- Beth Israel Lahey Health (Burlington, 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
- Cognizant (Boston, MA)
- …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