- AscellaHealth (Berwyn, PA)
- What we are looking for Optime Care seeks a Prior Authorization and Appeals Specialist for our Berwyn, PA location. We are looking for someone who is ... Prior Authorizations and Appeals process. + Respond to Prior Authorization denials and submit appeals , collecting appropriate clinical support to… 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
- 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
- UPMC (Pittsburgh, PA)
- **University of Pittsburgh Physicians is hiring a full-Time Sr. Authorization Specialist to help support their UPMC Magee-Womens Center for Fertility and ... from home flexibility, after completion of training. **Position Specifics:** The Sr. Authorization Specialist also functions as the IVF Financial counselor for… 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
- 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
- St. Luke's Health System (Boise, ID)
- …but is not limited to, patient registration, referral coordination, complex benefit verification, prior authorization and appeals , and responding to general ... **Overview** At St. Luke's our Infusion Authorization Specialists are responsible for securing prior authorizations for specialty medications administered at our… 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
- LA Care Health Plan (Los Angeles, CA)
- …dates for each file. Inform nurses of a new case received from Grievance and Appeals Specialist .; submit all Grievances and Appeals response letters to ... Preferred: Experience in Medi-Cal managed care. 1 year of experience in UM/ Prior Authorization . Skills Required: Demonstrated proficiency in Medical Terminology… 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
- Baptist Memorial (Memphis, TN)
- …order to enhance reimbursement and maximize customer satisfaction. + Submits retro- authorization requests, reconsiderations, and appeals with careful regard to ... filled in Memphis, TN; Jackson, MS The Denial Mitigation-Appeal Specialist II RN serves in a key role of...payer guidelines and BMHCC contracts as it pertains to authorization and clinical denials as well as clinical audits.… more
- Cardinal Health (Nashville, TN)
- … is responsible for reviewing and resolving claim denials related to prior authorization and medical necessity. This role ensures accurate documentation, ... or corrected claims to reduce revenue loss. The specialist works closely with clinical, billing, and authorization...Responsibilities_** + Review denied claims related to lack of prior authorization or medical necessity + Investigate… more
- Fairview Health Services (Minneapolis, MN)
- …Coordination of Benefits and copay assistance. + Coordinate with outside facilities on prior authorization and access as needed for MHFV providers. + Research ... resolving barriers on behalf of clinic care teams, including submitting and following prior authorizations/ appeals , alternate funding for claim appeals , and… more
- Ventura County (Ventura, CA)
- Medical Billing Specialist II - Patient Financial Services Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4940099) Apply Medical Billing ... Specialist II - Patient Financial Services Salary $49,302.23 -...and over adjustments; + Analyzes and updates claims generated prior to transmitting to the appropriate intermediary/payor within billing… more
- State of Colorado (Boulder County, CO)
- Highway Maintenance Specialist - Nederland Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4966393) Apply Highway Maintenance Specialist - ... your passions into a career as a Highway Maintenance Specialist . CDOT has a vacancy for a Highway Maintenance...obtained at any time after receipt of the applicant's authorization . As part of the employment screening an applicant… more
- Kestra Medical Technologies, Inc (Dallas, TX)
- …pre-authorizations requests, including notifying applicable parties of the determination. Assist with appeals for Prior Authorization denials + Upon ... or more years of experience with Insurance verifications, which include gathering prior authorization required documents and submitting/following-up prior … more
- AssistRx (Overland Park, KS)
- …restrictions and details on how to expedite patient access + Document and initiate prior authorization process and claims appeals + Report any reimbursement ... Day in the Life as a Bilingual Patient Access Specialist : This role works directly with healthcare providers &...complex reimbursement issues. This position also provides support for Prior Authorizations (PA) for an assigned caseload and helps… more
- State of Colorado (Fremont County, CO)
- Highway Maintenance Specialist - Cotopaxi (CDL Required) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4993833) Apply Highway Maintenance ... Specialist - Cotopaxi (CDL Required) Salary $53,400.00 - $54,000.00...obtained at any time after receipt of the applicant's authorization . As part of the employment screening an applicant… more