- St. Luke's University Health Network (Allentown, PA)
- …PCP and Specialty service lines. + Utilizes specific Epic Work Queues designed for Prior Authorization and Insurance Referral workflows to ensure correct ... Responsible for reviewing medical necessity of genetic testing/infusion services in addition to prior authorization to ensure revenue for services. + Monitors a… more
- University of Texas Rio Grande Valley (Edinburg, TX)
- Position Information Posting NumberSRGV8412 Working TitlePRIOR AUTHORIZATION AND REFERRAL SPECIALIST Number of Vacancies1 LocationEdinburg, Texas ... processing all prior authorizations and referrals and entering the completed referral into the electronic medical record system for claims adjudication to ensure… more
- Cardinal Health (Nashville, TN)
- …authorization requirements + Ensures compendia compliance and obtains all required authorization and referral information for patients' treatments. + Receives ... and ends when the patient's account balance is zero. Benefits and Authorization Coordinator This position is responsible for reviewing the physician's daily schedule… more
- Aston Carter (Stanford, CA)
- …policies. * Provides orientation and training to new staff as assigned. Skills Prior authorization , Medical, Retail pharmacy, Data entry, Health care, Medical ... terminology, Customer service, Administrative skills Top Skills Details Prior authorization ,Medical,Retail pharmacy,Data entry Additional Skills & Qualifications… more
- Henry Ford Health System (Troy, MI)
- …GENERAL SUMMARY: Unit Description: Health Alliance Plan (HAP) is looking to grow our Prior Authorization Team with experienced Registered Nurses! We are a team ... RN REFERRAL MANAGEMENT COORDINATOR (VIRTUAL) - PRIOR ...care, this is the team for you! + Processes referral requests by verifying network assignment, correct… more
- Guthrie (Vestal, NY)
- …and within required timeframes and assuring referrals are maintained within appropriate network and/or payer requirement. Remains current on referral policies ... requested that are not authorized by insurance. Education: High school diploma and prior experience with insurance authorization The pay range for this position… more
- Cambridge International Systems Inc (Doral, FL)
- …International Systems, Inc. has a full-time Department of Defense Information Network (DoDIN) Operations Lead opportunity available based in Doral, FL. Qualified ... Command has an exciting, challenging opportunity for someone versed in DoD network infrastructure and architecture. Person hired for our Department of Defense… more
- EAC Network (Hempstead, NY)
- …initial screening for each client. + Contact commercial plans for precertification, prior authorization , and follow-up recertification for new and existing ... Shift Day Job Category Nonprofit - Social Services EAC Network , a not-for-profit social service agency that empowers, assists,...purchase order requisitions. + Compile and maintain list of referral sources and send monthly emails with referral… more
- St. Luke's University Health Network (Easton, 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
- Bassett Healthcare (Cooperstown, NY)
- …is 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...meet Medicare regulations. Obtains prior approval or prior authorization as needed. Communicates referral… more
- Bassett Healthcare (Oneonta, NY)
- …Attends Patient Access Review Sessions (PARS) Obtains prior approval or prior authorization as needed. Communicates referral appointment and appointment ... 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 regards to referrals,… more
- AdventHealth (Denver, CO)
- …ongoing, new, or altered. After gathering clinical information, responsible for obtaining prior authorization for infusion and injectable medications based on ... medication-based referrals as well as expiring medication-based referrals. + Verifies Prior authorization requirements based on patients specific insurance… more
- Community Health Systems (Las Cruces, NM)
- …follows up with the insurance company until there is resolution of the prior authorization request - an approval, redirection, or denial. All activity ... linked to the referral requested. + Validates continuity of care and network integrity based on service line availability for quality patient care. + Sends all… more
- Logan Health (Bigfork, 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
- Bassett Healthcare (Cooperstown, NY)
- …manner as observed by direct supervisory observation and chart documentation Obtains prior authorization for treatment/ therapy plans, and medications to ensure ... adherence to the prescribed plan of care. Documentation of authorization is completed in the patient record/ referral Coordinates on time delivery of cancer drugs… more
- Covenant Health Inc. (Knoxville, TN)
- …of Covenant Health (http://www.covenanthealth.com) , our region's top-performing healthcare network . Position Summary: The Clinical Field Staff Supervisor (CFSS) ... company success of providing by effectively facilitating the relationship between referral sources, patients, caregivers and employees. Recruiter: Sandra Simmons ||… more
- University of Virginia (Charlottesville, VA)
- …out of network ' for services. b. Informs patients about the authorization status as necessary. c. Prepares patient financial liability estimates and takes ... staff is accomplished in a timely manner to ensure accurate pre-certification/ authorization information is aligned with accurate billing of services. i.… more
- University of Rochester (Rochester, NY)
- …gathers and sends information to insurance carrier and/or provider needed for obtaining referral or prior authorization for required preliminary testing. + ... plays a valuable support role in achieving the Primary Care Network goals. **SCHEDULE** + Position includes evenings/weekends/holidays **ESSENTIAL FUNCTIONS** +… more
- Intermountain Health (Ogden, UT)
- …and benefits. Coordinates referral for patients that will go out of network . Point of contact for surgery authorization questions. Obtain proper CPT code ... signed off and sent for hospital orders. + Obtains authorization for surgeries/hospital procedures by researching coverage and obtain...procedures by researching coverage and obtain prior auth for them. Verifies eligibility… more
- Intermountain Health (Logan, UT)
- …and benefits. Coordinates referral for patients that will go out of network . Point of contact for surgery authorization questions. Obtain proper CPT code ... signed off and sent for hospital orders. + Obtains authorization for surgeries/hospital procedures by researching coverage and obtain...procedures by researching coverage and obtain prior auth for them. Verifies eligibility… more