- St. Luke's University Health Network (Orwigsburg, PA)
- …regardless of a patient's ability to pay for health care. The Network Prior Authorization and Referral Specialist is responsible for the coordination of ... Provides insurance company with clinical information necessary to secure prior - authorization or referral . + Works...Thank you for your interest in St. Luke's!! St. Luke's University Health Network is an Equal Opportunity Employer.… more
- ManpowerGroup (Austin, TX)
- …services in Texas. This is a non-clinical, **remote** -review role focused on ** prior authorization ** and **utilization management** -ideal for RNs who thrive in ... * Evaluate the medical necessity and appropriateness of outpatient and out-of- network services. * Collaborate with healthcare providers to ensure high-quality,… more
- St. Luke's University Health Network (Bethlehem, PA)
- …Acquire and submit all necessary clinical information to insurance company needed to obtain prior authorization in a timely fashion + Obtains knowledge of any ... we serve, regardless of a patient's ability to pay for health care. The Referral Scheduling Specialist is a liaison between the providers and the patients. They are… more
- HonorHealth (AZ)
- …to become proficient. Essential Functions Perform tasks related to the management of prior authorization for patients served by infusion clinics. Reviews medical ... a respectful demeanor. Facilitates problem solving with clinical departments, providers, referral sources, insurance companies and authorization staff. Assists… more
- Tufts Medicine (Stoneham, MA)
- …under supervision. An entry level role that typically requires little to no prior knowledge or experience, work is routine or follows standard procedures, work is ... under supervision. An entry level role that typically requires little to no prior knowledge or experience, work is routine or follows standard procedures, work is… more
- Luke Staffing (GU)
- …TRICARE benefit for approval. + Ensures Line of Duty paperwork is on file prior to authorization . + Verify eligibility of beneficiaries using Defense Eligibility ... **NURSE - REFERRAL MANAGEMENT** **SITE OF SERVICE:** + Anderson Air...communication between beneficiaries, team members, internal staff and providers, network /outside providers and ancillary health care workers. + Reviews… more
- Praxis Health (Bend, OR)
- …and we value our employees. Benefit Highlights: + Medical, Dental, Vision with In- Network & Custom Network discounts + 401(K) with discretionary employer match ... testing performed in house Duties of this position will include obtaining prior authorizations for services that are not customary plan benefits, calling on… more
- Pine Rest Christian Mental Health Services (Grand Rapids, MI)
- …behavioral health system in the country, our 220-acre main campus, and our network of clinical sites across Michigan. We are a tight-knit community of healers ... incredible work. What Will You Do?As an Assessment & Referral Clinician at Pine Rest, you'll be part of...including interfacing with insurance and managed care companies for authorization . + Refer patients to outpatient services, either within… more
- Pine Rest Christian Mental Health Services (Grand Rapids, MI)
- …behavioral health system in the country, our 220-acre main campus, and our network of clinical sites across Michigan. We are a tight-knit community of healers ... work. What Will you Do? As an Assessment & Referral Registered Nurse (ARRN) at Pine Rest, you'll be...including interfacing with insurance and managed care companies for authorization . + Refer patients to outpatient services within or… more
- University of Virginia (Charlottesville, VA)
- …Division of Radiation Oncology to include; compliance and charge capture, referral /medical necessity, denial management/data collection and follow up, and project ... department billing team, and preauthorization team to ensure accurate precertification/ authorization information is aligned with accurate billing of services. +… more
- Cambridge International Systems Inc (Norfolk, VA)
- Network Engineer - TS/SCI Clearance | Norfolk, VA Cambridge International Systems, Inc. Join a dynamic global team united by shared values: commitment, integrity, ... in defense and security. We are currently seeking a Network Engineer to support operations in Norfolk, VA. This...events in timely manner; test and validate virtual environment prior to test execution and provide troubleshooting support during… more
- St. Luke's University Health Network (Allentown, PA)
- …needs change, the services may be performed at any level within the Network 's continuum of services and/or sites. JOB DUTIES AND RESPONSIBILITIES: + Demonstrates ... care. + Arranges for community services (including short and long-term placement) prior to discharge to meet patient's needs with recognition and documentation of… more
- Bassett Healthcare (Oneonta, NY)
- …a go to person for coworkers. + Obtains prior approval or prior authorization as needed. Communicates referral appointment and appointment instructions ... point of contact for patients within the Bassett Healthcare Network . This is a key role in the patient...Medicare regulations. + Obtains prior approval or prior authorization as needed. Communicates referral… more
- Actalent (Tempe, AZ)
- Job Title: Pharmacy Technician Job Description Join our dynamic Prior Authorization Operations team as a Pharmacy Technician. You will be responsible for ... processing prior authorization requests while maintaining high standards...Life and Disability Insurance, Tuition Reimbursement, and an Employee Referral Bonus after the contract period. Job Type &… more
- Actalent (Tempe, AZ)
- Job Title: Remote Pharmacy Technician Job Description Join our Prior Authorization Operations team where you will play a crucial role in processing prior ... delivery of outstanding service and quality. Responsibilities + Process and finalize prior authorization requests within clients' turnaround time and performance… more
- CenterWell (Cheyenne, WY)
- …lead strategy and execution for our referral management and specialist network solutions, including prior authorization and related EMR-integrated ... Define and track KPIs related to referral throughput, network utilization, and prior authorization efficiency; use data to drive continuous improvement.… more
- Bassett Healthcare (Cooperstown, NY)
- …Patient Access Review Sessions (PARS) + Obtains prior approval or prior authorization as needed. Communicates referral appointment and appointment ... point of contact for patients within the Bassett Healthcare Network . This is a key role in the patient...urgent referrals same day. Processes electronic or written routine referral requests within 24-72 hours + In regards to… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- …and Veterans ready for discharge to a VA health care facility. Obtains clear referral information and authorization for VHA to treat those still on active ... duty, which will include the MTF Medical Records; VA Referral Form (entitled Military Treatment Facility Referral ...Liaison); Admission Sheet; Clinical and Consult Orders; or other authorization for VHA to provide services and bill TRICARE… more
- Actalent (Tempe, AZ)
- …+ Conduct clinical reviews, analyses, recommendations, decisions, and documentation of prior authorization requests, medical exception requests, and appeal ... drug information support and research clinical literature documentation to support prior authorization decisions. + Prepare Pharmacy and Therapeutics meeting… more
- Covenant Health Inc. (Knoxville, TN)
- …of Covenant Health (http://www.covenanthealth.com) , our region's top-performing healthcare network . Position Summary: The Clinical Field Staff Supervisor (CFSS) ... success of providing by effectively facilitating the relationship between referral sources, patients, caregivers and employees. Recruiter: Madeline Fornadel ||… more