as necessary.
* Systems Expert: Familiarity with healthcare referral systems and insurance verification (ACH/Portals).
* Mission-driven: Deeply passionate about maternal health equity and the role doulas play in improving birth outcomes.
Bonus points if you have any of the following
* Experience in a fast-paced, high-growth startup environment.
* Background in revenue-driving roles or sales/enrollment operations.
* Experience with maternal health, midwifery, or doula services.
Why you should join our team
By joining Pomelo, you will get in on the ground floor of a fast-moving, well-funded, and mission-driven startup where you will have a profound impact on the patients we serve. And you'll learn, grow, be challenged, and have fun with your team while doing it.
We strive to create an environment where employees from all backgrounds are respected. We value working across disciplines, moving fast, data-driven decision making, learning, and always putting the patient first. We also offer:
* Competitive healthcare benefits
* Generous equity compensation
* Unlimited vacation
* Membership in the First Round Network (a curated and confidential community with events, guides, thousands of Q&A questions, and opportunities for 1-1 mentorship)
At Pomelo, we are committed to hiring the best team to improve outcomes for all mothers and babies, regardless of their background. We need diverse perspectives to reflect the diversity of problems we face and the population we serve. We look to hire people from a variety of backgrounds, including but not limited to race, age, sexual orientation, gender identity and expression, national origin, religion, disability, and veteran status.
Our salary ranges are based on paying competitively for our company's size and industry, and are one part of the total compensation package that also includes equity, benefits, and other opportunities at Pomelo Care. In accordance with New York City, Colorado, California, and other applicable laws, Pomelo Care is required to provide a reasonable estimate of the compensation range for this role. Individual pay decisions are ultimately based on a number of factors, including qualifications for the role, experience level, skillset, geography, and balancing internal equity. A reasonable estimate of the current salary range is $90,000-$115,000 plus a bonus. We expect most candidates to fall in the middle of the range. We also believe that your personal needs and preferences should be taken into consideration, so we allow some choice between equity and cash.
#LI-Remote
Potential Fraud Warning
Please be cautious of potential recruitment fraud. With the increase of remote work and digital hiring, phishing and job scams are on the rise with malicious actors impersonating real employees and sending fake job offers in an effort to collect personal or financial information.
Pomelo Care will never ask you to pay a fee or download software as part of the interview process with our company. Pomelo Care will also never ask for your personal banking or other financial information until after you have signed an offer of employment and completed onboarding paperwork that is provided by our People Operations team. All official communication with Pomelo Care People Operations team will come from domain email addresses ending in @pomelocare.com.
If you receive a message that seems suspicious, we encourage you to pause communication and contact us directly at ********************** to confirm its legitimacy. For your safety, we also recommend applying only through our official Careers page. If you believe you have been the victim of a scam or identity theft, please contact your local law enforcement agency or another trusted authority for guidance.
Work 100% remotely, set your own schedule, and earn additional income while making a real difference in men's health and lives. Hone is one of the fastest-growing health companies in the United States, and we are looking for physicians who have deep knowledge and experience in prescribing for men with hypogonadism. If you are a physician with a strong background in treating hypogonadism and experience prescribing testosterone and other hormone-optimizing pharmaceuticals, this is an opportunity to join a mission-driven team that is reshaping access to care. We treat patients with a combination of pharmaceutical products in accordance with AUA-defined protocols, supplements, and lifestyle changes. We are committed to making care more convenient and affordable for patients. Experience with weight-loss and thyroid medications is a plus, as we have expanded beyond men's hormones into these treatment areas. We have also launched services for women. Experience with women's hormone therapy allows you to see our female patients as well, but is certainly not required. We are looking nationwide and value physicians licensed in multiple states.
Who We Are
We're a modern health company with a simple mission: help our patients take control of their health and age with confidence. Our platform removes barriers to care through education, technology, and convenience. Our primary focus is hormone optimization for men. We are looking to add to our growing team of 150+ physicians who specialize in treating hormones and are passionate about improving patient outcomes through telemedicine. You'll join a supportive, innovative environment where you'll receive full training on our proprietary telemedicine platform, HIPAA-compliant technology, and technical support.
