- Beacon Hill (Robinson Township, PA)
- …insurance coverage - Identify any payer coverage restrictions- Document prior authorization and appeals protocols- Communicate regularly with internal and ... external partiesRequirements:- 1+ year(s) of experience in a healthcare or call center based role - Previous experience working in benefits verification a plus- Excellent communication skills- Computer proficiencyTo get your foot in the door with this… more
- Spectraforce Technologies Inc (Atlanta, GA)
- …handled. Collect PA requirements, follow up with the insurance for prior authorization status, and communicate the results to the healthcare provider. Conduct follow ... and coding support. Claims assistance, tracking and submission. Prior authorization assistance and tracking. Coordination of benefits. Benefit verification result… more
- Catholic Health Services (Melville, NY)
- …discover why Catholic Health was named Long Island's Top Workplace! Job Details The Appeals and Authorization Representative will perform activities to help ... limited to the following: Review providers' requests for services and coordinate appeals management review. Generate an appeal letter to substantiate the medical… more
- Veterans Benefits Administration (Waco, TX)
- …is not a virtual position. Position Description/PD#: Veterans Service Representative ( Authorization Quality Review Specialist); 37136A Relocation/Recruitment ... Regional Office (VARO), Veterans Service Center and BEST. The Authorization Quality Review Specialist is an integral part of...the Pension and Fiduciary Service and the Court of Appeals for Veterans Claims are met or implemented. Work… more
- Fairview Health Services (St. Paul, MN)
- …are met per payor guidelines. They will provide support and process prior authorization appeals and denials, when necessary, in conjunction with revenue cycle ... Fairview at the highest benefit level. The Financial Clearance Representative (FCR) must be able to effectively articulate payor...fails. + Follow up with insurance payors on prior authorization denials. Process authorization denial appeals… more
- Intermountain Health (Broomfield, CO)
- …all necessary demographic, financial, and clinical information from the patient or representative . Details: As an Insurance Authorization Specialist you need to ... Work daily reports to ensure all payer specific billing requirements and authorization requirements are met. Obtain and verify necessary demographic and billing… more
- Carle (Urbana, IL)
- Accounts Receivable Representative 2 + Department: Patient Financial Services + Entity: Champaign-Urbana Service Area + Job Category: Clerical/Admin + Employment ... a Friend Save Save Apply Now Position Summary: The Accounts Receivable Representative 2 is proficient in Accounts Receivable Representative 1 responsibilities.… 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
- CVS Health (Austin, TX)
- …has an exciting opportunity for a Senior Representative within our Prior Authorization & Appeals Administration department. In this role, the Senior Rep will ... - 1 plus years of experience in the CVS Caremark Prior Authorization and Appeals Administration department - Must be considered in good attendance and… more
- Houston Methodist (Cypress, TX)
- At Houston Methodist, the Case Management Representative position is responsible for providing clerical assistance and data management support to the case management ... securing signatures on the form from the patient or their legal representative , and answering questions regarding the appeal process + Distributes the Medicare… more
- Molina Healthcare (Bowling Green, KY)
- …guidelines, and CMS standards. + Provides coordination and processing of pharmacy prior authorization requests and/or appeals . + Explains Point of Sale claims ... those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs… more
- Corewell Health (Grand Rapids, MI)
- …prior authorization has been obtained; assists with retroactive insurance denials/ appeals . + Responsible for complex EMR/EHR scanning and Right Fax faxing and ... Job Summary As a Patient Services Representative with Corewell Health, you'll play a vital...+ Ability to perform the role of Patient Services Representative , Associate when necessary. + Actively participates in safety… more
- Commonwealth Care Alliance (Boston, MA)
- …members and all those involved in CCA members' care. The Member Service Representative (MSR) is responsible to provide a best-in-class service experience to all ... appointments, transportation, translation, and interpretation services. + Initiates prior authorization intake process. + Assist in resolving member billing… more
- Premier Medical Group of the Hudson Valley (Poughkeepsie, NY)
- JOB DESCRIPTION JOB TITLE: Insurance Follow up Representative DEPARTMENT/DIVISION: Billing STATUS: Full-time, Non-Exempt REPORTS TO: Billing Manager POSITION ... SUMMARY: The Insurance Follow up Representative is responsible for collecting and resolving outstanding third...up for various insurance plans + Working denials, submitting appeals and corrected claims + Thorough knowledge and understanding… more
- Emanate Health (Covina, CA)
- …( authorization , admissions) through Patient Financial Services (billing, insurance appeals , collections) procedure and policies. Ability to communicate in a ... enter on master spreadsheet. Assist with monthly audits for Patient Account Representative II, address and resolve account escalations, provide training support to… more
- Corewell Health (Reed City, MI)
- …prior authorization has been obtained; assists with retroactive insurance denials/ appeals . + Responsible for complex EMR/EHR scanning and Right Fax faxing and ... maintenance gaps. + Ability to perform the role of Patient Services Representative , Associate when necessary. + Actively participates in safety initiatives and risk… more
- CommonSpirit Health Mountain Region (Frisco, CO)
- …about your success. Responsible for initiating and documenting insurance notification, authorization , and/or reference numbers for all patients within all facilities ... and Case Management personnel to assist with the follow- up on appeals , denials, answer inquiries and update accounts as necessary. Responsible for communicating… more
- Emanate Health (Covina, CA)
- …( authorization , admissions) through Patient Financial Services (billing, insurance appeals , collections) procedure and policies. Ability to communicate in a ... clear and professional manner, and must have good oral and written skills. Must have high time management and organizational skills, problem solving skills. Proficient in Microsoft word, excel, outlook and similar programs. c. Minimum License Requirement :… more
- UNC Health Care (Chapel Hill, NC)
- …for the accurate and timely submission of claims follow up, reconsideration and appeals , response to denials, and re-bills of insurance claims, and all aspects of ... of experience in hospital or physician insurance related activities ( Authorization , Billing, Follow-Up, Call-Center, or Collections) **Job Details** Legal Employer:… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …reports ensures that all expected charges are received from providers. Verifies authorization when required for patient visits, and verifies such numbers are present ... & written correspondence. Responsible for pulling medical records to submit with claims appeals and as required by payors. Assists with other related duties as… more
