- Dialysis Clinic, Inc. (Sacramento, CA)
- …dialysis providers for the past 13 years in a row. The AR Specialist will provide continual and accurate documentation regarding eligibility, authorization , and ... for accuracy as well as sending out initial claims, corrected claims and appeals .Starting pay: $23.00/hr. This position is for the California / NM region.… 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
- Trinity Health (Farmington Hills, MI)
- …as part of the payment resolution team that receives, analyzes, and appeals denials received for an assigned PBS location. Reviews, researches and resolves ... knowledge of state/federal laws as they relate to contracts and the appeals process. Investigates and addresses overpayment and underpayment accounts with the… more
- Randstad US (Dallas, TX)
- medical appeals and denials specialist . + dallas , texas + posted april 30, 2024 **job details** summary + $20 - $20.93 per hour + temp to perm + high school + ... further. Must have at least 2 years of backend appeals and denials experience. salary: $20 - $20.93 per...Will be responsible for outstanding A/R in the TD Authorization work queues. The expected duties are to resolve… 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
- Trinity Health (Farmington Hills, MI)
- …Maintains knowledge of state/federal laws as they relate to contracts and the appeals process. Assists in training Payment Resolution Specialist I colleagues ... as to ensure timely follow-up and action for account appeals . + Works with Patient Access and other necessary...Patient Access and other necessary parties to resolve account authorization issues. + Applies knowledge of specific payer payment… 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
- Veterans Benefits Administration (Montgomery, AL)
- …of Veterans Affairs, Regional Office (VARO), Veterans Service Center and BEST. The Authorization Quality Review Specialist is an integral part of the VSC ... limited to: Performs individual quality reviews to determine the authorization quality level of individual VSRs for purposes of...the Pension and Fiduciary Service and the Court of Appeals for Veterans Claims are met or implemented. Work… 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
- Bon Secours Mercy Health (Springfield, OH)
- …are recognized for clinical and operational excellence. Patient Services Specialist Responsible for all aspects of scheduling, pre-registration and financial ... validation of accurate patient demographic and insurance information, obtaining pre-certification/ authorization , scheduling for inpatient and outpatient services, and entering… 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 hybrid (SHIFT: Days). *Purpose of this position:*The Prior Authorization Specialist plays a key role in the patient financial experience ... authorization submissions for timely response * Follows up on any prior authorization denials; assists Utilization Management with appeals , as needed *… more
- Providence (Portland, OR)
- …areas of specialist referral processing, diagnostic authorizations, prior authorization , denials/ appeals , and training. Providence caregivers are not simply ... - Experience in a referral management functional area such as prior authorization , referrals, appeals , business office or insurance health plans. **Preferred… more