What You'll Do
Conduct video-based consultations from anywhere with an internet connection
Review labs and create personalized treatment plans
Prescribe and titrate medications based on clinical findings
Educate patients on safe and effective hormone optimization
Provide feedback to help us continuously enhance the patient experience
What We're Looking For
MD or DO with an active license (multi-state licenses preferred)
Minimum 2 years of experience in Endocrinology, Urology, Family Medicine, or Hormone Therapy
DEA license with authority to prescribe Schedule III medications
Strong communication skills and a passion for patient-centered care
Comfort with technology and willingness to learn telemedicine workflows
Availability for at least 8 hours per week
A prescribing philosophy that values holistic care and hormone optimization, not just prescribing testosterone to everyone
Help men regain their health and confidence - from anywhere. If you are passionate about hormone health, thrive in innovative environments, and want to help men live their best lives, we would love to hear from you.
$110k-279k yearly est. Auto-Apply 60d+ ago
Scheduling Specialist Remote after training
Radiology Partners 4.3
Remote job
RAYUS now offers DailyPay! Work today, get paid today!
RAYUS Radiology is looking for a Scheduling Specialist to join our team. We are challenging the status quo by shining light on radiology and making it a critical first step in diagnosis and proper treatment. Come join us and shine brighter together! As a Scheduling Specialist, you will be responsible for providing services to patients and referring professionals by answering phones, managing faxes and scheduling appointments. This is a full-time position working 9:00AM - 5:30PM CST Mon-Fri, Rotating Saturday 7am-1pm CST.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
(85%) Scheduling Activities
Answers phones and handles calls in a professional and timely manner
Maintains positive interactions at all times with patients, referring offices and team members
Schedules patient examinations according to existing company policy
Ensures all appropriate personal, financial and insurance information is obtained and recorded accurately
Ensures all patient data is entered into information systems completely and accurately
Ensures patients are advised of financial responsibilities, appropriate clothing, preparation kits, transportation and/or eating prior to appointment
Communicates to technologists any scheduling changes in order to ensure highest level of patient satisfaction
Maintains an up-to-date and accurate database on all current and potential referring physicians
Handles overflow calls for other centers within market to ensure uninterrupted exam scheduling for referring offices
Provides back up coverage for front office team members as requested by supervisor (i.e., rest breaks, meal breaks, vacations and sick leave)
Fields 1-800 number calls and routes to appropriate department or associate (St. Louis Park only
(10%) Insurance Activities
Pre-certifies all exams with patient's insurance company as required
Verifies insurance for same day add-ons
Uses knowledge of insurance carriers (example Medicare) and procedures that require waivers to obtain authorization if needed prior to appointment
(5%) Other Tasks and Projects as Assigned
Work 100% remotely, set your own schedule, and earn additional income while making a real difference in men's health and lives. Hone is one of the fastest-growing health companies in the United States, and we are looking for physicians who have deep knowledge and experience in prescribing for men with hypogonadism. If you are a physician with a strong background in treating hypogonadism and experience prescribing testosterone and other hormone-optimizing pharmaceuticals, this is an opportunity to join a mission-driven team that is reshaping access to care. We treat patients with a combination of pharmaceutical products in accordance with AUA-defined protocols, supplements, and lifestyle changes. We are committed to making care more convenient and affordable for patients. Experience with weight-loss and thyroid medications is a plus, as we have expanded beyond men's hormones into these treatment areas. We have also launched services for women. Experience with women's hormone therapy allows you to see our female patients as well, but is certainly not required. We are looking nationwide and value physicians licensed in multiple states.
Who We Are
We're a modern health company with a simple mission: help our patients take control of their health and age with confidence. Our platform removes barriers to care through education, technology, and convenience. Our primary focus is hormone optimization for men. We are looking to add to our growing team of 150+ physicians who specialize in treating hormones and are passionate about improving patient outcomes through telemedicine. You'll join a supportive, innovative environment where you'll receive full training on our proprietary telemedicine platform, HIPAA-compliant technology, and technical support.
