- Fallon Health (Worcester, MA)
- …other applicable regulatory requirements, and customer expectations. The FH Authorization Coordinator serves to administer the FH prior authorization ... of Coverage, departmental policies and procedures, and regulatory standards. The Authorization Coordinator serves as a liaison between FH members… more
- Fallon Health (Worcester, MA)
- …of purpose** : Under the direction of the Manager of Prior Authorization , communicates with contracted and non-contracted facilities/agencies/providers to ... collect pertinent prior authorization request data and disseminates information...focus toward excellent customer service. In addition, the Service Coordinator will attain the targets for a customer service… more
- Evolent (Boston, MA)
- …years of experience in a Coordinator role either requesting or submitting prior authorization requests and/or relevant health care experience in claims or ... Stay for the culture. **What You'll Be Doing:** The ** Coordinator , Intake Utilization Management** at Evolent will serve as...will serve as a point of contact for processing prior authorization requests in accordance with departmental… more
- Boston Health Care for the Homeless Program (Boston, MA)
- …work with patients both in clinic and shelter settings. Responsibilities: Benefits Coordinator : + Primary provider of benefits assistance to all Family Team patients ... patients in obtaining the best available insurance type Administrative Coordinator : + Act as the primary Front Desk personnel...related field and/or have attained the requisite skills from prior work experience (1-2 years in a patient benefits… more
- Highmark Health (Boston, MA)
- …claims history, clearly defines the medical necessity of non-formulary and prior authorization medication exception requests. Interacts with pharmacy network ... Prioritize requests for drug authorizations or denials. + Review of prior authorization criteria for drug products. + Recommend staffing adjustments necessary to… more
- Beth Israel Lahey Health (Boston, MA)
- …advocating for the health of patients, families, and communities. The Nurse Coordinator is responsible for coordinating care for patients receiving treatment in a ... for patients from referral/consultation to discharge /follow up. Assists with pre- authorization process. Serves as contact and facilitator to receive consults and… more
- Tufts Medicine (Boston, 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
- Tufts Medicine (Boston, MA)
- …compliance/payroll, staffing, scheduling/core delivery, front desk operations, revenue capture, and prior authorization for patients as needed based on insurance ... coverage. 3. Acts as the first level "go-to person" for the clerical needs of the program including timesheets, office supply and check requests, managing mail and billing of contractees, developing, printing and dissemination of program fliers and family… more
- Beth Israel Lahey Health (Boston, MA)
- …for patients from referral/consultation to discharge /follow up. Assists with pre- authorization process. 2. Serves as contact and facilitator to receive consults ... Outlook, Word, Excel, PowerPoint or Access. **Preferred Qualifications:** 1. Prior experience in specialty service preferred. **Competencies:** 1. Decision Making:… more
- Beth Israel Lahey Health (Winchester, MA)
- …database under the direction of the Performance Improvement Coordinator . **Job Description:** **Qualifications** **Education/Experience Required:** + Associate's ... via internet and Epic such as health plan eligibility, PCP verification, prior referral history, etc. + Researches physician information such as health plan… more
- Boston Public Schools (Boston, MA)
- …of individual students. REPORTS TO: Home and Hospital Instruction, Program Coordinator RESPONSIBILITIES: + Thoroughly complete Scholastic Records for each student ... Follow the Home and Hospital Instructor Responsibilities list provided prior to the first tutoring assignment. + Maintain contact...+ Maintain contact with the guidance counselor, student support coordinator or the SESS coordinator from the… more
- Beth Israel Lahey Health (Westwood, MA)
- …and master an understanding of product and payer reimbursement landscape and prior authorization guidelines and processes. Collects and communicate all data ... needed to facilitate prior authorization approvals. Convey status updates as appropriate including information with appeals. + Provides exceptional customer… more
- Beth Israel Lahey Health (Boston, MA)
- …team members. **Essential Responsibilities:** + Obtains referrals required for patient prior to scheduled visits; maintains 100% compliance with referral management ... requirements and current knowledge base of referral and authorization rules and related policies for multiple insurance and managed care payers, including… more
- Lawrence General Hospital (Lawrence, MA)
- …utilizing Meditech assessment templates. + Provide clinical information needed for prior authorization to inpatient Behavioral Health facilities as needed. ... needs. + Work on collaboration with LGH staff, Behavioral Health Care Coordinator , and Technicians to develop an individualized comprehensive treatment plans and… more