- Harbor Health Services, Inc. (Mattapan, MA)
- …management including UM/CM, Grievance and Appeals, inpatient and outpatient services , medical policy, and clinical claims review In-depth experience of ... Harbor Health operates two Elder Service Plan Programs of All-Inclusive Care for the...Ensures timely responses to all requests related to medical review decisions and authorization issues from EOHHS,… more
- HCA Healthcare (Nashville, TN)
- …worth of each individual is recognized. Submit your application for the opportunity below: Inpatient Authorization Review Services SpecialistWork from ... 3% to 9% of pay (based on years of service ) + Employee Stock Purchase Plan with 10% off...benefits may vary by location._** We are seeking an Inpatient Authorization Review Services… more
- HCA Healthcare (Nashville, TN)
- …UT, VA). Do you want to join an organization that invests in you as an Inpatient Authorization Review Services Registered Nurse or Licensed Practical ... 3% to 9% of pay (based on years of service ) + Employee Stock Purchase Plan with 10% off...make a difference. We are looking for a dedicated Inpatient Authorization Review Services… more
- Molina Healthcare (Sparks, NV)
- …* At least 2 years experience, including experience in hospital acute care, inpatient review , prior authorization , managed care, or equivalent combination ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying...MCG guidelines. At least 2 years of experience with inpatient concurrent review , prior authorization … more
- Molina Healthcare (Akron, OH)
- …* At least 2 years experience, including experience in hospital acute care, inpatient review , prior authorization , managed care, or equivalent combination ... **JOB DESCRIPTION** Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Molina Healthcare (Yonkers, NY)
- …* At least 2 years experience, including experience in hospital acute care, inpatient review , prior authorization , managed care, or equivalent combination ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Molina Healthcare (Orem, UT)
- …* At least 2 years experience, including experience in hospital acute care, inpatient review , prior authorization , managed care, or equivalent combination ... and medical coding. JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that … more
- Molina Healthcare (North Las Vegas, NV)
- …* At least 2 years experience, including experience in hospital acute care, inpatient review , prior authorization , managed care, or equivalent combination ... residents preferred.** JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that … more
- Molina Healthcare (Fort Worth, TX)
- …Required Qualifications * At least 2 years experience in a hospital acute care, inpatient review , prior authorization , and/or managed care setting, or ... before you apply to this role. Job Summary Provides support for member services review assessment activities for a specific area of specialty. Responsible… more
- Molina Healthcare (AZ)
- …to plan members. * Provides leadership and expertise in performance of prior authorization , inpatient concurrent review , discharge planning, care management ... directors delivering oversight and expertise in appropriateness and medical necessity of services provided to members - ensuring members receive the most appropriate… more
- Cedars-Sinai (Beverly Hills, CA)
- …assessing their needs, coordinating care, communicating with health plans, including concurrent review to determine the appropriateness of services rendered and ... for continued review and follow up. + Authorizes all appropriate services based upon covered benefits and necessity of care provided. + Coordinates discharge… more
- Bozeman Health (Bozeman, MT)
- …patients and participation as a member of the nursing care team in direct services to patients. The Tele-Companion is responsible for the safety of a patient ... may also include but are not limited to performance of chart review , pre-visit planning, patient intake, production and management of schedule tracking and… more
- Mount Sinai Health System (New York, NY)
- …routine meetings with health system business leaders and managed care teams to review authorization performance, payer issues, and denials. . Build effective, ... **Job Description** **Director of Authorization -Patient Financial Services Mount Sinai Health...Cycle Management team, responsible for overseeing all aspects of authorization across the healthcare system. This includes inpatient… more
- Select Medical (Oklahoma City, OK)
- …insurance verification? Read more to unlock your future career!_** Our inpatient rehabilitation hospital is committed to providing exceptional and compassionate care ... partnership between Select Medical and SSM Health. This hospital provides inpatient physical rehabilitation for patients who are medically complex and in… more
- Carle Health (Urbana, IL)
- …completion of the Carle Phlebotomy in Training Program.The Hospital Phlebotomy team services the patients at Carle Foundation Hospital. This team serves patients ... from newborn to geriatric in the Emergency Department and all inpatient and outpatient areas of the hospital. The Hospital Phlebotomy team works closely with a… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …to promote cost savings. Supports and promotes cost-savings initiatives. Engages in review of medication insurance authorization status as applicable. + ... or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services , veteran status or any other… more
- Beth Israel Lahey Health (Boston, MA)
- …care relative to physical diagnosis and therapeutic management in an inpatient setting to patients with complex medical conditions, specifically patients with ... a clinical resource for staff through consultation formal and informal education, review of literature and participation in seminars and conferences. 3. Coordinates… more
- University of Utah Health (Salt Lake City, UT)
- …authorize the visit. + Secures prior authorization for high dollar services such as scheduled day surgeries, planned inpatient admissions, urgent admissions, ... verification, obtaining benefit information, calculating patient estimates and obtaining prior authorization before services are rendered. This position works… more
- Rush University Medical Center (Chicago, IL)
- …depending on the circumstances of each case. **Summary:** The Prior Authorization Specialist I is responsible for obtaining and resolving referral, precertification, ... and/or prior authorization to support insurance specific plan requirements for all...for all commercial, government and other payors across hospital ( inpatient & outpatient), ED, ancillary and clinic/ambulatory environments. In… more
- Fallon Health (Worcester, MA)
- …care providers as needed for the clinical review process * Conducts pre- authorization and concurrent clinical reviews requests for services such as DME, ... summary of purpose:** The PA Nurse uses a multidisciplinary approach to review service requests (prior-authorizations), focusing on selected complex medical and… more
