- Accounting Now (Tampa, FL)
- …medical records to support medical necessity) for a reconsideration, appeal, or retro authorization to the insurance carrier via payer portal, fax, etc Documents ... submit appeals or corrected claims in a timely manner. This position applies prior knowledge of denials to assess and ensure services/items billed are reasonable and… more
- 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
- 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
- Methodist Health System (Mansfield, TX)
- …professional responsible for verification of medical coverage, along with notification, prior authorization , and/or pre-determination of healthcare benefits for ... proposed medical services, to ensure reimbursement for rendered care. This position routinely works with...authorization and resolve issues that arise during the prior authorizations process. Supports and promotes the vision, mission,… more
- Trinity Health (Troy, 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
- Catholic Health Initiatives (Chattanooga, TN)
- …for insuring the necessary pre-certifications are obtained to receive proper reimbursement for scheduled cardiac imaging performed. Each case is evaluated ... necessity requirements are met. + Ensure timely updates of payer coverage. + Maintain vendor and payer ...for all cardiac imaging modalities. + Track and reconcile pre- authorization denials for process improvement. + Notify Manager/Director of… more
- University of Michigan (Ann Arbor, MI)
- …and obtaining prior authorizations for all Medicare, Medicaid and Third-Party payer equipment orders delivered by WSS. This includes but is not limited to ... Customer Service Representative Senior/Intermediate - Authorization Apply Now **How to Apply** A cover...3 years or more of experience in Complex Rehabilitation reimbursement /insurance coverage is desired. **Senior** + Experience working with… 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 (GA)
- …within targeted healthcare provider offices to assist healthcare professionals in resolving prior authorization and reimbursement issues that may be ... appropriate reimbursement and to support the company and divisional reimbursement strategy for Regeneron products within various payer segments. **A… more
- J&J Family of Companies (Gaithersburg, MD)
- …+ Reimbursement or relevant managed care experience (revenue cycle, buy-and-bill, prior authorization , coding, and appeals processes) + Ability to establish ... + Immunology disease state experience + Advanced degree and/or relevant certifications in prior authorization and/or billing and coding + Strong market access… more
- J&J Family of Companies (Raleigh, NC)
- …+ Reimbursement or relevant managed care experience (revenue cycle, buy-and-bill, prior authorization , coding, and appeals processes). + Ability to establish ... + Oncology disease state experience + Advanced degree and/or relevant certifications in prior authorization and/or billing and coding. + Strong market access… more
- J&J Family of Companies (OH)
- …* Reimbursement or relevant managed care experience (revenue cycle, buy-and-bill, prior authorization , coding, and appeals processes) * Ability to establish ... * Oncology disease state experience * Advanced degree and/or relevant certifications in prior authorization and/or billing and coding * Strong market access… more
- Regeneron Pharmaceuticals (Richmond, VA)
- … 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