What You'll Do
Conduct video-based consultations from anywhere with an internet connection
Review labs and create personalized treatment plans
Prescribe and titrate medications based on clinical findings
Educate patients on safe and effective hormone optimization
Provide feedback to help us continuously enhance the patient experience
What We're Looking For
MD or DO with an active license (multi-state licenses preferred)
Minimum 2 years of experience in Endocrinology, Urology, Family Medicine, or Hormone Therapy
DEA license with authority to prescribe Schedule III medications
Strong communication skills and a passion for patient-centered care
Comfort with technology and willingness to learn telemedicine workflows
Availability for at least 8 hours per week
A prescribing philosophy that values holistic care and hormone optimization, not just prescribing testosterone to everyone
Help men regain their health and confidence - from anywhere. If you are passionate about hormone health, thrive in innovative environments, and want to help men live their best lives, we would love to hear from you.
$70k-184k yearly est. Auto-Apply 60d+ ago
Clinical Scheduling Specialist
Midi Health
Remote job
Master Clinical Scheduler @ Midi Health: 👩 ⚕️💻
Midi is seeking an experienced Master Scheduler to join our cutting edge healthcare start-up. This is a rare opportunity to start at the ground level of a fast-growing healthcare practice! We offer a flexible work schedule and 100% remote environment with a competitive salary, benefits and a kind, human-centered environment.
Business Impact 📈
Sole responsibility for creating every Midi clinician's schedule in Athena
Daily monitoring of clinician schedules
Management of patient waiting list to backfill patients as times become available
Rescheduling of patients as needed
Adjustment of clinician schedules as needed
Cross-coverage of Care Coordinator Team responsibilities as assigned
What you will need to succeed: 🌱
Availability! 5 days per week, 8 hour shift + 30 min unpaid lunch - 9:30 AM to 6 PM PST
Minimum of five (3) years as a Clinical Scheduler building clinician schedules (preferably in AthenaHealth)
Minimum of 1 year experience working for a digital healthcare company
Proficiency in scheduling across multiple time zones
Self-starter with strong attention to detail
What we offer:
Compensation: $30/hour, non-exempt
Full Time, 40-hour work-week
Fully remote, work from home opportunity!
Benefits (medical, dental, vision, 401k)
The interview process will include: 📚
Interview with Recruiter (30 min Zoom)
Interview with Scheduling Supervisor + Lead Scheduler (30 min Zoom)
Final Interview with Practice Manager (30 min Zoom)
***Scheduled Shift Time is M-F 9:30am-6pm PST***
Thanks for your interest in Midi 👋While you are waiting for us to review your resume, here is some fun content to check out! Check us out here and here. Trust that our patients love❣️us! #Menopauseishot
#LI-DS1
Please note that all official communication from Midi Health will come from **************** email address. We will never ask for payment of any kind during the application or hiring process. If you receive any suspicious communication claiming to be from Midi Health, please report it immediately by emailing us at ********************.
Midi Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Please find our CCPA Privacy Notice for California Candidates here.
$30 hourly Auto-Apply 13d ago
Central Scheduling Specialist- Remote
HMC External
Remote job
The Central Scheduling Specialist coordinates the verification, scheduling, pre-registration, and authorization for medical services. Responsibilities include the accurate collection and entry of required financial and demographic patient information, scheduling management to maximize the efficiency of the visit, communicating preparatory instructions, and collection of payment. This role requires a high level of independent judgment in order to successfully coordinate and obtain authorization requests for governmental and complex managed care patients in a timely and efficient manner. Utilizing telecommunications and computer information systems, this individual will be responsible for handling inbound and outbound calls with a focus on exceptional service to patients, employees, and providers. In order to ensure an extraordinary patient experience, multitasking between different patient care areas will be required. The Central Scheduling Specialist is best defined as a highly independent and flexible resource that functions in alignment with the patient experience initiative. Performs all job duties and responsibilities in a courteous manner according to the Hurley Family Standards of Behavior.Works under the supervision of the department director or designee who assigns and reviews conformance with established procedures and standards.
High school graduate and/or GED equivalent.
Associate's degree in Business Administration or equivalent degree.
-OR-
Two (2) years of experience working in a call center or experience performing scheduling, registration, billing or front-desk responsibilities in a medical (hospital or physician office/clinic) setting
Knowledge of a call center environment and capable of handling a high call volume while maintaining high performance.
