- TEKsystems (Rochester, NY)
- …lines of business including Medicare D to determine what type of prior authorization review is required, documents any relevant medication history and ... Description: The Pharmacy Prior Authorization Technician performs functions as permitted by law including the initial level processing and review of prior … more
- Molina Healthcare (IA)
- …family include those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and ... NCQA guidelines, and CMS standards. + Provides coordination and processing of pharmacy prior authorization requests and/or appeals. + Explains Point of Sale… more
- Arnot Health (Elmira, NY)
- …prior anatomy education. Reports directly to the Central Scheduling/Pre- Authorization Supervisor. DUTIES AND RESPONSIBILITIES: COMMUNICATION: 1. Promptly answers ... receive the maximum reimbursement that is allowable. 9. Demonstrates knowledge of Medicare requirements for approved ICD-9 codes and to communicate to the provider… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *SUMMARY:* We are currently seeking a* Prior Authorization Representative Senior*to join our*Financial Securing*team. This full-time role will primarily work ... remotely (SHIFT: Days M-F). *Purpose of this position:*The Prior Authorization Specialist plays a key role...Verifies medical necessity in accordance with the Centers for Medicare & Medicaid Services (CMS) standards and communicates relevant… more
- UNC Health Care (Goldsboro, NC)
- …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...the EHR and updates referral statuses. Acts as a representative to complete referrals and financial information which serves… more
- Tidelands Health (Pawleys Island, SC)
- …responsible for accurate and complete insurance verification, financial clearance and prior authorization , and complete pre-registration of all scheduled ... least one (1) year of experience in Healthcare Revenue Cycle that includes prior authorization . **ADDITIONAL PREFERRED EXPERIENCE:** + Knowledge of CPT and ICD… 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 ... multiple resources for patient services. May also perform duties for prior authorization , referrals (incoming/outgoing), good faith estimates, and/or payment… 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 ... Two (2) years of experience in Healthcare Revenue Cycle that includes prior authorization . **KNOWLEDGE/SKILLS/ABILITIES** : * Ability to interact successfully… more
- Catholic Health Services (Melville, NY)
- …an online system to secure authorizations for scheduled procedures requiring an authorization , prior to the date of service. Responsibilities: Utilize work ... authorization is needed and understand payer specific criteria to appropriately secure authorization and clear the account prior to service where possible.… more
- St. Luke's University Health Network (Quakertown, PA)
- …their visit. + Responsible for contacting the SLPG practice or Network Prior Authorization Department to obtain required insurance referrals and pre-certs ... pay for health care. JOB SUMMARY The Patient Access Representative I is responsible for the entire scope of...prior to service to decrease denials for no authorization . + Must obtain Medical license Number, NPI and… more
- Sharp HealthCare (San Diego, CA)
- …**FTE** 1 **Shift Start Time** **Shift End Time** Certified Revenue Cycle Representative (CRCR) - HFMA; HS Diploma or Equivalent **Hours** **:** **Shift Start ... and Federal regulations governing registration/billing activities including JCAHO, Title XXII, Medicare and Medi-Cal regulations. ICD-9, and CPT 4 coding experience… more
- Catholic Health Services (Melville, NY)
- …explain benefit information, confirm patient responsibility amounts, and secure authorization for services. Scheduling Representative will communicate policies, ... authorization is needed and understand payer specific criteria to appropriately secure authorization and clear the account prior to service where possible.… more
- Surgery Care Affiliates (Fort Myers, FL)
- …individual payer websites to obtain eligibility, benefits and/or pre-certs and authorization information. + Enter the patient insurance information into patient ... center compliance with CMS Conditions for Coverage guidelines in contacting patient's prior to the date of service to review, Physician Ownership, Advance Directives… more
- US Tech Solutions (May, OK)
- …includes problem resolution, business writing, quality improvement and customer service **Skills:** Prior Authorization Medicare and Medicaid Call handling ... phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and...clients or lines of business and in accordance with Medicare Part D CMS Regulations. Must apply information provided… more
- Surgery Care Affiliates (New Albany, IN)
- …individual payer websites to obtain eligibility, benefits and/or pre-certs and authorization information. + Enter the patient insurance information into patient ... center compliance with CMS Conditions for Coverage guidelines in contacting patient's prior to the date of service to review, Physician Ownership, Advance Directives… more
- Trinity Health (Brighton, MI)
- …registration record. Communicates with patients their financial responsibility, benefit and authorization status prior to clinical services. Facilitate cash ... PURPOSE** Under limited supervision; determines need for and obtains authorization for treatment/procedures and assignment of benefits required. Provides...collection as appropriate prior to and at the time of service, including… more
- Tidelands Health (Georgetown, SC)
- …multiple resources for patient services. May also perform duties for prior authorization , referrals (incoming/outgoing), good faith estimates, and/or payment ... and forms completed including and not limited to the following: Medicare Secondary Payer Questionnaire, Advance Beneficiary Notice (ABN waiver), HIPAA Privacy… more
- Tufts Medicine (Lowell, MA)
- …under supervision. An entry level role that typically requires little to no prior knowledge or experience, work is routine or follows standard procedures, work is ... responsible for verifying patient insurance, confirming benefits eligibility, performing pre- authorization , pre-certification, and/or notification as required by third party… more
- TEKsystems (San Diego, CA)
- …inbound calls and some follow up calls Answers calls and questions on prior authorization , general questions and some confidential information Great customer ... Description: Customer service representative working in a call center environment Handling… more
- Spectrum Health Services (Philadelphia, PA)
- …+ Obtains patient's signature on health care forms (for example, Medicaid and Medicare Authorization Forms, etc.). + Scan patient's identification and insurance ... is the first point of contact for the organization. The Patient Service Representative must have interpersonal skills and critical thinking to be successful in this… more