- A-Line Staffing Solutions (Cleveland, OH)
- …Medical Claims, Appeals, Mail Order Medications, Insurance Verification, Pharmacy, Prior Authorization , Patient Counselor, Healthcare, Inbound Calls, Outbound ... Medical Claims, Appeals, Mail Order Medications, Insurance Verification, Pharmacy, Prior Authorization , Patient Counselor, Healthcare, Inbound Calls, Outbound… more
- Compass Health Network (Wentzville, MO)
- …referral requestso Prepare and process all referral paperwork, including pre-certification and prior authorization requestso Work with the patient to schedule ... required by Compass HealthComplete Medication and Durable Medical Equipment (DME) prior authorization and documentation as neededObtaining results from… more
- Compass Health Network (Wentzville, MO)
- …referral requestso Prepare and process all referral paperwork, including pre-certification and prior authorization requestso Work with the patient to schedule ... required by Compass Health* Complete Medication and Durable Medical Equipment (DME) prior authorization and documentation as needed* Obtaining results from… more
- Accounting Now (Tampa, FL)
- …submit appeals or corrected claims in a timely manner. This position applies prior knowledge of denials to assess and ensure services/items billed are reasonable and ... medical records to support medical necessity) for a reconsideration, appeal, or retro authorization to the insurance carrier via payer portal, fax, etc Documents and… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …QualificationsPreferred Licensure or other certifications: Certified Rehabilitation Nurse .Preferred Educational Requirements: Preferred Experience: Three (3) years ... care facilities, physicians, family members, patients, etc.)Ensures that appropriate authorization for an assessment is obtained based on referral source.Performs… more
- Actalent (San Bernardino, CA)
- …to within scope of practice to Discharge assistant. Skills: Utilization review, prior authorization , Care management, Case management, interqual, ncqa, ncqa ... standards Top Skills Details: Utilization review, prior authorization ,Care management Additional Skills & Qualifications: California RN License BLS AHA Must be… more
- CVS Health (Lansing, MI)
- …8a-5pm Est time.) No travel is required.Applicants from any state can apply. Prior Authorization UM Nurse Consultant Utilizes clinical experience and ... in state of residence 3+ years of Nursing experiencePreferred Qualifications Prior authorization utilization experience preferred Outpatient Clinical experience… more
- Centene Corporation (New York, NY)
- …role but must reside within New York state.** **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service and ... interdepartmental teams, to assess medical necessity of care of member + Escalates prior authorization requests to Medical Directors as appropriate to determine… more
- Actalent (Charleston, SC)
- …+ Care management + Acute care + Discharge planning + Insurance verification + Prior authorization + Registered Nurse + Data entry Additional Skills ... & Qualifications: + Experience in case management PREFERRRED + Bachelor of Science in Nursing REQUIRED + At least 3 years working as an RN in a hospital environment Experience Level: Intermediate Level About Actalent Actalent is a global leader in engineering… more
- Public Consulting Group (Augusta, ME)
- …PA reviews/dispositions based on business rules and workflow policies; + Work with the Prior Authorization unit staff members to monitor work queues and complete ... **Overview** **Registered Nurse - Health Services Consultant** ** Authorization ...people they serve. **Responsibilities** **Position Duties:** + Manage medical Prior Authorizations (PA) as assigned by the PA supervisor,… more
- CVS Health (Lansing, MI)
- …per the needs of the department - 3+ years clinical experience as a Registered Nurse - 3+ years of Managed Care experience - 1+ years of Utilization Management ... experience - Travel Required up to 5% for meetings/audits - Must have MS office suites experience Preferred Qualifications: - Experience with MedCompass - 1+ year Leadership experience (formal or informal roles) - Ability to communicate effectively with… more
- Baptist Memorial (Memphis, TN)
- …strategy. Specifically the managed care techniques the Coordinator uses focuses on prior authorization for services using evidence based criteria. Areas of ... Summary The Authorization Coordinator is responsible for facilitating information documentation...payer with patient access + Communicate with Utilization Review Nurse + Works assigned queues in the electronic medical… more
- Northeast Family Services (West Springfield, MA)
- …to join our growing Massachusetts CBHI team as an Intake Screener and Authorization Specialist! The Intake Screener and Authorization Specialist manages all ... scheduling clients' appointments. To be successful in the Intake Screener and Authorization Specialist position, you should be highly organized, be detail oriented,… more
- Northeast Family Services (New Rochelle, NY)
- …join our growing New York team as a Bilingual Intake Screener and Authorization Specialist! The Bilingual Intake Specialist (English / Spanish) manages all aspects ... and initial treatment plans. To be successful in the Intake Screener and Authorization Specialist position, you should be highly organized, be detail oriented, have… more
- Veterans Affairs, Veterans Health Administration (Iron Mountain, MI)
- …ADMINISTRATIVE RESPONSIBILITIES: 1. Provides guidance and consultation to the nurse practitioners or physician assistants assigned in their respective areas ... designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment… more
- MD Anderson Cancer Center (Houston, TX)
- …Practice Registered Nurse from the Texas State Board of Nursing prior to 1/1/2003. Graduate education and related Texas Board of Nursing authorization ... be consistent with clinical practice area and patient population. **EXPERIENCE** Preferred: Prior experience as Advanced Practice Registered Nurse . Preferred: … more
- Martin's Point Health Care (Portland, ME)
- …a need for inpatient/ outpatient authorizations. This position receives and reviews prior authorization requests for specific inpatient and outpatient medical ... to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of a team responsible...continuity of care Job Description Key Outcomes/Results: + Review prior authorization requests ( prior … more
- Louisiana Department of State Civil Service (Jackson, LA)
- PRACTICAL NURSE -LICENSED 1/2/3 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4266808) Apply PRACTICAL NURSE -LICENSED 1/2/3 Salary ... has a Special Entrance Rate at each level Practical Nurse -Licensed 1 has an SER of $19.48 per hour....employee may be required to serve a trial detail prior to being permanently promoted. + TEMPORARY JOB APPOINTMENT:… more
- Louisiana Department of State Civil Service (Homer, LA)
- PRACTICAL NURSE - LICENSED 1, 2, OR 3 Print...employee may be required to serve a trial detail prior to being permanently promoted. + TEMPORARY JOB APPOINTMENT: ... (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4475334) Apply PRACTICAL NURSE - LICENSED 1, 2, OR 3 Salary Depends on Qualifications Location… more
- Louisiana Department of State Civil Service (Angola, LA)
- REGISTERED NURSE 1, 2, 3 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4452168) Apply REGISTERED NURSE 1, 2, 3 Salary Depends on ... employee may be required to serve a trial detail prior to being permanently promoted + TEMPORARY JOB APPOINTMENT:...has a Special Entrance Rate at each level Registered Nurse 1 has an SER of $29.84 per hour.… more
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