- Saint Luke's (Kansas City, MO)
- **Job Description** Obtain precertification / prior authorizations for surgeries and procedures. Ensure that all appropriate clinical documentation is present and ... submitted. Responsible for ensuring surgical and procedure codes are accurate and in compliance with guidelines and regulations. Collaborates and communications with the multidisciplinary team, including patients. Responsible responsible for tracking all… more
- Urology Clinics of North Texas (Mesquite, TX)
- Radiation/Oncology Verification Specialist Job Details Job Location 1650 Republic Pkwy Ste 150, Mesquite, TX 75150 - Mesquite, TX Description Responsible for ... verifying insurance benefits, obtaining precertification or predetermination if required along with making sure a valid referral is on file if needed for both… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Clinical Referral Specialist , Centralized Referrals Full Time, 80 Hours Per Pay Period, Day Shift Covenant Medical Group is Covenant Health's employed and ... sleep medicine and urology. Position Summary: The Referral and Precertification Specialists manages scheduling for specialty facilities and procedures, creates… more
- Union Hospital (Terre Haute, IN)
- You belong at Union! The PreCertification Specialist plays a key role in providing the highest quality of patient care while the patient is at Union Health. ... grasp of standard written and verbal English. Knowledge of precertification requirements. Knowledge of medical terminology. Courteous, cooperative attitude. Written… more
- Henry Ford Health System (Troy, MI)
- The purpose of the Central Authorization Specialist position is to centrally facilitate the successful procuring of insurance authorizations for ordered procedures ... providing timely and accurate information to payors'. The Central Authorization Specialist helps drive change by identifying areas where performance improvement is… more
- Elevance Health (Plano, TX)
- …The **Referral Specialist III** is responsible for issues involving the precertification and prior authorization review. This level is expected to be able to ... infusion centers, and the home setting. **Title** : Referral Specialist III - Paragon Healthcare **Location:** TX-PLANO, 3033 W...perform all of the duties the Referral Specialist I and II in addition to the following… more
- Penn Medicine (Cherry Hill, NJ)
- …day. Are you living your life's work? **Job Title:** Preregistration Specialist **Department:** Financial Clearance **Location:** Penn Medicine Cherry Hill- 1865 ... Route 70 E **Hours:** Mon-Fri office hours **Summary:** + The Pre-Registration Specialist reports to the Supervisor of Financial Clearance. This individual possesses… more
- Penn Medicine (Philadelphia, PA)
- …each day. Are you living your life's work? Job Title: Preregistration Specialist Department: Oral Max Surgery Location: Perelman Center for Advanced Medicine-3400 ... Civic Center Blvd Hours: Full Time Summary: + The Pre-Registration Specialist reports to the Supervisor of Financial Clearence. This individual possesses an in-depth… more
- Trinity Health (Waterbury, CT)
- …Trinity Health Of New England is looking for an experienced **Behavioral Health Specialist , Social Worker** to come join our team of highly specialized integrated ... behavioral health professionals. The **Behavioral Health Specialist ** is a **L** **i** **censed Social Worker, LCSW** who provides psychiatric evaluations for… more
- Brockton Hospital (West Bridgewater, MA)
- …the lives and health of our patients. Position Summary: Financial Clearance Specialist ensures all necessary information is proactively obtained and verified for ... Location: 750 W. Center Street, West Bridgewater, MA Department: Financial Clearance Specialist This is a full-time 40 hour/ week position Responsibilities: +… more
- MyFlorida (La Belle, FL)
- HEALTH SUPPORT SPECIALIST - 64066122 Date: Sep 19, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... Requisition No: 858906 Agency: Department of Health Working Title: HEALTH SUPPORT SPECIALIST - 64066122 Pay Plan: Career Service Position Number: 64066122 Salary:… more
- Dartmouth Health (White River Junction, VT)
- Care Team Specialist Full Time, Days $10,000 Sign-On for Qualified Candidates! Why work as a Patient Access Representative at the Visiting Nurse and Hospice for ... Patient Access Representative: * Verifies patient insurance and obtains precertification and/or preauthorization as appropriate. * Obtains needed forms/information… more
- MetroHealth (Cleveland, OH)
- **Utilization Review Specialist -Utilization Management** **Location:** **METROHEALTH MEDICAL CENTER** **Biweekly Hours:** **80.00** **Shift:** **10a-6:30p** **The ... from an accredited institution. * 2 years of experience in medical insurance precertification for either a hospital or insurance company will be accepted in lieu… more
- Cognizant (Phoenix, AZ)
- …in utilization management to include Clinical Appeals and Grievances, precertification , initial and concurrent reviews . Intermediate Microsoft Office knowledge ... (Excel, Word, Outlook) . In-patient and outpatient experience **These will help you stand out** . Epic experience . Experience in drafting appeals disputing inpatient clinical validations audits is a plus. We're excited to meet people who share our mission and… more
- Vanderbilt University Medical Center (Brentwood, TN)
- …proper resources if needed with assistance from the Lead/Manager. + Obtains precertification or proper insurance approval prior to surgical procedures. + Notifies ... and forwards paperwork for insurance certification to billing office and obtains additional paperwork if needed, for compliance. + Monitors surgery schedule and ensures optimization of resources and workflow. + Maintains quality in operations impacting… more
- Trinity Health (Athens, GA)
- …information to health plan case managers for special procedure precertification and out-of-plan or out-of-network referrals; monitors authorizations or denials ... and follows up, as necessary. 11. Communicates referral status to staff and physicians; ensures that authorizations have been processed accurately and in a timely manner to coincide with patient treatment plan. 12. Assists offices in resolving billing… more
- Children's Clinics (Tucson, AZ)
- …of AHCCCS, CRS, and private insurance guidelines + Knowledge of precertification , referrals, and prior authorization + Knowledge of medical terminology, CPT, ... and ICD-10 codes and practices + Skill and proficiency in using Microsoft Office Suite + Ability to maintain confidentiality of patient, personnel, and corporate data + Ability to cross reference data to assure accuracy and completeness + Ability to post… more
- Beth Israel Lahey Health (Cambridge, MA)
- …Analyzed clinical documentation in support of ordered procedure(s) and submitted precertification requests through various insurance fax lines, phone systems, and ... web portals. Follow up on pending accounts and involve ordering provider offices as needed to obtain approvals. + Escalates challenging accounts to provider representative to ensure accounts are approved at least two weeks prior to patient appointment/surgery.… more
- Vanderbilt University Medical Center (Nashville, TN)
- …proper resources if needed with assistance from the Lead/Manager. + Obtains precertification or proper insurance approval prior to surgical procedures. + Notifies ... and forwards paperwork for insurance certification to billing office and obtains additional paperwork if needed, for compliance. + Monitors surgery schedule and ensures optimization of resources and workflow. + Maintains quality in operations impacting… more
- Atlantic Health System (Morristown, NJ)
- …plan of care. + Assists with referrals of patients to the appropriate specialist for diagnosis or treatment. + Performs other related duties as assigned. Required: ... AAMA, NAHP, ARMA, AMT, AMCA, or NCCT. + OR Precertification agreement must be signed if expired or receiving...AAMA, NAHP, ARMA, AMT, AMCA, or NCCT. + OR Precertification agreement must be signed if expired or receiving… more