Knowledge of registration, scheduling, authorization, and referral policies and procedures relative to an outpatient clinic and surgical setting.
Demonstrates extensive knowledge of insurance plan pre-certification/referral requirements and processes.
Working knowledge of medical terminology, procedure and diagnosis coding, and billing procedures.
Proficient in business office information systems & software such as Google Suite & Microsoft Office containing spreadsheet and database applications.
Manage multiple, changing priorities in an effective and organized manner, under stressful demand while maintaining exceptional service. Maintain composure when dealing with difficult situations and responding professionally.
Independently recognize a high priority situation, taking appropriate and immediate action. Make decisions in accordance with established policies and procedures.
Knowledge of hospital operations and / or Ambulatory Clinic operations.
Excellent verbal and written communications skills and a pleasant and professional phone demeanor.
Ability to develop effective relationships with colleagues, physicians, providers, leaders, and other across the organization.
Demonstrates a genuine interest in helping our patients, providers, and other employees by using excellent communication skills, being polite, friendly, patient and calm under pressure.
PREFERRED QUALIFICATIONS: Working knowledge of Epic Revenue Cycle applications: Resolute Hospital Billing, Resolute Professional Billing, Single Business Office, Cadence, or Grand Central.
Schedules, cancels, reschedules appointments / services for designated departments. Manages scheduling to maximize the efficiency of the visit / provider. Monitors appointment schedules daily for cancellations, rescheduling, and no shows as well as other stats or changes; communicates timely with all departments impacted. Generates daily-weekly-monthly reports in order to manage schedules and distributes information as needed.
Performs pre-registration functions within designated time frame in advance of the patient appointment (including, but not limited to) obtaining and / or verifying demographic, clinical, financial, insurance information, and eligibility for scheduled service / procedure. Confirms Primary Care Provider making necessary updates as appropriate.
Identifies insurance companies requiring prior authorization and / or referrals for services and obtains authorization / referral for all services. Coordinates incoming / outgoing authorizations for procedures and testing requested by providers for all government and third-party payers, including emergent authorizations due to walk-in patients.
Informs the patient of their visit-specific preparatory instructions and ensures notification about their upcoming appointments. Schedules pre-admission testing when needed and assists in arranging necessary lab orders. Obtains all necessary information required by third-party payors for treatment authorization requests.
Courteously accepts and places telephone calls, and interacts with physicians and associates while providing services. Resolves or tactfully directs complaints, problems; obtains information and responds to inquiries within 24-48 hours. Frequently communicates with patients/family members/guarantors, physicians/office staff, medical center, and payors via telephone, email, enterprise EMR or other electronic services. Escalates issues that cannot be resolved in accordance with departmental guidelines.
Performs price estimates upon patient request in order to assist the patient in identifying their expected full patient liability and / or residual financial responsibility.
Educates the patient relative to their insurance policy / benefits. Collects patient / guarantor liabilities and refers patients who are uninsured / underinsured to Insurance Services Specialists for financial assistance or governmental program screening and application processes. Refers patients to the Financial Customer Service Specialist to resolve outstanding self-pay balances.
Maintains a log / guide with up-to-date information related to services in need of pre-certification or require referrals per insurance carrier. This includes compliance with regulatory requirements and ensuring all changes are incorporated into daily job functions.
Works with the coding department to validate the accuracy of the authorized service in comparison to the procedure performed. Discrepancies are addressed immediately within timelines set forth by the specific payer's guidelines for correction. Reports procedural updates to leadership.
Triages misrouted telephone and patient portal inquiries promoting an exceptional patient and provider experience. Makes follow-up calls to provider offices and / or testing sites to ensure receipt of all necessary information for the patient's visit.
Recommends modifications to existing policies or workflows that support the values of Hurley Medical Center and will increase efficiency and promote data integrity.
Maintains thorough knowledge of policies, procedures, and standard work within the department in order to successfully perform duties on a day-to-day basis. Able to work in a fast-paced call center environment while maintaining efficiency and accuracy.
Performs other related duties as required. Utilizes new improvements and/or technology that relate to job assignment. Involvement in special projects as needed.
