- St. Luke's University Health Network (Allentown, PA)
- …regardless of a patient's ability to pay for health care. The Network Prior Authorization and Referral Specialist is responsible for the coordination of ... Provides insurance company with clinical information necessary to secure prior - authorization or referral + Works...Thank you for your interest in St. Luke's!! St. Luke's University Health Network is an Equal Opportunity Employer.… more
- 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 (Bethlehem, PA)
- …serve, regardless of a patient's ability to pay for health care. The Practice Prior Authorization and Referral Specialist is responsible for the coordination ... of prior -authorizations and referral process for patients being referred for specialty care,...scheduling, and referrals. The specialist will secure the necessary prior authorization , then notify the patient aiding… more
- UPMC (Pittsburgh, PA)
- …care for those suffering with neurological Conditions. **Responsibilities:** + Prior authorization responsibilities1. Reviews and interprets medical record ... UPMC system and insurance payor or contracted provider web sites to perform prior authorization , edit, and denial services.4. Utilize authorization resources… more
- UPMC (Lemoyne, PA)
- …+ Performs other duties as assigned by manager. + Utilizes electronic referral and authorization services as available. + Communicates with insurance ... able to work between 8:30am - 5:00pm and has prior experience with insurance referrals, verification and authorizations. If...to referrals and authorizations. + Maintains up to date referral and authorization guidelines and requirements from… 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 (Bethlehem, PA)
- …services. + Validates Third party coverage to assure appropriate financial database; obtains prior authorization for visits on an exception basis. + Develops and ... all programs of the Visiting Nurse Association of St. Luke's Hospital & Health Network to build and enhance relationships with referral sources and facilitate… 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)
- …providers and other community resources as requested, including completion of referral and authorization processes as appropriate. + Maintains professional ... of the discharge process. + Participates in reimbursement, certification and authorization related activities as directed. + Documents payer and authorization… 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)
- …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)
- …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)
- …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
- Kepro (Harrisburg, PA)
- …post-acute or rehabilitation environment required + Minimum of one year UR and/or Prior Authorization or related experience + Must be proficient in computer ... medical record documentation supports the need for services + Initiates a referral to the physician consultant and processes physician consultant decisions ensuring… more
- Apria (Harrisburg, PA)
- …**removal of Company equipment outside of the United States is not permitted without prior authorization .** If you feel this opportunity could be the next step ... recurring patient accounts to obtain the documentation from the referral source required to bill the individual health insurance...You excel in getting people involved and building a network of contacts that allow you to multiply your… more
- Highmark Health (Pittsburgh, PA)
- …more of the following processes (scheduling, pre-registration, financial clearance, authorization and referral validation and pre-serviceability estimations and ... **Company :** Allegheny Health Network **Job Description :** GENERAL OVERVIEW: This job...medical benefits and insurance information + Collects copays and prior balances and posts payment transactions. Does not calculate… more