- 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
- 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
- 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
- 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
- Hackensack Meridian Health (Belle Mead, NJ)
- …to ensure the procedure is a covered service under the patients plan prior to receiving services. + Verifies pre- authorization requirements and follows up ... all Medicare, Medicaid and managed care patients to identify network status and coordination of benefits. Obtains all applicable...prior to the date of service. + Verifies pre- authorization requirements and follows up with both the referring… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …processes, resources and systems in support of patient assistance programs (incl. prior authorization , voucher and copay programs) and carries out analytical ... prepare reports and conduct analyses across multiple programs (eg, prior authorization , voucher and copay programs) *...The internal career site is available from your home network as well. If you have trouble accessing your… more
- Cardinal Health (Trenton, NJ)
- … intake, investigating all patient health insurance benefits, identifying & initiating prior authorization and step therapy reviews, proactively following up ... experience conducting and documenting patient health insurance benefit investigations, prior authorizations, and appeals, preferred + Knowledge of Medicare, Medicaid… more
- Cardinal Health (Trenton, NJ)
- …and/or Medical Claims billing and Coding work experience * 1-2 years' experience with Prior Authorization and Appeal submissions * Ability to work with high ... of their patient journey to therapy. These steps include patient referral intake, investigating all patient health insurance benefits, and proactively following… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …Center, Raritan Bay Medical Center Behavioral Health and other HMH Network Behavioral Health. Manages case pre-admission, including requests for medical records ... and other clinical information as required prior to evaluation. Helps make proper referrals when appropriate....assessment. + Notifies units of pending admissions. + Performs pre-certification/ authorization reviews with payers in the absence of a… more
- The Center for Great Expectations (Somerset, NJ)
- …individual and team goals and objectives established by supervisor based on prior performance evaluation. 6.) Comply with HIPAA guidelines regarding client rights ... family counseling to address trauma and co-occurring mental health disorders; provide referral to higher level of care when necessary. + Maintain Performcare… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …Patient Journey from enrollment, to benefit verification through final approval including prior authorization management, and into appropriate pharmacy fill & ... The internal career site is available from your home network as well. If you have trouble accessing your...by our company as a result of an agency referral where no pre-existing agreement is in place. Where… more