- St. Luke's University Health Network (Allentown, PA)
- …the department, coordinating day-to-day activities, including direction of the Network Prior Authorization and Referral Specialists. JOB DUTIES AND ... patient's ability to pay for health care. The Manager, Network Prior Authorization Services is...continued ongoing efforts of successfully integrating prior authorization specialists duties that are referral work… more
- University of Washington (Seattle, WA)
- …entered into EpicCare. Creates and pends referral orders according to network guidelines + Manage urgent referrals/ prior authorizations to expedite the ... **Job Description** **UW Medicine Primary Care - Prior Authorization Team** has an outstanding...MEDICINE PRIMARY CARE** UW Medicine Primary Care is a network of clinics located throughout the Puget Sound region.… more
- LaSante Health Center (Brooklyn, NY)
- LaSante Health Center is seeking a Referrals and Prior Authorization Specialist to join our team. The ideal candidate will help ensure patients have seamless ... to medications, diagnostic imaging, and specialty care by managing prior authorization requests for insurance and guiding... requests for insurance and guiding patients through the referral process. This position offers the opportunity to be… more
- Hartford HealthCare (Hartford, CT)
- …**Administrative* **Organization:** **Hartford HealthCare Medical Group Specialists* **Title:** * Prior Authorization Specialist - Physical Medicine Rehab ... here. We invite you to become part of Connecticut's most comprehensive healthcare network . Hartford HealthCare Medical Group is one of the largest medical practices… more
- Hartford HealthCare (Manchester, CT)
- …preferred. *EXPERIENCE:* * 2 years Hospital or medical office insurance/ authorization /precertification/ referral work experience. * 2 years customer service. ... are prevented. 7. Verifies insurance policy benefit information and obtains Authorization /Precertification prior to the patient's visit, scheduled surgery,… more
- CenterWell (Helena, MT)
- …Care to lead strategy and execution for our referral management, payer prior authorization , and specialist network solutions. This role is critical ... Define and track KPIs related to referral throughput, network utilization, and prior authorization efficiency; use data to drive continuous improvement.… more
- Trinity Health (Davenport, IA)
- …regarding referral status, appointments, and test results. + Supports network integrity and aligns work to organizational goals. Collaborates with colleagues ... department efficiency by contributing to the improvement of workflow processes related to referral and authorization tasks. + Proactively serves as a patient… more
- Pine Rest Christian Mental Health Services (Grand Rapids, MI)
- …behavioral health system in the country, our 220-acre main campus, and our network of clinical sites across Michigan. We are a tight-knit community of healers ... incredible work. What Will You Do?As an Assessment & Referral Clinician at Pine Rest, you'll be part of...including interfacing with insurance and managed care companies for authorization . + Refer patients to outpatient services, either within… more
- Bassett Healthcare (Cooperstown, NY)
- …a go to person for coworkers. + Obtains prior approval or prior authorization as needed. Communicates referral appointment and appointment instructions ... point of contact for patients within the Bassett Healthcare Network . This is a key role in the patient...Medicare regulations. + Obtains prior approval or prior authorization as needed. Communicates referral… more
- St. Luke's University Health Network (Allentown, PA)
- …needs change, the services may be performed at any level within the Network 's continuum of services and/or sites. JOB DUTIES AND RESPONSIBILITIES: + Demonstrates ... care. + Arranges for community services (including short and long-term placement) prior to discharge to meet patient's needs with recognition and documentation of… more
- Beth Israel Lahey Health (Winchester, MA)
- …information via internet and Epic such as health plan eligibility, PCP verification, prior referral history, etc. + Researches physician information such as ... with Primary Care Physician offices for final status. + Completes and processes referral authorization requests (via internet or paper referral form)… more
- Bassett Healthcare (Clinton, NY)
- …a go to person for coworkers. + Obtains prior approval or prior authorization as needed. Communicates referral appointment and appointment instructions ... point of contact for patients within the Bassett Healthcare Network . This is a key role in the patient...urgent referrals same day. Processes electronic or written routine referral requests within 24-72 hours + In regard to… more
- Logan Health (Kalispell, MT)
- …benefit statuses as needed. + Determine and process pre-certification or referral requirements per protocol. + Communicate with providers regarding out-of- network ... barriers and document accordingly. + Estimate and collect patient liability prior to service, following cash management policies. + Maximize collection of co-pays… more
- Veterans Affairs, Veterans Health Administration (Lexington, KY)
- …health information in accordance with all laws and regulations governing authorization and disclosure of health information. Responsibilities The GS-6 Medical ... not limited to: Responsible for evaluating the adequacy of each completed authorization form. Screens each request for information to determine urgency and assures… more
- Covenant Health Inc. (Knoxville, TN)
- …+ Verifies insurance coverage on each new referral taken. + Obtains a Prior Authorization and or Recertification when required by the insurance company. + ... Receives referrals and new orders on patients. Responsible for verification, prior authorization , and Recertification of insurance. Negotiates pricing with… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …and related health plan functions such as member services, claims, and the referral process. As well as functions related to legislative and federal regulatory ... division. + Serves as the primary contact for providers regarding authorization , information requests, claim inquiries and benefits. Provides triage assistance to… more
- GE Aerospace (Lynn, MA)
- …within the Defense Counterintelligence and Security Agency (DCSA), DCSA Assessment and Authorization Manual (DAAPM) and as they apply to various defense industry ... compliant solutions to our customers. **Key Responsibilities:** + Certify IT assets prior to submission to DCSA for accreditation and ensure compliance with… more
- Highmark Health (Pittsburgh, PA)
- …and overseeing referral screening/management. **ESSENTIAL RESPONSIBILITIES** + Prior Authorization & Utilization Management: Reviews pharmacy utilization ... **Company :** Allegheny Health Network **Job Description :** **JOB SUMMARY** This position...administration of effective and efficient processing for pharmacy benefits prior authorization processes, insurance evaluations, addressing patient… more
- Bassett Healthcare (Cooperstown, NY)
- …so that bed placement can occur and an active patient account is available prior to arrival, to accommodate Physician office order entry + Monitors Intake Logistics ... insurance eligibility for direct admits and facility transfers; obtains authorization if necessary + Assists C3s (Hub and Unit)...entering bed request in Care Logistics software. + Contacts referral destination in person, by phone, fax or EPIC… more
- Beth Israel Lahey Health (Exeter, NH)
- …company. Communicate with practice staff on updates or roadblocks. 4. Obtain referrals/ prior authorization as necessary and schedule appointments with Core ... Hospital allows patients to access seamless, coordinated care within one trusted network . At Core Physicians, you'll find a supportive environment that values… more