- MaineGeneral Health (Waterville, ME)
- Job Summary:MaineGeneral Health is seeking an experienced Authorization Review Specialist to ensure the accuracy of inpatient and outpatient surgery prior ... + Experience: A minimum of 2 years of experience in surgical authorization review , surgical coding, or a related healthcare role is highly preferred. Familiarity… more
- Veterans Benefits Administration (St. Petersburg, FL)
- …Affairs, Regional Office (VARO), St. Petersburg Decision Review Operations Center. The Authorization Quality Review Specialist (AQRS) is an integral part ... of the Decision Review Operations Center's quality assurance program and is a...limited to: Performs individual quality reviews to determine the authorization quality level of individual VSRs for purposes of… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- **39493BR** **Extended Job Title:** Prior Authorization Specialist **Org Level 1:** Texas Tech Unv Hlth Sci Ctr El Paso **Position Description:** Responsible for ... + High school diploma or GED plus current certification as a Prior Authorization Certified Specialist (PACS), Certified Healthcare Access Associate (CHAA), or… more
- Ortho Sport and Spine Physicians (Atlanta, GA)
- Position Overview: We are seeking a highly organized and detail-oriented Pre- Authorization Specialist to join our team at Ortho Sport & Spine Physicians. This ... to providing exceptional patient support. Key Responsibilities: Submit and track authorization requests with insurance companies for procedures such as MRI, spine… more
- St. Luke's University Health Network (Allentown, PA)
- …for reviewing medical necessity of genetic testing/infusion services in addition to prior authorization to ensure revenue for services. + Monitors a ll hospital sch ... + Utilizes specific Epic Work Queues designed for Prior Authorization and Insurance Referral workflows to ensure correct process...and provide peer to peer info for scheduling. + Review payer medical policies and contact the health plan's… more
- Texas Health Action (Austin, TX)
- …throughout the state. Read more about THA here: http://texashealthaction.org. The Prior Authorization Specialist serves our Kind Clinics and Waterloo Counseling ... a week. Core Functions: + As a Prior Authorizations Specialist , you will be responsible for managing the prior...healthcare providers to gather necessary documentation and information + Review and submit prior authorization requests to… more
- Centene Corporation (Raleigh, NC)
- …and referrals in accordance with policies and guidelines + Supports the authorization review process by researching and documenting necessary medical information ... North Carolina.** **Position Purpose:** Acts as a resource and supports the prior authorization request process to ensure that all authorization requests are… more
- Baptist Memorial (Memphis, TN)
- Summary Authorization Denial Specialist ensures that chemotherapy (specialty group) and other infusions/radiation therapy/radiology/ surgical services meet ... education + Employee referral program Job Summary: Position: 18063 - Specialist - Authorization Denial Facility: BMHCC Corporate Office Department: HS Denial… more
- BrightSpring Health Services (Oklahoma City, OK)
- …Time Off & Holidays Responsibilities + Initiate, process, and oversee the clinical review of prior authorization requests for medication and supply, ensuring ... our growing network of branches and healthcare professionals. The Prior Authorizaton Specialist will be responsible for activities relating to the proper initiation,… more
- UNC Health Care (Goldsboro, NC)
- …and well-being of the unique communities we serve. Summary: The Pre- Arrival Authorization Specialist I will serve patients/customers and physician offices by ... payers electronically; call insurance companies as needed. 3. Initiates the authorization /precertification process for referrals in Epic. 4. Update the referral… more
- Actalent (St. Louis, MO)
- Prior Authorization Specialist Job Description Support a variety of outpatient clinics in a pharmacy prior authorization capacity. You will report to the ... submitted within a 30-minute timeframe, with the remaining 20% requiring more detailed review . + Work within EPIC in a shared queue environment. + Evaluate patients'… more
- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: The Authorization Specialist works with providers, patients, ancillary departments, pharmacy and insurance carriers to ensure that all information ... and insurance claim submission. Experience with healthcare insurance prior authorization /coding and performing insurance carrier/managed care review preferred.… more
- Fairview Health Services (St. Paul, MN)
- …and patients/guarantors. **Responsibilities Job Description** **Job Expectations:** + Review medical chart/history and physician order(s) to determine likely ... policies to determine if the service meets medical necessity guidelines. + Review and determine appropriate clinical documentation to submit to ensure a complete… more
- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: Review and maintain EPIC work queues. Communicate with insurance carriers via web, phone, and fax to obtain benefit and authorization requirements. ... procedures. Communicate with physician offices and facilities to notify of authorization status. Minimum Qualifications: High School degree or equivalent and two… more
- TEKsystems (Minneapolis, MN)
- …provided by the Patient Assistance Program. The PAC will coordinate review of all application documents conduct insurance investigations when applicable assess ... on contract Skills/Qualifications: + 5+ years of Insurance verification and prior authorization + 3+ years of healthcare call center experience + Experience bein… more
- Trinity Health (Syracuse, NY)
- …**EDUCATION, TRAINING, EXPERIENCE, CERTIFICATION AND LICENSURE:** Certified Coding Specialist , Accredited Record Technician (or eligible), Registered Record ... PC/CRT skills. Close visual/concentration efforts required (due to potential to review records continuously). Excellent communication skills, both oral and written,… more
- Spectrum Billing Solutions (Skokie, IL)
- …billing software). + Understanding of mental and behavioral health treatment services. Utilization Review Specialist | Utilization Management Specialist | UR ... information to ensure medical necessity and compliance of utilization review guidelines. + Obtain initial and continuing authorization...| UR Specialist | Revenue Cycle Utilization Review Specialist | ABA Utilization Review… more
- LA Care Health Plan (Los Angeles, CA)
- …safety net required to achieve that purpose. Job Summary The Supervisor, Authorization Technician supports the Utilization Management (UM) Specialist by handling ... Common Procedure Coding System (HCPCs) codes. Technical Support to UM Specialist : Processing of time sensitive authorization and pre-certification requests… more
- Westborough Behavioral Healthcare Hospital (Westborough, MA)
- …Employee Discount Program + Employee Assistance Program Job Description: The Utilization Review Specialist is responsible for monitoring adherence to the ... Westborough Behavioral Healthcare Hospital is looking for a UR Specialist to provide Per Diem coverage. Benefits Include +...hospital's utilization review plan to ensure the effective and efficient use… more
- Sanford Health (ND)
- …Collection of clinical information necessary to initiate commercial payor authorization . Obtain and maintain appropriate documentation concerning services in ... technology applications to insurance companies and contracted vendors to assure authorization for patients. May participate in providing assistance in financial aid… more