- University of Colorado (Aurora, CO)
- Prior Authorization and Payer Reimbursement Coordinator - 33254 University Staff **Description** **University of Colorado Anschutz Medical Campus** ... - Hemophilia & Thrombosis Center** **Job Title: Prior Authorization and Payer Reimbursement Coordinator** **Position #: 00821459 - Requisition: #**… more
- University of Miami (Miami, FL)
- …CORE FUNCTIONS: + Adhere and perform timely prospective review for services requiring prior authorization as well as timely concurrent review for continuation of ... for expedited requests and prioritizes caseload accordingly + Maintains knowledge regarding payer reimbursement policies and clinical guidelines. + This list of… more
- Logan Health (Whitefish, MT)
- …Health intranet related to payer requirements needed to successfully obtain a prior authorization . + Contacts patient and/or clinic to advise if ... authorizations for all procedural orders by successfully completing the prior authorization process per department procedure and protocol. Qualifications:… more
- St. Luke's University Health Network (Allentown, PA)
- …serve, regardless of a patient's ability to pay for health care. The Network Prior Authorization and Referral Specialist is responsible for the coordination of ... information + Provides insurance company with clinical information necessary to secure prior - authorization or referral + Works in alignment with Central… more
- BrightSpring Health Services (Englewood, CO)
- …nationwide through our growing network of branches and healthcare professionals. The Prior Authorization Specialist role will be responsible for activities ... prior authorizations. This role requires working knowledge of pharmacy benefits and prior authorization process. NOTE: Work Schedule: Monday - Friday / 9:00am… more
- Glens Falls Hospital (Glens Falls, NY)
- …the collection of patient financial obligations / secure payment arrangements . Contact provider/ payer to obtain prior authorization . Gather additional ... & coordination of benefit . Prepare and compile necessary documentation to secure prior authorization . . Collect clinical information regarding service to be… more
- Rush University Medical Center (Chicago, IL)
- …Lead is responsible for obtaining and resolving referral, precertification, and/or prior authorization to support insurance specific plan requirements for ... the patient's clinical background and clinical information that is required for the payer to issue a referral or an authorization . Per referral guidelines,… more
- Cleveland Clinic (Cleveland, OH)
- …responsible for conducting, completing and follow up activities for necessary third party prior authorization requests for high cost medications. The Pharmacy ... Under the guidance of the Department Manager, the Pharmacy Authorization Representative ensures optimal reimbursement for high...preferred. + Prior knowledge of healthcare insurance prior authorization preferred. + Ability to multitask… 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 work ... include payer notification, authorization management, denial management, escalations, and communication and coordination between payer , business office and… more
- Trinity Health (Albany, NY)
- … authorization and denials within assigned service line ensuring appropriate prior authorization for related services, drugs, treatments, and supplies. ... knowledge of the patient population and types of services patients receive. + Prior authorization experience involving drugs and ancillary testing desirable. +… more
- Baptist Memorial (Memphis, TN)
- …per insurance medical policies/ FDA/NCCN guidelines. Initiates and coordinates pre-certifications/ prior -authorizations per payer guidelines prior to ... all authorization denial communications received in order to optimize reimbursement Requirements, Preferences and Experience Education Minimum Required 3 - 5… more
- AbbVie (Atlanta, GA)
- …Payers. Examples include criteria changes or barriers in medical policy, Prior Authorization requirements, coding changes, claim submission requirements or ... of Durysta, Ozurdex and XEN Gel Stent reimbursement process, appropriate reimbursement , and respective payer landscape. + Demonstrates competence in the… more
- Regeneron Pharmaceuticals (Phoenix, AZ)
- … Payer Formularies and restrictive Utilization Management Criteria including: Prior Authorization Processes, Step Edits, Appeals, detailed Clinical ... relates to the Regeneron product portfolio. Support the company and divisional reimbursement strategy for Regeneron products within various payer segments. The… more
- LifePoint Health (Wilson, NC)
- …Growing Tree On-Site Childcare Facility . And much more *_Position Summary_*: The Prior Authorization Coordinator is an essential part of a multi-disciplinary ... team that provides high-quality patient care. The Prior Authorization Coordinator processes all inbound ...incoming authorization requests according to urgency, obtain authorization via the payer website or by… more
- Regeneron Pharmaceuticals (Atlanta, GA)
- … Payer Formularies and restrictive Utilization Management Criteria including: Prior Authorization Processes, Step Edits, Appeals, detailed Clinical ... relates to the Regeneron product portfolio. Support the company and divisional reimbursement strategy for Regeneron products within various payer segments. The… more
- Bausch + Lomb (Seattle, WA)
- …foundational knowledge of benefit verifications and prior authorization /pre-determination requirements and knowledge of reimbursement processes within ... with a unique HCPCS code. + Knowledge of private payer , Medicare and Medicaid structure, systems, and reimbursement... payer , Medicare and Medicaid structure, systems, and reimbursement process. + Ability to analyze and interpret regulation… more
- Regeneron Pharmaceuticals (Dallas, TX)
- … Payer Formularies and restrictive Utilization Management Criteria including: Prior Authorization Processes, Step Edits, Appeals, detailed Clinical ... relates to the Regeneron product portfolio. Support the company and divisional reimbursement strategy for Regeneron products within various payer segments. The… more
- Regeneron Pharmaceuticals (Providence, RI)
- …health insurance claim forms including UB-04, CMS-1500, explanation of benefits, and prior authorization forms, and super bills charge tickets to troubleshoot ... staff) and effectively manage product concerns. + Proactively update customers regarding reimbursement requirements, payer trends, and payer policy changes… more
- Fairview Health Services (Minneapolis, MN)
- …to pharmacy services while documenting accurate referral and reimbursement ( payer ) information, coordinating the intake and benefit authorization process + ... coding. Knowledge of medical benefit investigation and securing or prior authorization securing for medical benefit. + **License/Certification/Registration**… more
- Keystone Lab (Asheville, NC)
- …fe es, covered or non-covered items, diagnosis, modifiers, valid HCPC, prescriptions, authorization , eligibility, etc. + Monitor websites for payer policy ... opportunity awaits a highly qualified Medical Insurance Billing & Reimbursement Analyst I in one of the most beautiful...in all aspects of job performance. + Adhere to payer timely filing limits and work accounts to resolve… more