- Accounting Now (Tampa, FL)
- The Denials Specialist performs advanced-level work related to clinical and coding denial management and appeals follow-upThe individual is responsible for ... Denials Specialists to compile appropriate documentation and medical records to submit appeals or corrected claims in a timely mannerThis position applies prior… more
- Spectraforce Technologies Inc (Atlanta, GA)
- …on how to expedite patient access. Could include documenting and initiating prior authorization process, claims appeals , etc. Completes quality review of work as ... Title: Benefits Verification Specialist Location: Remote Duration: 3+ month's Working hours:...PA requirements, follow up with the insurance for prior authorization status, and communicate the results to the healthcare… more
- Spectraforce Technologies Inc (Atlanta, GA)
- Title: Patient Access Specialist Location: Remote Duration: 3+ month's Shift timings: 8:00 am - 8:00 pm EST Job Details: Complete data entry from the enrollment form ... handled. Collect PA requirements, follow up with the insurance for prior authorization status, and communicate the results to the healthcare provider. Conduct follow… more
- Dialysis Clinic, Inc. (Sacramento, CA)
- …setting with a lower caregiver-to-patient ratio than other providers.The AR Specialist will provide continual and accurate documentation regarding eligibility, ... authorization , and other insurance coverage information for assigned patients...well as sending out initial claims, corrected claims and appeals .Starting pay: $23.00/hr. This position is for the California… more
- Dexian - DISYS (Prairie Village, KS)
- …provided for a specific pharmaceutical product. The Benefits Verification Specialist will support the healthcare providers addressing questions regarding coding ... for Prior Authorizations (PA) for an assigned caseload and helps navigate the appeals process to access medications. Ensure cases move through the process as… more
- Compass Health Network (St. Charles, MO)
- …interest you, if running a Medication Clinic and acting as a case manager appeals to you! Our Compass Health Network Nursing Staff use the Compass "Champion" ... clientele. This role will actively communicate with their Clinical Doctor and Customer Relations Specialist to ensure our clients are taken care of. This is a full… more
- Compass Health Network (St. Charles, MO)
- …interest you, if running a Medication Clinic and acting as a case manager appeals to you! Our Compass Health Network Nursing Staff use the Compass "Champion" ... clientele. This role will actively communicate with their Clinical Doctor and Customer Relations Specialist to ensure our clients are taken care of. This is a full… more
- Carle (Urbana, IL)
- Outpatient Denial/ Appeals Specialist - RN + Department: Revenue Cycle - CFH_10_19 + Entity: Champaign-Urbana Service Area + Job Category: Clerical/Admin + ... documentation review to establish and manage clinical and prior authorization denial appeals for the Carle enterprise. Represents Carle in clinical meetings… more
- VNS Health (Manhattan, NY)
- OverviewResolves grievances, appeals and external reviews for one of the following VNS Health Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage ... appeal decision. Develops correspondence communicating the outcome of grievances and appeals to enrollees and/or providers. Assists with collecting and reporting… more
- US Tech Solutions (RI)
- **Job Title: Prior Authorization Specialist ** **Location: Fully remote** **Duration: 12 months contract** **Job Description:** + Prior Authorization ... courteous phone assistance to all callers through the criteria based prior authorization process. + Maintains complete, timely and accurate documentation of reviews.… 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 **Job Summary** Processes referrals and prior authorizations using established insurance company guidelines. Obtains ... employer. **Job Detail** **Job Opening ID** 254300 **Working Title** Prior Authorization Specialist **Job Title** Patient Services Intermediate **Work Location**… more
- US Tech Solutions (May, OK)
- …phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of reviews. Transfers ... assigned by the leadership team. Work closely with providers to process prior authorization (PA) and drug benefit exception requests for multiple clients or lines of… more
- Intermountain Health (Broomfield, CO)
- …and clinical information from the patient or representative. Details: As an Insurance Authorization Specialist you need to know how to: Verify the ordering ... Work daily reports to ensure all payer specific billing requirements and authorization requirements are met. Obtain and verify necessary demographic and billing… more
- G-TECH Services, Inc. (Detroit, MI)
- Support providers and reviewers with prior authorization requests for post-acute care services. Includes manually entering authorization requests into Care ... algorithms embedded in the care management system to administratively approve prior authorization requests. May work with providers to secure discharge plans, Notice… more
- CareOregon (Portland, OR)
- …of prior authorization and formulary exception decisions. + Perform prior authorization reviews with pharmacist oversight. Appeals and Grievances + Explain ... Arizona, Nevada, Texas, Montana, or Wisconsin. Job Title Pharmacy Benefit Specialist II Exemption Status Non-Exempt Department Pharmacy Manager Title Pharmacy… more
- Abbott (Orlando, FL)
- …requests for patient-specific LOA/SCAs either directly or indirectly by working with Authorization /LOA specialists. The VOB specialist will be required to work ... insurance companies and performs follow up activities to assist in obtaining prior authorization determinations. + Files appeals for denied benefits coverage to… more
- The Mount Sinai Health System (New York, NY)
- …all aspects of the concurrent review program, insurance certification, and authorization process for all Psychiatric or Chemical Dependency Inpatient Units (subject ... Develops ongoing relationships with insurance provider case managers to maximize authorization potential. Communicates with inpatient clinical staff to insure timely… more
- Abbott (Orlando, FL)
- …helping address some of the World's greatest healthcare challenges. The Authorization /LOA Specialist , Customer Service is responsible for contacting insurance ... secure and communicate authorization determinations in a timely manner. The Authorization / LOA specialist will be responsible for appealing adverse … more
- Hartford HealthCare (Hartford, CT)
- …specialties. *_ Job Description_* Under the direction of the Manager, a Prior Authorization Specialist performs all clerical duties required to obtain insurance ... Must have consistent documentation in EPIC to support the obtained insurance authorization . Will communicates changes in payer and or federal regulatory guidelines… more
