- Trinity Health (Farmington Hills, MI)
- …Position (Pay Range: $39.8218-$59.7327) Applies clinical and comprehensive payer and appeals knowledge in reviewing all post-billed denials (inclusive of clinical ... of claim escalations. Responsible for leveraging clinical and broad payer and appeals knowledge, and standard procedures to track appeals through first,… more
- Abbott (Plano, TX)
- …Our 114,000 colleagues serve people in more than 160 countries. **Sr. Appeals Specialist , Patient Therapy Access Team** **Position Location: 6600 Pinecrest ... Our location in **Plano, TX** currently has an opportunity for a **Sr. Appeals Specialist ** . This role is responsible for facilitating and assisting… more
- Alight (TX)
- …of Be Alight. Learn more at careers.alight.com. **About the Role** The Appeals Specialist reviews adverse determination outcomes for Short Term Disability ... and Great Place to Work!** **Do you want to be part of a collaborative Appeals team?** **Our Story** At Alight, we believe a company's success starts with its… more
- Trinity Health (Farmington Hills, MI)
- …Responsible for leveraging clinical knowledge and standard procedures to track appeals through first, second, and subsequent levels, and ensuring timely filing ... of appeals as required by payers, in addition to promoting...clinical input to Pre-Service staff in order to facilitate authorization approvals; + Assists in marketing efforts and the… more
- Sanford Health (Sioux Falls, SD)
- …for Nursing Education Accreditation (NLN CNEA). One (1) year experience required in appeals , medical necessity, or prior authorization process. If a graduate of ... interpretation of policies, and handling of correspondence related to denials and appeals submitted by providers and members. Must administer benefits in accordance… more
- Montrose Memorial Hospital (Montrose, CO)
- …day direction from the leadership in Spine and Pain. . The Hospital Prior Authorization Specialist is an advocate for the patient's medical needs and financial ... payer to patient for timely health care diagnostics and treatments. The Prior Authorization Specialist supports the provider and patient's plan of care as… more
- Montrose Memorial Hospital (Montrose, CO)
- …meeting the highest standards of healthcare. About The Career: The Hospital Prior Authorization Specialist is an advocate for the patient's medical needs and ... payer to patient for timely health care diagnostics and treatments. The Prior Authorization Specialist supports the provider and patient's plan of care as… more
- Montrose Memorial Hospital (Montrose, CO)
- …meeting the highest standards of healthcare. About The Career: + The Hospital Prior Authorization Specialist is an advocate for the patient's medical needs and ... payer to patient for timely health care diagnostics and treatments. The Prior Authorization Specialist supports the provider and patient's plan of care as… more
- University of Michigan (Ann Arbor, MI)
- Prior Authorization Specialist Apply Now **Summary** Processes referrals and prior authorizations using established insurance company guidelines. Obtains ... employer. **Job Detail** **Job Opening ID** 246886 **Working Title** Prior Authorization Specialist **Job Title** Patient Services Intermediate **Work Location**… more
- Logan Health (Whitefish, MT)
- …and resolving authorization denials as needed. Prepares, submits, and tracks appeals as necessary. Accurately documents patient accounts of all actions taken. + ... authorizations for all procedural orders by successfully completing the prior authorization process per department procedure and protocol. Qualifications: + Minimum… more
- Fairview Health Services (St. Paul, MN)
- …and determine appropriate clinical documentation to submit to ensure a complete authorization request. + Submit and manage authorization requests and/or ensure ... + Facilitate insurance denial mitigation steps such as peer-to-peer reviews and appeals in conjunction with revenue cycle, care teams, utilization review, and… more
- Baystate Health (Springfield, MA)
- …prior authorizations and referrals. Coordinates and processes documentation necessary for insurance appeals related to referrral and authorization as well as ... **Summary:** The Referral Authorization Coordinator is responsible for providing a variety...clear communication between providers, staff, insurers, and families. The specialist works closely with the clinical department staff, prescribing… more
- LA Care Health Plan (Los Angeles, CA)
- …safety net required to achieve that purpose. Job Summary The Supervisor, Authorization Technician supports the Utilization Management (UM) Specialist by handling ... Common Procedure Coding System (HCPCs) codes. Technical Support to UM Specialist : Processing of time sensitive authorization and pre-certification requests… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …role will primarily work remotely (SHIFT: Days). *Purpose of this position:*The Prior Authorization Specialist plays a key role in the patient financial ... authorization submissions for timely response * Follows up on any prior authorization denials; assists Utilization Management with appeals , as needed *… more
- Swedish Health Services (Seattle, WA)
- **Description** The Prior Authorization Specialist facilitates processing of medication prior authorizations for clinic patients in accordance with established ... + 2 years Experience in an area such as prior authorizations, medical audits, appeals or delegation. + 1 year Epic software experience. **Why Join Providence?** Our… more
- Trinity Health (Fort Wayne, IN)
- …support of activities including but not limited to benefits investigation, prior authorization request and submission, overturning appeals , and enrolling patient ... Type:** Full time **Shift:** **Description:** The Specialty Pharmacy Revenue Cycle Specialist is responsible for performing the appropriate processes to obtain and… more
- University of Rochester (Rochester, NY)
- POSITION SUMMARY: Serves as the patient referral and prior authorization specialist , with oversight of data and compliance to enterprise standards and referral ... and prior authorization guidelines. Communicates regularly with patients, families, clinical and...and tracking all assistance provided. Accountable for planning, execution, appeals and efficient follow through on all aspects of… more
- Kelsey-Seybold Clinic (Pearland, TX)
- …a liaison to the Grievance and Appeals Department for Medicare Advantage appeals . The Utilization Review Specialist (LVN) is responsible for completion and ... **Responsibilities** The Utilization Review Specialist (LVN) is responsible for conducting medical reviews,...to determine medical necessity for health care services requiring authorization prior to services being rendered for members. The… more
- State of Colorado (Fort Collins, CO)
- DFPC Fire Resource Specialist Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4510574) Apply DFPC Fire Resource Specialist Salary ... own expense. Should a small stipend be granted, prior authorization by the appointing authority is required. Current Location:...the Job The primary purpose of the Fire Resource Specialist position is to perform State Fire Coordination functions,… more
- Lakeshore Bone & Joint Institute (Chesterton, IN)
- …and Scheduling Specialist is responsible for the following tasks: Precertification/Prior Authorization & Scheduling: o MRI o PT/DME o Surgery o In Office ... Injections The Pre-Certification and Scheduling Specialist is responsible for completing the pre- authorization and scheduling process for MRI and surgery. The… more