- US Tech Solutions, Inc. (Atlanta, GA)
- Job Title: Prior Authorization Specialist Location: Fully Remote Duration: 12 months contract Job Description: The CD Representative II will work closely ... with providers to process prior authorization (PA), and drug benefit exception...behalf of as the client and in accordance with Medicare Part D CMS Regulations. Must apply information [provided… more
- A-Line Staffing Solutions (Monroeville, PA)
- …EOB, Benefit, Patient Service, PBM, Enrollment, Provider Services, Pharmacy, prior authorization , reimbursement counselor, Medical customer service, inbound ... calls, outbound calls, answer phones, make calls, medical terminology, medical office, medical claims, healthcare claims, claims processing more
- CVS Health (Austin, TX)
- …Rep II, Operations you will work closely with healthcare providers to process Prior Authorizations (PA) and drug benefit exception requests in a call center ... member and client satisfaction. You will be performing all work in accordance with Medicare Part D guidelines. As a Rep II, Operations, you'll show a high level… more
- Elevance Health (Denver, CO)
- …the following:** + 8 AM-5 PM + 9 AM-6 PM + 10 AM-7 PM The ** Authorization Representative II** is responsible for the administration of prior authorizations ... include, but are not limited to: + Reviews accuracy and completeness of prior authorization information requested and ensures supporting documents are present… more
- The Cigna Group (Bloomfield, CT)
- …- Remote, United States** The Grievance team manages Cigna Healthcare - Medicare /Medicaid grievances that are presented by our member's or their representatives ... pertaining to the authorization of or delivery of clinical and non-clinical services....Grievances coordinator position is focused on the processing of Medicare customer grievances. This associate may screen incoming complaints… more
- BrightSpring Health Services (Arlington, TX)
- …an understanding of Insurance and Medicaid formularies and processes including the prior authorization processes + Makes outgoing calls to Facilities, Plans, ... + Provide clinical support to members of the RxAllow team regarding prior authorization concerns / submissions + Conducts job responsibilities in accordance with… more
- BrightSpring Health Services (Arlington, TX)
- …claims. + Understands Insurance and Medicaid formularies and processes, including the prior authorization processes. + Makes outgoing calls to Facilities, Plans, ... + Provides clinical support to members of the RxAllow team regarding prior authorization concerns + Achieves productivity goals with regard to calls/claims per… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *SUMMARY:* We are currently seeking a* Prior Authorization Representative Senior*to join our Financial Securing team. This full-time role will primarily work ... remotely (SHIFT: Days). *Purpose of this position:*The Prior Authorization Specialist plays a key role...Verifies medical necessity in accordance with the Centers for Medicare & Medicaid Services (CMS) standards and communicates relevant… more
- Logan Health (Whitefish, MT)
- … authorizations for all procedural orders by successfully completing the prior authorization process per department procedure and protocol. Qualifications: ... of CPT, HCPCS codes and medical records to insurance carriers to expedite prior authorization requests. + Accurately secures patients' demographics and medical… more
- UCLA Health (Los Angeles, CA)
- Description As a Patient Authorization Representative , you will be responsible for: + Pre-encountering and pre-registering patients as well as providing ... insurance and enter insurance benefits information into the CareConnect system prior to appointments + Determining co-pays and deductibles; confirming and obtaining… more
- Tidelands Health (Pawleys Island, SC)
- …responsible for accurate and complete insurance verification, financial clearance and prior authorization , and complete pre-registration of all scheduled ... least one (1) year of experience in Healthcare Revenue Cycle that includes prior authorization . **ADDITIONAL PREFERRED EXPERIENCE:** + Knowledge of CPT and ICD… more
- Tidelands Health (Pawleys Island, SC)
- …responsible for accurate and complete insurance verification, financial clearance and prior authorization , and complete pre-registration of all scheduled ... Five (5) year of experience in Healthcare Revenue Cycle that includes prior authorization . **KNOWLEDGE/SKILLS/ABILITIES** : * Ability to interact successfully… more
- St. Luke's University Health Network (Quakertown, PA)
- …their visit. + Responsible for contacting the SLPG practice or Network Prior Authorization Department to obtain required insurance referrals and pre-certs ... pay for health care. JOB SUMMARY The Patient Access Representative I is responsible for the entire scope of...prior to service to decrease denials for no authorization . + Must obtain Medical license Number, NPI and… more
- Sharp HealthCare (San Diego, CA)
- …**FTE** 0 **Shift Start Time** **Shift End Time** Certified Revenue Cycle Representative (CRCR) - HFMA; HS Diploma or Equivalent **Hours** **:** **Shift Start ... and Federal regulations governing registration/billing activities including JCAHO, Title XXII, Medicare and Medi-Cal regulations. ICD-9, and CPT 4 coding experience… more
- Tidelands Health (Pawleys Island, SC)
- …multiple resources for patient services. May also perform duties for prior authorization , referrals (incoming/outgoing), good faith estimates, and/or payment ... multiple resources for patient services. May also perform duties for prior authorization , referrals (incoming/outgoing), good faith estimates, and/or payment… more
- Surgery Care Affiliates (Mokena, IL)
- …individual payer websites to obtain eligibility, benefits and/or pre-certs and authorization information. * Enter the patient insurance information into patient ... center compliance with CMS Conditions for Coverage guidelines in contacting patient's prior to the date of service to review, Physician Ownership, Advance Directives… more
- Surgery Care Affiliates (Pinehurst, NC)
- …individual payer websites to obtain eligibility, benefits and/or pre-certs and authorization information. + Enter the patient insurance information into patient ... center compliance with CMS Conditions for Coverage guidelines in contacting patient's prior to the date of service to review, Physician Ownership, Advance Directives… more
- Corewell Health (Southfield, MI)
- …the Financial Clearance Rep is responsible for ensuring accounts are financially cleared prior to the date of service. Financial Clearance Reps are responsible for ... all Financial Clearance duties to ensure the account is financially cleared prior to service. The Financial Clearance Rep is responsible for gathering demographic… more
- Tidelands Health (Myrtle Beach, SC)
- …multiple resources for patient services. May also perform duties for prior authorization , referrals (incoming/outgoing), good faith estimates, and/or payment ... and forms completed including and not limited to the following: Medicare Secondary Payer Questionnaire, Advance Beneficiary Notice (ABN waiver), HIPAA Privacy… more
- Tidelands Health (Murrells Inlet, SC)
- …multiple resources for patient services. May also perform duties for prior authorization , referrals (incoming/outgoing), good faith estimates, and/or payment ... and forms completed including and not limited to the following: Medicare Secondary Payer Questionnaire, Advance Beneficiary Notice (ABN waiver), HIPAA Privacy… more