$27k-41k yearly est. Auto-Apply 1d ago
Referrals Specialist
Hawai'i Island Community Health Center 3.8
Remote job
Starting at $19.50 hourly
Join Our Team as a ReferralsSpecialist!
Are you passionate about providing excellent patient care and making a difference in your community? Hawaii Island Community Health Center is looking for a dedicated ReferralsSpecialist to join our team!
Position Summary:
As a ReferralsSpecialist, you will play a crucial role in managing external patient referrals and follow-up in collaboration with the provider and other members of the patient care team. Under the general direction of the Health Services Manager and Referrals Supervisor, you will maintain electronic patient files, respond to and fulfill requests for medical records, and assist in the collection of data. Additionally, you will coordinate travel for patients to and from appointments.
Schedule:
Monday-Friday (most weekends off)
Work hours are between 6:00 AM and 6:00 PM, with shifts totaling either 8 hours or 10 hours per day.
Opportunity to work from home on occasions, following work from home guidelines.
Benefits Include:
Retirement plan
Medical, Vision, and Dental Insurance
Pet insurance
Paid time off
Employee Assistance Program
Other ancillary benefits
Education and Experience:
High School graduate or GED certificate
One year of related clinical office experience and/or training; OR any equivalent combination of experience, training, and/or education
Desirable experience includes:
Familiarity with QUEST and other insurance programs
Familiarity with Hawaiʻi Health Care Networks
Knowledge of ICD-10 and CPT coding
Key Responsibilities:
Prioritize patient referrals to manage patient flow for maximum efficiency and optimum care provision
Utilize medical records appropriately to document care within the scope of job duties
Coordinate referrals, preauthorization, and follow-up with appropriate external resources
Develop and maintain tracking systems for referrals to outside resources
Actively participate in quality improvement and risk management programs
Participate as an active team member on the patient care team
Engage in continuing education activities
Demonstrate competency in managed care preauthorization for travel
Document appropriately in the patient medical record
Facilitate quality specialty medical, diagnostic, and therapeutic services via appropriate referral and tracking for follow-up
Maintain positive interpersonal relations with physicians, patients, patient families, visitors, and co-workers in a professional and confidential manner
Embrace the philosophy of continuous quality improvement
Maintain a safe, clean, and confidential working environment consistent with OSHA, HIPAA, and HHC standards
Communicate accurate and pertinent information with patient care providers and other members of the care delivery team to facilitate effective and efficient patient referrals and tracking
Apply age-specific/cultural considerations to the referral process
Manage changes in work demand during the workday
Ensure patient/family satisfaction with referral services
Keep supervisor informed of problems or issues; monitor supplies needed; perform other duties as assigned
Why Join Us?
At Hawaii Island Community Health Center, we are committed to providing high-quality healthcare services to our community. Join our team and be part of a supportive and dynamic environment where you can grow professionally and make a meaningful impact.
Apply Today!
If you are ready to take on this rewarding role, please submit your application and resume. We look forward to welcoming you to our team!
$19.5 hourly Auto-Apply 60d+ ago
Booking & Scheduling Specialist
Traveling With McHaila
Remote job
We're seeking a reliable and detail-oriented Booking & Scheduling Planner to support clients by coordinating schedules, managing bookings, and ensuring a seamless experience from start to finish. This fully remote role is ideal for someone who enjoys organization, client communication, and keeping details running smoothly. This is perfect for individuals who can work independently while using the resources and tools provided.
What Youll Do:
Manage bookings, schedules, and confirmations
Communicate with clients to gather details and provide updates
Ensure accuracy and timely follow-ups
Deliver professional, friendly support throughout the process
What Were Looking For:
Strong organizational and communication skills
Customer service or administrative experience (preferred, not required)
Comfortable working independently in a remote setting
Detail-oriented, dependable, and tech-comfortable
Must be able to book, plan and create itineraries for clients and deliver quotes from start to finish
Must be a citizen of the US, UK, Australia, Mexico, Spain and LATAM
Why This Role Stands Out:
100% remote flexibility
Training and ongoing support provided
Opportunity for growth within a supportive team
$33k-48k yearly est. 6d ago
V104 - Intake and Scheduling Specialist
Flywheel Software 4.3
Remote job
For ambitious, culturally diverse, curious minds seeking booming careers, Job Duck unlocks and nurtures your potential. We connect you with rewarding, remote job opportunities with US-based employers who recognize and appreciate your skills, allowing you to not just survive but thrive.
