- St. Luke's University Health Network (Allentown, PA)
- …PCP and Specialty service lines. + Utilizes specific Epic Work Queues designed for Prior Authorization and Insurance Referral workflows to ensure correct ... for reviewing medical necessity of genetic testing/infusion services in addition to prior authorization to ensure revenue for services. + Monitors a ll hospital… more
- University of Rochester (Rochester, NY)
- POSITION SUMMARY: Serves as the patient referral and prior authorization specialist , with oversight of data and compliance to enterprise standards and ... referral and prior authorization guidelines....required for testing and services ordered by referred to specialist includes, preparing and providing multiple, complex details to… more
- Glens Falls Hospital (Glens Falls, NY)
- …career at Glens Falls Hospital! Come join our team of insurance experts as the Referral & Authorization Specialist ! This position can further develop your ... 30 hours per week, can be found here. **Job:** **Administrative/Clerical* **Title:** * Referral & Authorization Specialist * **Location:** *NY-Glens Falls*… more
- Glens Falls Hospital (Glens Falls, NY)
- …career at Glens Falls Hospital! Come join our team of insurance experts as the Referral & Authorization Specialist ! This position can further develop your ... at least 30 hours per week, can be found here. **Job:** **Administrative/Clerical* **Title:** * Referral & Authorization Specialist - Cancer Center - Medical… more
- Atlantic Health System (Morristown, NJ)
- Overview: We are seeking a skilled Medical Prior Authorization Specialist to join our team. The ideal candidate will be responsible for obtaining prior ... entire authorization process. Responsibilities: 1. Initiate and manage the prior authorization process for all obstetrical patients and gynecological… more
- Children's Clinics (Tucson, AZ)
- Children's Clinics is seeking a Full-Time Prior Authorization Specialist . As a member of the dynamic Prior Authorization team the individual will ... Must have thorough knowledge of AHCCCS, CRS and third party insurance prior authorization and referral guidelines + Experience in precertification, referrals… more
- UPMC (Pittsburgh, PA)
- **UPMC University of Pittsburgh Physicians is hiring a full-time Authorization Specialist to join their team at the** Heart Vascular Institute at CHP! This ... all work is to conform. The expertise of the Authorization Specialist shall include working knowledge in...of UPMC in the performance of duties. **Responsibilities:** + Prior authorization responsibilities1. Reviews and interprets medical… more
- UPMC (Pittsburgh, PA)
- University of Pittsburgh Physicians is hiring a full-time Authorization Specialist to support UPMC Vision Institute, Mercy Pavilion. This role will work Monday ... occur to limit the ability to work remotely. Responsibilities: + Prior authorization responsibilities1. Reviews and interprets medical record documentation… more
- UPMC (Pittsburgh, PA)
- **UPMC Department of Plastic Surgery is hiring a Part-Time Authorization Specialist . This is a Monday-Friday, daylight position. No nights, weekends, or ... holidays!** **Responsibilities:** + Prior authorization responsibilities: 1. Reviews and interprets...using ICD-9-CM, CPT, and HCPCS Level II. 4. Provides referral /pre-notification/ authorization services timely to avoid unnecessary delays… more
- Centene Corporation (Tallahassee, FL)
- …**Position Purpose:** Works with the utilization management team and supports the prior authorization request process to ensure that all authorization ... and maintains authorization requests for services in accordance with the insurance prior authorization list and routes to the appropriate clinical reviewer +… more
- Centene Corporation (Tallahassee, FL)
- …extended schedule including nights, weekends and holidays**_** **Position Purpose:** Leads the prior authorization request process to ensure work queue is ... with policies and procedures + Develops in-depth knowledge of prior authorization review process and insurance coverage...such as history, diagnosis, and prognosis based on the referral to the clinical reviewer for determination + Assists… more
- Baptist Memorial (Memphis, TN)
- …+ Employee referral program Job Summary: Position: 18063 - Specialist - Authorization Denial Facility: BMHCC Corporate Office Department: HS Denial Mitigation ... Summary Authorization Denial Specialist ensures that chemotherapy...per insurance medical policies/ FDA/NCCN guidelines. Initiates and coordinates pre-certifications/ prior -authorizations per payer guidelines prior to services… more
- Centene Corporation (Tallahassee, FL)
- …with a weekend rotation **Position Purpose:** Acts as a resource and supports the prior authorization request process to ensure that all authorization ... such as history, diagnosis, and prognosis based on the referral to the clinical reviewer for determination + Verifies... requests for services in accordance with the insurance prior authorization list and routes to the… more
- University of Rochester (Rochester, NY)
- Responsibilities **Position Summary** Serves as the patient referral and prior authorization specialist , with oversight of data and compliance to ... enterprise standards and referral and prior authorization guidelines....required for testing and services ordered by referred to specialist includes, preparing and providing multiple, complex details to… more
- UNC Health Care (Goldsboro, NC)
- …and well-being of the unique communities we serve. Summary: The Pre- Arrival Authorization Specialist I will serve patients/customers and physician offices by ... obtaining authorizations from insurance payers prior to services been scheduled or rendered at UNC Health Wayne for outpatient & inpatient visits. Obtains insurance… more
- UPMC (Lancaster, PA)
- …for authorization , if applicable. + Sends appointment request to specialist with appropriate patient records. Processes insurance referral if applicable. ... Referral team is looking for a Central Insurance Referral Specialist to join their fast-paced team...other duties as assigned by manager. + Utilizes electronic referral and authorization services as available. +… more
- Banner Health (Glendale, AZ)
- …clinical information needed for the payor authorization and the facility or specialist prior to the services being rendered. The position is responsible for ... you. Apply now. This position is responsible for coordinating referral orders for a continuation of treatment, such as...the payor authorization and the facility or specialist prior to the services being rendered.… more
- Banner Health (Mesa, AZ)
- …clinical information needed for the payor authorization and the facility or specialist prior to the services being rendered. The position is responsible for ... you. Apply now. This position is responsible for coordinating referral orders for a continuation of treatment, such as...the payor authorization and the facility or specialist prior to the services being rendered.… more
- Chenega Corporation (NM)
- …Services** ' company, is looking for a fully remote ** Referral Specialist ** to ensure accuracy and completion of authorization data from customer ... information, medical records, referral / authorization forms, Military Treatment Facility electronic transmission and other documents into medical management… more
- Northern Light Health (Fort Fairfield, ME)
- …timely. They assist with insurance prior authorizations. The role of the referral specialist is critical to assure that every patient receives the definitive ... care that they need. A major role of the Referral Specialist is to communicate progress of...current knowledge of various insurance processes necessary to obtain prior authorization ; follows Prior … more
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