Reauthorization Specialist Job at Arcadia Home Care and Staffing

Medical Records and Authorization Specialist

As a member of the Baxter Finance team, you have the critical thinking and analy...

Location

United States , Houston

Salary:

49600.00 - 53000.00 USD / Year

Baxter

Expiration Date

Until further notice

Requirements

High school diploma or equivalent required
Associates degree or higher preferred
3+ years of industry experience in health insurance
Knowledge of Federal, State, and Local regulations, guidelines, and standards, including a working knowledge of HIPAA rules and regulations
Third party payer experience strongly preferred
Experience in reviewing medical records and obtaining third-party payer reimbursement
Exceptional written, verbal, and interpersonal communications
Strong critical thinking and problem-solving skills
Detail orientated and ability to multi-task
Ability to work independently as well as in a team environment

Job Responsibility

Perform Medical Records and Authorization Specialist duties including documentation collection and review, prior authorization and reauthorization submissions
Communicate directly with client medical records depts, patients, healthcare teams, sales teams, and insurance companies
Collaborate cross-functionally with other Cardiology Health teams
Ensure coverage and payer requirements
Gather clinical documentation to support medical necessity for Cardiology devices
Process paper and electronic correspondence, including logging and distribution of payer and patient inquiries
Establish and maintain positive partnerships with sales team and healthcare teams
Review and assess clinical documentation to ensure all applicable coverage criteria requirements are met
Prepare and submit prior authorization initial and renewal requests to all insurance companies
Process authorization decisions from payers timely to streamline and drive revenue

What we offer

Support for Parents
Continuing Education/ Professional Development
Employee Heath & Well-Being Benefits
Paid Time Off
2 Days a Year to Volunteer
Medical and dental coverage that start on day one
Insurance coverage for basic life, accident, short-term and long-term disability, and business travel accident insurance
Employee Stock Purchase Plan (ESPP)
401(k) Retirement Savings Plan (RSP)
Flexible Spending Accounts

Fulltime

Medical Records and Authorization Specialist

As a member of the Baxter Finance team, you have the critical thinking and analy...

Location

United States , Houston

Salary:

49600.00 - 53000.00 USD / Year

Baxter

Expiration Date

Until further notice

Requirements

High school diploma or equivalent required
Associates degree or higher preferred
3+ years of industry experience in health insurance
Knowledge of Federal, State, and Local regulations, guidelines, and standards, including a working knowledge of HIPAA rules and regulations
Third party payer experience strongly preferred
Experience in reviewing medical records and obtaining third-party payer reimbursement
Exceptional written, verbal, and interpersonal communications
Strong critical thinking and problem-solving skills
Detail orientated and ability to multi-task
Ability to work independently as well as in a team environment

Job Responsibility

Perform Medical Records and Authorization Specialist duties including documentation collection and review, prior authorization and reauthorization submissions
Communicate directly with client medical records depts, patients, healthcare teams, sales teams, and insurance companies
Collaborate cross-functionally with other Cardiology Health teams
Ensure coverage and payer requirements
Gather clinical documentation to support medical necessity for Cardiology devices
Process paper and electronic correspondence, including logging and distribution of payer and patient inquiries
Establish and maintain positive partnerships with sales team and healthcare teams
Review and assess clinical documentation to ensure all applicable coverage criteria requirements are met
Prepare and submit prior authorization initial and renewal requests to all insurance companies
Process authorization decisions from payers timely to streamline and drive revenue

What we offer

Support for Parents
Continuing Education/ Professional Development
Employee Heath & Well-Being Benefits
Paid Time Off
2 Days a Year to Volunteer
Medical and dental coverage that start on day one
Insurance coverage for basic life, accident, short-term and long-term disability, and business travel accident insurance
Employee Stock Purchase Plan (ESPP)
401(k) Retirement Savings Plan (RSP)
Flexible Spending Accounts

Fulltime

Medical Records and Authorization Specialist

As a member of the Baxter Finance team, you have the critical thinking and analy...

Location

United States , Houston

Salary:

49600.00 - 53000.00 USD / Year

Baxter

Expiration Date

Until further notice

Requirements

High school diploma or equivalent required
Associates degree or higher preferred
3+ years of industry experience in health insurance
Knowledge of Federal, State, and Local regulations, guidelines, and standards, including a working knowledge of HIPAA rules and regulations
Third party payer experience strongly preferred
Experience in reviewing medical records and obtaining third-party payer reimbursement
Exceptional written, verbal, and interpersonal communications
Strong critical thinking and problem-solving skills
Detail orientated and ability to multi-task
Ability to work independently as well as in a team environment

Job Responsibility

Perform Medical Records and Authorization Specialist duties including documentation collection and review, prior authorization and reauthorization submissions
Communicate directly with client medical records depts, patients, healthcare teams, sales teams, and insurance companies
Collaborate cross-functionally with other Cardiology Health teams
Ensure coverage and payer requirements
Gather clinical documentation to support medical necessity for Cardiology devices
Process paper and electronic correspondence, including logging and distribution of payer and patient inquiries
Establish and maintain positive partnerships with sales team and healthcare teams
Review and assess clinical documentation to ensure all applicable coverage criteria requirements are met
Prepare and submit prior authorization initial and renewal requests to all insurance companies
Process authorization decisions from payers timely to streamline and drive revenue

What we offer

Support for Parents
Continuing Education/ Professional Development
Employee Heath & Well-Being Benefits
Paid Time Off
2 Days a Year to Volunteer
Medical and dental coverage that start on day one
Insurance coverage for basic life, accident, short-term and long-term disability, and business travel accident insurance
Employee Stock Purchase Plan (ESPP)
401(k) Retirement Savings Plan (RSP)
Flexible Spending Accounts

Fulltime

Mid-Level Environmental Specialist

At Boeing, we innovate and collaborate to make the world a better place. We’re c...

