- University of Texas Rio Grande Valley (Edinburg, TX)
- Position Information Posting NumberSRGV7496 Working TitlePRIOR AUTHORIZATION AND REFERRAL SPECIALIST (UT Health RGV Cancer and Surgery Center) Number of ... FTE1.0 FLSANon-Exempt Scope of Job Responsible for obtaining and processing all prior authorizations and referrals and entering the completed referral into the… more
- Logan Health (Whitefish, MT)
- … authorizations for all procedural orders by successfully completing the prior authorization process per department procedure and protocol. Qualifications: ... codes and medical records to insurance carriers to expedite prior authorization requests. + Accurately secures patients'...available for hospitals from the Centers for Medicare and Medicaid Services in 2023. We take pride in providing… more
- CVS Health (Pittsburgh, PA)
- …processing issues. * Routes and triages complex claims to Senior Claim Benefits Specialist . * Proofs claim or referral submission to determine, review or apply ... High School diploma or GED equivalent. Preferred Qualifications + Medicaid + QNXT + Medical Coding Education High School...required to have received at least one COVID-19 shot prior to your first day of employment and to… more
- University of Colorado (Aurora, CO)
- …agency (https://www.jobelephant.com/) As a key member of the Revenue Cycle Team, the Prior Authorization and Payer Reimbursement Specialist (PAPR) at the ... State and Federal requirements; including but not limited to Medicaid , Medicare, case logs, and drug logs as required....a key member of the Revenue Cycle Team, the Prior Authorization and Payer Reimbursement Specialist… more
- Rush University Medical Center (Chicago, IL)
- …**Work Schedule:** 8 Hr (8:00:00 AM - 4:30:00 PM) **Summary:** The Pre- Authorization Specialist Lead is responsible for obtaining and resolving referral, ... precertification, and/or prior authorization to support insurance specific plan...outpatient), ED, and clinic/ambulatory environments. In addition, the Pre- Authorization Specialist II may be responsible for… more
- University of Colorado (Aurora, CO)
- …the medical necessity for each patient behavioral health treatment and documentation Medicaid authorization . **Work Location:** Onsite **Why Join Us:** _Read CU ... Program Director. This position is responsible for managing various aspects of patient Medicaid authorization for residential treatment based on ASAM level of… more
- MyFlorida (Fort Myers, FL)
- …discrepancies. The incumbent initiates office supply orders using Agency systems and obtains prior authorization from Field Office Manager prior to ... 68020069 - REGULATORY SPECIALIST I Date: Apr 16, 2024 Location: FT...entity. The Agency is responsible for administering the Florida Medicaid program, the licensure and regulation of nearly 50,000… more
- Tarrytown Rehabilitation & Nursing Center (Everett, MA)
- …skills + Demonstrated knowledge ( Medicaid , Medicare) and case management process ( prior authorization and appeals) required + Ability to multi-task and adapt ... CLINICAL REIMBURSEMENT SPECIALIST / MULTI FACILITY We offer competitive compensation and...responsibility. Ensures compliance with federal and state regulations, MA Medicaid , Medicare and Managed Care payment systems. Monitors, consults,… more
- Masonicare (Wallingford, CT)
- …to determine reason for ineligible status + Obtains authorizations for BHP and Medicaid Prior Authorization programs using electronic request system + ... Regulatory Management Specialist Job Location: Wallingford Center, Connecticut Regulatory Management...not be paid + Responsible for adherence to the Medicaid programs + Reviews eligibility of all patients on… more
- Truman Medical Centers (Kansas City, MO)
- …for special projects. They will ask key questions to help facilitate the prior authorization and scheduling process for specified procedures and Admission ... self-pay patients to review eligibility for the University Health Discount and/or Medicaid . The Utilization Specialist will be expected to communicate financial… more
- TEKsystems (San Antonio, TX)
- …party payer benefits and eligibility (online or telephone) 8. Initiate prior authorization /pre-certification with third party payers (online/telephone) 9. ... customer service, call center, health care, medical billing, benefit verification, prior authorization , claims processing, insurance, medical claim, accounting,… more
- Elevance Health (Plano, TX)
- …include, but are not limited to: + Reviews accuracy and completeness of prior authorization information requested and ensures supporting documents are present ... and 1-2 days in office per week. The **Intake Specialist ** is responsible for the administration of prior... authorizations/appeals. + Document insurance company interactions and all prior authorization information in system. + Reviews… more
- Omaha Children's Hospital (Omaha, NE)
- …weekend rotation** **$500 Hiring Bonus!** We're searching for a **Patient Access Specialist ** to facilitate admission and registration process for all inpatients and ... supporting the medical needs of the patient. + Obtains authorization for medical treatment/testing or admission from parents or...at time of registration. Also looks for existing or prior balances and works to collect those. Refers family… more
- University of Texas Rio Grande Valley (Rio Grande, TX)
- …needed in PM system. Assists clinic staff with CPT codes so clinic can obtain prior authorization or communicates with clinic staff to contact payers when codes ... demographic and insurance information, verifying insurance, entering referral information and/or prior authorization , posting charges and/or payments for clinic… more
- TEKsystems (San Antonio, TX)
- …party payer benefits and eligibility (online or telephone) 8. Initiate prior authorization /pre-certification with third party payers (online/telephone) 9. ... customer service, call center, health care, medical billing, benefit verification, prior authorization , claims processing, insurance, medical claim, accounting,… more
- AdventHealth (Hinsdale, IL)
- …Verifies medical necessity in accordance with Centers for Medicare & Medicaid Services (CMS) standards and communicates relevant coverage/eligibility information to ... and during or after care for unscheduled patients. Accurately enters required authorization information in AdventHealth systems to include length of authorization… more
- Arkansas Children's (Little Rock, AR)
- …Genetics, Sleep lab and Heart Station departments. 2. Preregisters, obtains prior authorization , price estimates, PCP referrals, upfront collections and ... Shift:** Day Shift **Time Type:** Full time **Department:** CC017115 Outpatient Prior Authorizations **Summary:** Monday-Friday, 8:00 am - 5:00 pm ▬ On-Premises… more
- Healthfirst (New York, NY)
- …enroll them into one of the government programs offered by Healthfirst such as Medicaid , Child Health Plus (CHP), Essential Plan (EP) or a Qualified Health Plan ... also responsible for assisting current Healthfirst members by recertifying them into Medicaid , EP, QHP or CHP. Marketplace Facilitated Enrollers are required to… more
- Billings Clinic (Billings, MT)
- …must complete several pre-employment requirements prior to starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) ... to learn more! Health Information Management (HIM) Specialist HEALTH INFO MGMT (HIM) - HOSP (BILLINGS CLINIC HOSPITAL) req7322 Shift: Day, Evening Employment Status:… more
- Sanford Health (SD)
- …relating to the implementation, ongoing evaluation, and improvements to UM and/or prior authorization processes with applicable. Completes activities relating to ... regulations and internal policies that effect resource utilization and potentially, prior authorization . Assists the department in monitoring the utilization… more