As a lifestyle company, we ensure that everybody working here has a fantastic time, which is why we've earned the Great Place to Work Certification every year since 2022!
Job Description:
This role at Job Duck offers the opportunity to support a fast‑paced professional environment where responsiveness and smooth communication truly make a daily impact. The position centers around assisting clients with care, managing incoming calls with a warm and engaging presence, and ensuring that follow‑ups and intakes are handled with clarity and consistency. You will contribute by preparing polished templates, maintaining accurate spreadsheets, and coordinating schedules so operations run seamlessly.
A candidate who thrives in this role enjoys interacting with others, communicates with confidence, and stays organized even when navigating multiple software tools at once. If you bring strong English skills and a naturally outgoing approach to your work, you will excel here.
• Salary Range: 1,150 USD to 1,220 USD
Responsibilities include, but are not limited to:
Client intake and follow-up.
Templates drafting.
Create and maintain spreadsheets
Support general administrative functions
Handle scheduling and calendar coordination
Answering phone calls (approximately 10/day), it can vary
Requirements:
Strong written and spoken English
Excellent grammar and communication skills
Responsive and detail‑oriented
Comfortable using multiple software platforms simultaneously
Outgoing communication style
Ability to stay organized while handling varied administrative tasks
CRM: Lawmatics
VoIP: RingCentral
Internal communication: Microsoft Teams Channel, Slack
Outlook
Work Shift:
9:00 AM - 6:00 PM [EST][EDT] (United States of America)
Languages:
English, Spanish
Ready to dive in? Apply now and make sure to follow all the instructions!
Our application process involves multiple stages, and submitting your application is just the first step. Every candidate must successfully pass each stage to move forward in the process.
Please keep an eye on your email and WhatsApp for the next steps. A recruiter will be assigned to guide you through the application process. Be sure to check your spam folder as well.
$30k-43k yearly est. Auto-Apply 8d ago
Authorization Specialist
Seaport Scripps Home Health
Remote job
Pay Range: $21.00 - $25.00 per hour Schedule: Full-time, 5 days/week (8:30 AM - 5:00 PM PST) with weekend rotation or staggered schedule including one fixed weekend day
About Us
At Seaport Scripps Home Health, our mission is simple yet powerful: to provide LIFE CHANGING SERVICE to our patients and their families. We believe a career in healthcare is one of the noblest professions, and exceptional clinical operations leadership makes home health possible.
Our team is committed to delivering superior clinical outcomes and outstanding patient and family satisfaction. Through dedication and compassion, we strive to be the provider of choice in the communities we serve.
We foster a culture that values:
Celebration of successes and making work enjoyable
Highest standards of care and professionalism
Continuous learning and growth
Respect and empathy for others
Innovation and good judgment
And most importantly, we put employees first, because we know great care starts with a great team.
Job Summary
The Authorization Specialist plays a key role in ensuring smooth operations by verifying insurance eligibility, obtaining authorizations, and managing related clerical tasks. This position supports intake processes, maintains accurate clinical records, and fosters positive relationships with providers and referral sources.
Key Responsibilities
Verify insurance eligibility and confirm payer sources for all referrals
Manage the authorization process, including monitoring calls and requests from providers
Obtain and provide clinical information needed for authorizations
Communicate authorization status to field and scheduling staff
Provide backup support to Intake and Scheduling Coordinators
Protect patient and organizational confidentiality
Maintain knowledge of state, federal, and CHAP documentation regulations
Qualifications
Minimum 1 year of experience in insurance eligibility and authorizations (home health experience preferred)
Knowledge of information systems and corporate business management
Familiarity with governmental regulations
Strong communication and public relations skills
Ability to work independently with organization, flexibility, and cooperation
About Seaport Scripps Home Health
We are part of the Pennant Group, a nationwide network with 300+ locations. This gives us the stability of a proven healthcare leader while allowing us to operate locally with autonomy and innovation.