Location

United States , Wichita

Salary:

80450.00 - 123350.00 USD / Year

Boeing

Expiration Date

Until further notice

Requirements

Bachelor's degree in the field of Environmental Science/Chemistry or other scientific fields with 0-5 years’ experience required in environmental compliance
Knowledge of common practices, policies, and procedures related to environmental compliance regulations
Familiarity with Federal and State environmental regulations related to SARA, TSCA, EPCRA, and PFAS reporting
Ability to monitor and evaluate production processes for potential efficiency opportunities and turn those opportunities into real chemical-use reduction projects
Ability to assist other Spirit facilities in implementing these chemical-use reduction projects where appropriate
Software skills, including use of Microsoft Office software and web-based safety data sheet management applications
Verbal and written communication skills necessary to explain complex information to individuals unfamiliar with environmental regulations
Skills necessary to deliver presentations to groups unfamiliar with environmental regulations
Time management and organizational skills necessary to manage multiple projects, appropriately prioritize workload, plan for resources to meet deadlines and goals, and effectively respond to any emergent needs
Ability to anticipate and identify problems and use sound judgment and fact-based analysis to develop effective and efficient solutions

Job Responsibility

Completes all necessary monitoring, recordkeeping, reporting, and permitting tasks for the Superfund Amendments and Reauthorization Act (SARA) program, the Toxic Substances Control Act (TSCA) program, and the Emergency Planning and Community Right-to-Know Act (EPCRA) program at our Wichita, Kansas facility
Serves as the chemical regulation compliance focal for the Wichita facility, providing guidance on all chemical-related compliance decisions
Develops and improve inspection checklists used to evaluate environmental regulation compliance for each manufacturing area at the Wichita facility
Summarizes inspection results for presentation to site leadership and assists in developing corrective action plans for any compliance issues
Assesses the impact of emerging environmental issues, legislation, and regulations on company operations, and implements appropriate programs as a response is developed
Works regularly with environmental compliance agencies and environmental contacts both internal and external to Spirit
Coordinates and conveys input into the developing legislation and regulatory programs by meeting with representatives of industry, regulatory agencies, government, and the public
Conducts studies and performs analyses and calculations involving appropriate design, selection, installation, and operation of pollution control equipment, waste and chemical process systems, and remediation
Develops, implements, and monitors environmental projects and programs ensuring compliance with applicable laws, regulations, and permits and the mission, goals, and objectives of the company
Prepares permit applications and regulatory reports

What we offer

Generous company match to your 401(k)
Industry-leading tuition assistance program pays your institution directly
Fertility, adoption, and surrogacy benefits
Up to $10,000 gift match when you support your favorite nonprofit organizations

Fulltime

Pharmacy Insurance Clearance Specialist

Location

United States , Oakbrook Terrace; Milwaukee

Salary:

22.50 - 33.75 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

High School Graduate
Typically requires 1 year of experience in health care, insurance industry, call center, or customer service setting
Demonstrate ability to identify and understand issues and problems
Ability to problem solve in a high profile and high stress area
Mathematical aptitude, effective communication, and critical thinking skills
Ability to prioritize and organize workload
Excellent verbal and written communication skills
Knowledge of medical terminology
Demonstrated technical proficiency including experience with insurance authorization/eligibility tools, EPIC, Microsoft Office, Internet browser and telephony systems

Job Responsibility

Participates in department staff meetings and keeps abreast of continuing education
Data entry
Pre-registers and registers patients using established procedures
Manages incoming and outgoing calls to complete pre-registration
Communicates with physician and patients regarding status of authorization requests
Ensures completion of all established policies and procedures for identification and notification of the Primary Care Physician
Coordinates with patient and provider to ensure patient can select the most cost-effective options
Maintains knowledge of all stand-alone computer software programs to verify eligibility
Identifies and assists patients with access to internal and external financial assistance programs
Initiates communication to the patient when authorization is not obtained

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Fulltime

Pharmacy Insurance Clearance Specialist

This job description indicates the general nature and level of work expected of ...

