- 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 ... Responsible for reviewing medical necessity of genetic testing/infusion services in addition to prior authorization to ensure revenue for services. + Monitors a… more
- St. Luke's University Health Network (Allentown, PA)
- …Acquire and submit all necessary clinical information to insurance company needed to obtain prior authorization in a timely fashion + Obtains knowledge of any ... we serve, regardless of a patient's ability to pay for health care. The Referral Coordinator is a liaison between the providers and the patients. They are… more
- Lancaster General Health (Lancaster, PA)
- …and Referrals. Must be knowledgeable in all areas of insurance verification and authorization / referral processes. + Maintain accurate and current referral ... to patient what their insurance company requires to meet referral / authorization compliance. + Must have the ability...to patients who have not been seen within the prior 18 months at their LGHP PCP office and… more
- Lancaster General Health (Lancaster, PA)
- …and Referrals. Must be knowledgeable in all areas of insurance verification and authorization / referral processes. + Maintain accurate and current referral ... to patient what their insurance company requires to meet referral / authorization compliance. + Must have the ability...to patients who have not been seen within the prior 18 months at their LGHP PCP office and… more
- St. Luke's University Health Network (Allentown, PA)
- …needs change, the services may be performed at any level within the Network 's continuum of services and/or sites. JOB DUTIES AND RESPONSIBILITIES: + Demonstrates ... care. + Arranges for community services (including short and long-term placement) prior to discharge to meet patient's needs with recognition and documentation of… more
- Lancaster General Health (Lancaster, PA)
- …patient, guarantor, coverage and hospital account information. Performs required referral / authorization processes and enters orders for applicable tests. ... + Understands insurance company coverage and referral / authorization requirements of payors. Performs electronic and...yearly competency evaluation and training). + One (1) year prior experience of Revenue Cycle in a Hospital/Medical Office… more
- Lancaster General Health (Lancaster, PA)
- …patient, guarantor, coverage and hospital account information. Performs required referral / authorization processes and enters orders for applicable tests. ... + Understands insurance company coverage and referral / authorization requirements of payors. Performs electronic and...guidelines and order release process(es). + One (1) year prior experience of Revenue Cycle in a Hospital/Medical Office… more
- Lancaster General Health (Lancaster, PA)
- …patient, guarantor, coverage and hospital account information. Performs required referral / authorization processes and enters orders for applicable tests. ... + Understands insurance company coverage and referral / authorization requirements of payors. Performs electronic and...guidelines and order release process(es). + One (1) year prior experience of Revenue Cycle in a Hospital/Medical Office… more
- Lancaster General Health (Lancaster, PA)
- …and Referrals. Must be knowledgeable in all areas of insurance verification and authorization / referral processes. + Serve as liaison for patient with doctor ... explain to patient what their insurance company requires to meet referral / authorization compliance. **SECONDARY FUNCTIONS:** **The following duties are… more
- Lancaster General Health (Lancaster, PA)
- …and Referrals. Must be knowledgeable in all areas of insurance verification and authorization / referral processes. + Serve as liaison for patient with doctor ... explain to patient what their insurance company requires to meet referral / authorization compliance. **SECONDARY FUNCTIONS:** **The following duties are… more
- Lancaster General Health (Lancaster, PA)
- …patient, guarantor, coverage and hospital account information. Performs required referral / authorization processes and enters orders for applicable tests. ... + Understands insurance company coverage and referral / authorization requirements of payors. Performs electronic and...guidelines and order release process(es). + One (1) year prior experience of Revenue Cycle in a Hospital/Medical Office… more
- Lancaster General Health (Lancaster, PA)
- …a comprehensive understanding of practice operations including: scheduling; registration; authorization / referral and billing/coding functions. + Ensure smooth ... Practice Manger position start date. Current Practice Managers hired prior to 7/1/2021 are grandfathered and must have a...MEDICINE LANCASTER GENERAL HEALTH as a result of the referral or through other means. PENN MEDICINE LANCASTER GENERAL… more
- Lancaster General Health (Lancaster, PA)
- …working in a surgical office or as a surgical scheduler. + Prior pre- authorization experience. + Bi-lingual (Spanish). + Insurance pre-certification experience. ... that all patient consents are available in the chart prior to the day of the procedure. + Reviews...MEDICINE LANCASTER GENERAL HEALTH as a result of the referral or through other means. PENN MEDICINE LANCASTER GENERAL… more
- Merck (West Point, PA)
- …brand operating metrics. VCM PM will help the SCWG/ VCMT to serve as a network level escalation team, to manage issues and risks escalated from sites and functions ... that require network level responses and communications. This is a highly...business case/NPV analysis, product COGS interrogation and effective risk authorization stewardship. + Understanding of product commercial strategy to… more
- Merck (West Point, PA)
- …Additionally, the VCM PL will lead the SCWG/ VCMT to serve as a network level escalation team, to manage issues and risks escalated from sites and functions ... that require network level responses and communications. The VCM PL will...business case/NPV analysis, product COGS interrogation and effective risk authorization stewardship + Understanding of product commercial strategy to… more
- Lancaster General Health (Lancaster, PA)
- …into the computer system + Determine whether an appointment will require an insurance referral or authorization (and enter into system upon receipt) to ensure ... electronic medical record experience + One (1) year of prior revenue cycle in a medical office or hospital...MEDICINE LANCASTER GENERAL HEALTH as a result of the referral or through other means. PENN MEDICINE LANCASTER GENERAL… more
- Lancaster General Health (Lancaster, PA)
- …available risk management models and decision trees to determine risk and prior probabilities for patients seeking genetic testing. + Collaborates with medical team ... and privacy of patients. + Assists patients with insurance reimbursement and pre- authorization for each genetic test ordered and including appropriate proof of… more