Our Core Values guide everything we do:
Celebration
Accountability
Passion for Learning
Love One Another
Intelligent Risk Taking
Customer Second
Ownership
Benefits
Competitive compensation
Health, dental, vision, life, and disability insurance
Pre-tax healthcare and dependent care flexible spending accounts
401(k) plan with generous company match
Critical illness benefit
Tuition reimbursement
Paid time off
Employee assistance program
Seaport Scripps Home Health is an Equal Opportunity Employer. We evaluate qualified applicants without regard to race, color, religion, sex, national origin, disability, veteran status, or other protected characteristics.
The employer for this position is stated in the job posting. The Pennant Group, Inc. is a holding company of independent operating subsidiaries that provide healthcare services through home health and hospice agencies and senior living communities located throughout the US. Each of these businesses is operated by a separate, independent operating subsidiary that has its own management, employees and assets. More information about The Pennant Group, Inc. is available at ****************************
$21-25 hourly Auto-Apply 10d ago
Authorization Specialist
Select Ortho
Remote job
What we do: Select Ortho is a rapidly growing national company that provides expertise, convenience, and reliability in the delivery and fitting of orthoses and durable medical equipment to orthopedic practices and their patients. Select Ortho leverages resources, technology, and expertise to increase net collection rates, improve compliance, and streamline supply chain in managing the DME Service Line™.
The high value we place on our employees is reflected in our competitive pay and exceptional benefits package, which includes Medical insurance (company pays 75% of the premium), Dental and Vision (company pays 100% of the premium), free life insurance, generous paid vacation time, paid sick time, paid company holidays, and more!
What we stand for: Our goal is to achieve nothing less than ecstatic customers. We do that by operating in a healthy culture of excellence and hiring employees who are happy to go the extra mile to achieve that vision. Working with purposeful energy and accountability comes naturally. Credibility always matters and small details are huge!
Are you ready to make a difference in the world? If so, read on!
Position Summary:
This is a full-time remote position. A DMEPOS Authorization Specialist requests, conducts follow-up and obtains authorizations for plans that require authorization.
The DMEPOS Authorization Specialist is responsible for ensuring positive client relationships, provides support and training on all company policies and procedures as they relate to authorization and analyzes process flow for efficiency. The position ensures HIPAA Standards are being followed at all times and recommends process improvements when necessary.
Position Duties:
Ensures all Authorization tasks are completed on schedule: Tasks include same-day authorizations, authorizations from previous business day, and on-going follow-up to ensure authorizations are obtained in a timely manner
Ensures department is focused on customer care for both internal and external customers
Establishes and maintains a high functioning environment that ensures effective, efficient and
safe operation of the practice and responds to client, patient, and staff needs
Daily, weekly, or monthly tracking and reporting
Participation in weekly conference calls
Tracking and organizing authorization information
Effectively communicating outstanding authorizations with clinics and management
Proactively seeks to improve job knowledge on all insurance updates and researches
Changes as it pertains to authorization
Provides ongoing training for clinic and billing staff on insurance authorization changes and updates
Monitors and evaluates goals, driving for standardized effective solutions to existing problems
Help with administrative assignments and projects, as needed
Serve as the liaison to clinic and billing departments
Keep up with compliance, coverage criteria, ICD-10 information and update all employees, as needed
Other duties as assigned
Required Education:
High School Degree or Equivalent
Preferred Education
2 Years experience in Authorizations
Qualifications
Requirements:
General knowledge of authorization process
General knowledge of medical insurances in the area the position is being offered
The ability to work quickly and accurately, and pay attention to detail
Skills in answering a telephone in a pleasant and helpful manner
Establish and maintain effective working relationships with patients, employees, and the public
Experience with All Microsoft Office Products - proficiency with Excel and Word mandatory
Work Related Characteristics:
Has the desire to provide excellent customer service
Is kind and considerate towards coworkers
Cares about the quality of work produced
Has the ability to work independently
Is interested in the company's goals and actively works to help achieve them
Believes in and embodies the behaviors outlined in the company's Core Values
This position has no direct supervisory responsibilities but does serve as a mentor for new DMEPOS Coordinators, Billing Specialists and other positions.
