- Commonwealth Care Alliance (Boston, MA)
- …Duties & Responsibilities:** + Conducts timely clinical decision review for services requiring prior authorization in a variety of clinical areas, including but ... **Required Knowledge, Skills & Abilities (must have):** + Experience with prior authorization and retrospective reviews + Proficiency reviewing clinical/medical… more
- Tidelands Health (Myrtle Beach, SC)
- …responsible for accurate and complete insurance verification, financial clearance and prior authorization , and complete pre-registration of all scheduled ... least two (2) years of experience in Healthcare Revenue Cycle that includes prior authorization . **Skills and Abilities** + Ability to interact successfully with… 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 ... identifying deductibles, copayments, coinsurance, and policy limitations. Obtains referral, authorization and pre-certification information if needed; documents this information… more
- Stanford Health Care (Palo Alto, CA)
- …Proficiency In At Least ONE of the Following Specialized Functions:- Medication Prior Authorization - Specialized Data Collection & Coordination- Cross-trained to ... is accurate, and assist with general questions about appointments, authorization , payments, billing, and schedules.- Patient Escalations: Seek, Identifies, and… 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 ... + Assisting with procedures. + Preparing and administering medications with physician's authorization , + Performing EKGs. + Using CPR skills when required. + Drawing… more
- BroadPath Healthcare Solutions (Tucson, AZ)
- …claims + Generate emergency reports and authorizations for claims that lack prior authorization + Adjudicate third-party liability and coordination of benefit ... knowledge of plan contracts, provider pricing, member eligibility, referral authorization procedures, benefit plans, and capitation arrangements + Ensure correct… more
- UTMB Health (Webster, TX)
- …of immunizations Works with patients, providers, and payers to obtain prior authorization Resolves billing/adjudication issues encountered in the processing ... of prescription Proficient in the use of financial assistance software Proficient in C2 safe operation and/or OR anesthesia narcotic reconciliation Advanced skill in the use of technology within area of assignment Works with leaders and team members to solve… more
- BroadPath Healthcare Solutions (Tucson, AZ)
- …and UM protocols to confirm member and provider details when evaluating prior authorization and appeal submissions _Responsibility D: Participates in quality ... to detail **Preferred:** + 2+ years of direct experience with UM Prior Authorizations, Appeals, Fair Hearings and External Medical Review + Community Health… more
- Peoples Home Health, LLC (Pensacola, FL)
- …insurance policy benefits to accurately reflect coverage amounts and Client co-pay ( prior approval of insurance authorization ). The Intake Specialist must be ... to discuss and relay appropriate clinical information to obtain authorization for Home Care Services. They are also responsible...an accredited LPN program. Minimum three (3) years of prior experience in a medical field or medical office… more
- Stony Brook University (Stony Brook, NY)
- …with the transferring hospital, Patient Access and physicians and payers for authorization prior to transfer from other hospitals. + Consistent documentation ... of care from initial assess point. Follows cases for authorization for in patient stay. + Staff review short...Brook Medicine, Stony Brook University Hospital and related facilities. ** Prior to start date, the selected candidate must meet… more
- Moses/Weitzman Health System (Hartford, CT)
- …by laws in a timely manner, included by not limited to intake, prior authorization request, progress notes, treatment plan documentation, and discharge. + ... Completes and locks all treatment notes no later than the end of the next business day. + Completes reports as required for outside agencies such as DCF, Family Relations, probation, and others with appropriate releases signed by clients. + Participates as a… more
- Stanford Health Care (San Jose, CA)
- …logs for cardiac medication management + Monitor, initiate and submits electronic prior authorization for cardiac medications **Education Qualifications** + High ... School Diploma or GED equivalent + Medical AssistantCertificate/Diploma from an approved school/institution or equivalent documented training/experience **Experience Qualifications** + At least four years of overall experience (Including external experience).… more
- Highland Hospital (Rochester, NY)
- …who is unavailable + Complete clinical documentation, forms/paperwork requested by patients, prior authorization appeals, sign home care orders + Coordinate with ... other providers, home care and hospice teams, and pharmacies + Assist in development of practice, community outreach, educational materials, ect Duties may include presentations + Maintain professional credentials to allow for uninterrupted billing and… more
- Olympus Corporation of the Americas (Center Valley, PA)
- …the office and other settings of care. Educate customer about appropriate billing, prior authorization and denial resolution steps. + Provide customers with ... guidance on payer decision-making process including coverage policies and guidelines. + Educate customers about the benefit of Olympus Reimbursement support services and programs and steps to facilitate participation. + Assure consistent communication and… more
- Moses/Weitzman Health System (Portland, CT)
- …by laws in a timely manner, included by not limited to intake, prior authorization request, progress notes, treatment plan documentation, and discharge. + ... Completes and locks all treatment notes no later than the end of the next business day. + Completes reports as required for outside agencies such as DCF, Family Relations, probation, and others with appropriate releases signed by clients. + Participates as a… more
- Christus Health (Elkhart, TX)
- …firearms training, weapon qualification, and firearms retention training must be completed prior to letter of authorization to carry is issued Successful ... the TDPSPSB security commission course must obtain their commission prior to hire. If the license status is ACTIVE...40 hours of training and receiving a letter of authorization from the CHRISTUS Vice President of Security to… more
- Luke Staffing (Yigo, GU)
- …TRICARE benefit for approval. + Ensures Line of Duty paperwork is on file prior to authorization . + Verify eligibility of beneficiaries using Defense Eligibility ... Enrollment Reporting System (DEERS) and initiates/coordinate communication between beneficiaries, team members, internal staff and providers, network/outside providers and ancillary health care workers. + Reviews and enters first right of refusal referrals… more
- Caris Life Sciences (Irving, TX)
- …manage the Eligibility team, ensuring accurate and timely insurance verification, prior authorizations, and benefit assessments. + Develop and monitor team ... performance metrics, ensuring goals are met for turnaround time, accuracy, and payer compliance. + Collaborate with payers to resolve eligibility discrepancies, denials, and escalations. + Work closely with Revenue Cycle leadership to identify trends, gaps,… more
- Principal Financial Group (New York, NY)
- …made us a trusted leader for more than 140 years! **Who You Are** + Prior experience in Asset Management. + Bachelor's degree in Business, Finance, or related field; ... IA or Chicago, IL, or New York, NY. **Work Authorization /Sponsorship** At this time, we're not considering applicants that...that need any type of immigration sponsorship (additional work authorization or permanent work authorization ) now or… more
- Applied Research Solutions (Bedford, MA)
- …in accordance with security policies and procedures as outlined in the security authorization package; + Maintain equivalent IAM Level 2 certifications based off of ... + Ensure all users have the requisite security clearances, authorization , need-to-know, and are aware of their security responsibilities...firmware of a system with the ISSM and AO/DAO prior to the change; + Formally notify the ISSM… more
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