Location

United States , Oakbrook Terrace; Milwaukee

Salary:

22.50 - 33.75 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

High School Graduate
Typically requires 1 year of experience in health care, insurance industry, call center, or customer service setting
Demonstrate ability to identify and understand issues and problems
Ability to problem solve in a high profile and high stress area
Mathematical aptitude, effective communication, and critical thinking skills
Ability to prioritize and organize workload
Excellent verbal and written communication skills
Knowledge of medical terminology
Demonstrated technical proficiency including experience with insurance authorization/eligibility tools, EPIC, Microsoft Office, Internet browser and telephony systems

Job Responsibility

Participates in department staff meetings and keeps abreast of continuing education
Data entry
Pre-registers and registers patients using established procedures
Ensures accurate entry of patient demographic and insurance information
Manages incoming and outgoing calls to complete pre-registration with patients
Communicates with physician and patients regarding status of authorization requests
Ensures completion of all established policies and procedures for identification and notification of the Primary Care Physician
Coordinates with patient and provider to ensure patient can select the most cost-effective options
Maintains knowledge of all stand-alone computer software programs to verify eligibility
Identifies and assists patients with access to internal and external financial assistance programs

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program
Opportunity for annual increases based on performance
Premium pay such as shift, on call, and more
Incentive pay for select positions

Fulltime

New

Leading Hand Process Operator

Reporting to the Shift Supervisor, the Leading Hand Process Operator is responsi...

Location

Australia , Pilbara

Salary:

Not provided

PLS

Expiration Date

Until further notice

Requirements

Prior experience as a Senior Process Operator in fixed operating plant or equipment in the mining industry
Previous experience in the Pilbara
Physical fitness to perform role and meet the physical demands required to respond in emergency or rescue situations
Mechanical aptitude
Teamwork and ability to contribute to a team
Initiative
Proactive safety focus
Computer literacy

Job Responsibility

Supporting the Supervisor in providing guidance and leadership to Process Operators across all areas of the production plant
Ensure compliance to operating procedures
Supporting the Supervisor in training and developing the processing team within the Supervisors span of control, providing on the job training and coaching to shift crew participants
Coordinate and delegate priorities that may shift quickly to adjust the demands of processing delivery
Liaise with the Shift Supervisor to assist in the management of workforce scheduling as needed to meet fluctuation demands, and coverage needs
Liaise with the Shift Supervisor on the daily tasks and jobs required
Communicate with the Shift Supervisor any issues that may arise and work with the operators to resolve

What we offer

18 weeks parental leave for primary carers and 4 weeks for secondary carers
Health and wellbeing allowance
Quarterly short-term incentive bonus that recognises individual and business performance
PLS employee share scheme
Novated leasing through salary sacrifice
Newly refurbished facilities at Pilgangoora including gym, tennis, pickleball and volleyball courts, sports oval, and scenic walking tracks
Paid community leave
Monthly employee recognition awards
Access to PLS’ KidsCo School Holiday Program

Fulltime

New

Pharmacy Technician

We’re building a world of health around every individual — shaping a more connec...

Location

United States , Shorewood

Salary:

17.00 - 27.00 USD / Hour

CVS Health

Expiration Date

May 30, 2026

Requirements

Must comply with any state board of pharmacy requirements or laws governing the practice of pharmacy, which includes but is not limited to, age, education, and licensure/certification
If the state board of pharmacy does not address or mandate a minimum age requirement, must be at least 16 years of age
If the state board of pharmacy does not address or mandate a minimum educational requirement, must have a high school diploma or equivalent, or be actively enrolled in high school or high school equivalency program
Regular and predictable attendance, including nights and weekends
Ability to complete required training within designated timeframe
Attention and Focus: Ability to concentrate on a task over a period of time
Ability to pivot quickly from one task to another to meet patient and business needs
Ability to confirm prescription information and label accuracy, ensuring patient safety
Customer Service and Team Orientation: Actively look for ways to help people, and do so in a friendly manner
Notice and understand patients’ reactions, and respond appropriately

Job Responsibility

Living our purpose by following all company SOPs at each workstation to help our Pharmacists manage and improve patient health
Following pharmacy workflow procedures at each pharmacy workstation (i.e., production, pick-up, drive-thru, and drop-off) for safe and accurate prescription fulfillment
Contributing to positive patient experiences by showing empathy and genuine care: creating heartfelt and personalized moments while serving patients at pick-up, drive-thru, and over the phone
keeping patients healthy by offering immunizations and other services at the register and over the phone
and demonstrating compassionate care by solving or escalating patient problems
Completing basic inventory activities, as permitted by law, and as directed by the pharmacy leadership team, such as accurately putting away medication deliveries and completing cycle counts, returns-to-stocks, waiting bin inventories, etc.
Contributing to a high-performing team, embracing a growth mindset, and being receptive to feedback
actively seeking opportunities to expand clinical and technical knowledge needed to better assist patients
Remaining flexible for both scheduling and business needs, while contributing to a safe, inclusive, and engaging team dynamic
voluntarily traveling to stores in the market to work shifts as needed by the business

What we offer

medical, dental, and vision coverage
paid time off
retirement savings options
wellness programs
and other resources

Fulltime

Reauthorization Specialist

Arcadia Home Care and Staffing - an Addus family company

Location:
United States , Frisco

Category:
-

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:
February 13, 2026

Looking for more opportunities? Search for other job offers that match your skills and interests.

Similar Jobs for Reauthorization Specialist

Medical Records and Authorization Specialist

Medical Records and Authorization Specialist