Work Environment:
The DMEPOS Authorization Specialist may occasionally interact with our Client's Billing Office. As such, professionalism and consideration for the Client's staff are essential at all times.
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.
This is largely a sedentary role. While performing the duties of this job, the employee is regularly required to communicate effectively.
~ Select Ortho is an equal opportunity employer that places high value on diversity and inclusion in people, ideas and our collaborative culture.~
$28k-39k yearly est. 18d ago
Medical Central Scheduling Specialist - Remote
Qualderm Partners 3.9
Remote job
Job Description
Candidates must reside within a reasonable driving distance of Lombard, IL.
Hours Scheduled: Mon-Thurs 9:30am-6pm/Fridays 8am-5pm
QualDerm Partners is the largest multi-state female-founded and owned dermatology network in the U.S., with over 150 locations across 17 states. Our commitment is to educate, protect, and care for your skin while delivering the highest quality dermatological services. We strive to make skin health accessible to all while fostering a rewarding work environment for both our patients and employees.
Position Summary:
The Remote Central Scheduling Specialist will be responsible for managing and coordinating the scheduling of patient appointments across our various practice locations. This role requires exceptional customer service skills and the ability to handle a high volume of calls while ensuring that each patient feels valued and supported throughout their scheduling experience.
Requirements
High School Diploma required; Associate's Degree preferred.
Minimum of 1 year customer service experience in a healthcare setting preferred.
Strong communication and interpersonal skills.
Ability to manage multiple tasks efficiently in a fast-paced environment.
Proficiency in scheduling software and Microsoft Office applications.
Understanding of HIPAA regulations is a plus.
Benefits
Competitive Pay
Medical, dental, and vision
401(k) - The company match is 100% of the first 3%; and 50% of the next 2%; immediately vested
Paid Time Off - accrual starts upon hire, plus 6 Paid Holidays and 2 floating days
Company paid life insurance and additional coverage available
Short-term and long-term disability, accident and critical illness, and identity theft protection plans
Employee Assistance Program (EAP)
Employee Discounts
Employee Referral Bonus Program
QualDerm Partners, LLC is proud to be an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
Compensation Range: $17.00 - 19.50 per hour. Final offer will be based on a combination of skills, experience, location, and internal equity.
$17-19.5 hourly 1d ago
Authorization Specialist II- Evernorth
Cigna Group 4.6
Remote job
As an Authorization Specialist II, you will help ensure patients receive timely access to therapy by overseeing prior authorization workflows, supporting clinical partners, and guiding team members through consistent, high‑quality processes. You will play a key role in improving efficiency, enhancing service delivery, and supporting a compassionate, patient‑focused care experience.
Responsibilities
Oversee authorization processes, including formulary exceptions and renewal timelines, ensuring accuracy and compliance.
Direct daily workflow for authorization specialists, aligning operations with patient needs and departmental priorities.
Develop work schedules, lead staff meetings, and communicate updates regarding internal processes and contracts.
Support recruitment, onboarding, training, and competency development to maintain a skilled team.
Monitor team performance, provide feedback, and recommend corrective action when needed.
Ensure productivity, regulatory compliance, and accreditation standards are consistently met.
Serve as a resource for team members, helping troubleshoot authorization issues and operational challenges.
Collaborate on identifying process efficiencies and presenting improvement ideas to leadership.
Perform responsibilities according to organizational competencies and behaviors.
Complete additional duties as assigned to support operational excellence.
Required Qualifications
High school diploma or GED.
Minimum 2 years of experience in pharmacy claims, pharmacy technician support, or related healthcare roles.
Knowledge of medical terminology and coordination of benefits.
Proficient computer and Microsoft Office skills.
Strong customer service orientation and ability to maintain confidentiality.
Preferred Qualifications
Experience with payer websites and authorization requirements.
Familiarity with pharmacy payer systems and workflows.
Ability to work independently with minimal supervision.
Strong organizational, communication, and time‑management skills.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an hourly rate of 19 - 29 USD / hourly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
At The Cigna Group, you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here.
About The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.