- Intermountain Healthcare (Salt Lake City, UT)
- …follow-up on appeals and denials when requested Contacts patient/provider when authorization is unsecured prior to scheduled date of service Effectively ... Job Description: The Pre-Access Authorization Specialist I is responsible for...responsible for accurately verifying and completing insurance eligibility, securing prior authorization and managing authorization … more
- Lincare Holdings, Inc. (Nashville, TN)
- …and centers associated with the patient's account. Job Responsibilities: Prioritize incoming prior authorization requests Evaluate and triage prior ... authorization rejections to determine validity of the prior authorization Communicate as needed with patients regarding clinical information to be used when… more
- UPHAMS CORNER HEALTH CENTER (Dorchester, MA)
- …with access to external care from handling registration, obtaining insurance prior authorization , appointment scheduling and communicating to the patients' ... care referrals/authorizations when the patient has an insurance that requires insurance prior authorization for an external specialty/imaging appointment. Once … more
- State of Colorado (Glenwood Springs, CO)
- …improvements, then consider turning your passions into a career as a Highway Maintenance Specialist . CDOT has a vacancy for a Highway Maintenance Specialist at ... each maintenance patrol location has at least one lead highway maintenance specialist and multiple highway maintenance specialists. Your main job activities include:… more
- UC Davis Health (Sacramento, CA)
- … authorization requests to requesting parties. Assists with processing of prior authorization and patient assistance program requests. Maintains database of ... in Health System Outpatient Pharmacy. Experience working in a Specialty Pharmacy. Prior Authorization and/or Patient Assistance Program experience in Epic EMR,… more
- Elevance Health (Irving, TX)
- …and the home setting._ **Referral Specialist II/Patient Access (Pre & Prior Authorizations, Appeals , Insurance) - Paragon Infusion** **Location:** 3033 W ... weeks/30 days at the Plano, TX office. The **Referral Specialist II** is responsible for providing support to a...additional information if necessary. + Ability to initiate pre-determination, prior authorizations, and appeals for denials based… more
- Elevance Health (Chicago, IL)
- ** Appeals Referral Specialist ** **Location :** **Hybrid** - This role requires associates to be in-office **3 days per week** , fostering collaboration and ... - Friday 10:30 am - 7:00 pm CST The ** Appeals Referral Specialist ** is responsible for providing...an impact:** + Initiates and manages clinical referrals for pre- authorization . + Acts as a liaison between hospital, health… more
- US Tech Solutions (RI)
- **Job Title: Prior Authorization Specialist ** **Location: Fully remote** **Duration: 12 months contract** **Job Description:** + Prior Authorization ... and courteous phone assistance to all callers through the criteria based prior authorization process. + Maintains complete, timely and accurate documentation… more
- Montrose Memorial Hospital (Montrose, CO)
- …Commission meeting the highest standards of healthcare. About The Career: + The Hospital Prior Authorization Specialist is an advocate for the patient's ... through payer to patient for timely health care diagnostics and treatments. The Prior Authorization Specialist supports the provider and patient's plan… more
- US Tech Solutions (May, OK)
- …and courteous phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of ... as assigned by the leadership team. Work closely with providers to process prior authorization (PA) and drug benefit exception requests for multiple clients… more
- TEKsystems (Des Moines, IA)
- Description This team is 100% remote and looking for candidates with prior authorization experience, experience working major insurance and web portals, and ... provider locations in the state of Iowa with their prior authorization work. Candidates can sit anywhere...addition, assists patients with billing related inquiries if necessary Appeals denied claims for related services, drugs, treatments and… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …the Clinical Authorization Specialist will bring clinical expertise to the prior authorization and appeals processes and serve as a liaison and ... Prior Authorization Supervisor , the Clinical Authorization Specialist is responsible for managing all...+ Root causes claim denials, reprocesses, and submits claim appeals . + Creates drug cost estimates for both on-label… more
- Dana-Farber Cancer Institute (Brookline, MA)
- The Cell Therapy Clinical Authorization Specialist is responsible for the comprehensive coordination and management of all prior authorization activities ... experience required. + Case Management, Utilization Review, Oncology, Cellular Therapy and/or Prior Authorization experience is preferred. + Licensed as a… more
- Omaha Children's Hospital (Omaha, NE)
- …purpose and make a difference where it matters most. **A Brief Overview** The Authorization Specialist plays a critical role in ensuring patients receive timely ... denials by collaborating with clinical, administrative, and financial teams. The Authorization Specialist supports efficient operations by ensuring compliance… more
- Intermountain Health (Phoenix, AZ)
- **Job Description:** The Pre-Access Authorization Specialist I is responsible for accurately verifying and completing insurance eligibility, securing prior ... guarantor + Accurately verifies all pertinent patient related insurance eligibility, benefits, authorization ; follow-up on appeals and denials when requested +… more
- University of Washington (Seattle, WA)
- …MEDICAL CENTER PHARMACY DEPARTMENT** is looking for an outstanding **AMBULATORY INFUSION AUTHORIZATION SPECIALIST .** . **WORK SCHEDULE** * Full-Time / 40 hours ... Clearance team to evaluate and further develop systems and processes to track prior authorizations, reauthorizations, and appeals . * Assist in identification of… more
- Rochester Regional Health (Rochester, NY)
- …communication across the care team. RESPONSIBILITIES: + Coordinate and submit prior authorization requests for cardiology medications, and monitor approvals, ... Job Title: Medication Authorization SpecialistDepartment: SCHI Brighton Location: 1445 Portland Avenue,...step therapy requirements, and appeals to ensure timely access to treatment. + Collaborate… more
- Trinity Health (Stafford Springs, CT)
- …troubleshooting accounts that are being held in A/R due to lack of prior authorization **Minimum Qualifications** + Education: High School Graduate, some college ... all infusions and testing performed in the department are reviewed and prior auth or predetermination is obtained + Responsible for satisfying admission notice… more
- Baptist Memorial (Memphis, TN)
- …order to enhance reimbursement and maximize customer satisfaction. + Submits retro- authorization requests, reconsiderations, and appeals with careful regard to ... Overview Specialist -Denial Mitigation II RN Job Code: 21432 FLSA...payer guidelines and BMHCC contracts as it pertains to authorization and clinical denials as well as clinical audits.… more
- City and County of San Francisco (San Francisco, CA)
- …and letters. 4. Determine urgent needs that requires home care service to start prior to IHSS authorization . 5. Evaluate applicant's ability to manage own care ... like in action. Under direction, the 2916 Social Work Specialist performs a variety of specialized duties in support...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
