- Froedtert South (Kenosha, WI)
- Prior Authorization / Referral Specialist Froedtert South Kenosha, WI (Onsite) Full-Time Apply Now Job Details Position Purpose: A Pre- Authorization / ... are in place prior to services being rendered + Notifies patient/department when authorization / referral has not been obtained prior to service date #ind1… more
- HonorHealth (Phoenix, AZ)
- …as necessary to become proficient. Perform tasks related to the management of prior authorization for patients served by infusion clinics. Reviews medical ... a respectful demeanor. Facilitates problem solving with clinical departments, providers, referral sources, insurance companies and authorization staff. Assists… more
- Hackensack Meridian Health (Neptune, 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
- Guthrie (Johnson City, NY)
- …and within required timeframes and assuring referrals are maintained within appropriate network and/or payer requirement.| Remains current on referral policies ... are not authorized by insurance. Education: High school diploma and prior experience with insurance authorization The pay range for this position is $17.00 -… more
- Chenega Corporation (NM)
- …remote ** Referral Specialist** to ensure accuracy and completion of authorization data from customer information, medical records, referral / authorization ... document contents to ensure accuracy and to correct inconsistencies. Prioritizes referral / authorization submissions and forwards documents to appropriate parties… 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
- Hartford HealthCare (Farmington, CT)
- …different specialties. *_ Job Description_* Under the direction of the Manager, a Prior Authorization Specialist performs all clerical duties required to obtain ... you to become part of Connecticut's most comprehensive healthcare network . Hartford HealthCare Medical Group is one of the...clinical departments, as applicable. . Monitors and reviews the prior authorization work queue daily to verify… more
- Praxis Health (Canby, OR)
- …years of experience in a medical office setting and a background in insurance authorization and scheduling. Duties of this position will include obtaining prior ... and we value our employees. Benefit Highlights: + Medical, Dental, Vision with In- Network & Custom Network discounts + 401(K) with discretionary employer match… more
- Sanford Health (Sioux Falls, SD)
- …regulations and internal policies that effect resource utilization and potentially, prior authorization . Assists the department in monitoring the utilization ... Summary** Communicate with providers and/or members regarding management of out-of- network exception requests. Provide care coordination for designated Health Plan… more
- Cambridge International Systems Inc (Doral, FL)
- …International Systems, Inc. has a full-time Department of Defense Information Network (DoDIN) Operations Lead opportunity available based in Doral, FL. Qualified ... Command has an exciting, challenging opportunity for someone versed in DoD network infrastructure and architecture. Person hired for our Department of Defense… more
- Health Advocates Network (Folsom, CA)
- Health Advocates Network is hiring a **Denials Analyst** **(2 Years Exp Req)** ! This is a full-time contract position at a nationally recognized hospital located in ... a Library of Payer reference material regarding requirements for pre- authorization , medical necessity, and documentation requirements. Works with the Revenue… 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 (Hackensack, NJ)
- …by the ABN advance beneficiary notice in alignment with Medicare guidelines. + Document prior authorization requirements in each referral by each CPT or ... in the HMH Health care system. This pertains to Prior Authorization for Oncology services, as well...to Hackensack Meridian Oncology/Radiation standards and protocols within the network . + Submits all referral information to… more
- Veterans Affairs, Veterans Health Administration (Grand Junction, CO)
- …when a signed, written request is received, or upon the Veteran's valid authorization to a third party. Responsibilities -Evaluates the adequacy of each completed ... authorization form. -Screens each request for information to determine...of records containing information regarding the treatment of or referral for drug and/or alcohol abuse, Sickle Cell Anemia… more
- Bassett Healthcare (Cooperstown, NY)
- …is a go to person for coworkers. Obtains prior approval or prior authorization as needed. Communicates referral appointment and appointment instructions ... point of contact for patients within the Bassett Healthcare Network . This is a key role in the patient...urgent referrals same day. Processes electronic or written routine referral requests within 24-72 hours In regard to referrals,… more
- Sharp HealthCare (San Diego, CA)
- …guidelines to approve referral requests as outlined in the SCMG prior authorization document and desktop procedures.Research and assist in the benefit ... Microsoft Word and Excel certification preferred. **Essential Functions** + Prior Authorization Obtain necessary medical/clinical information utilizing multiple… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- …and Veterans ready for discharge to a VA health care facility. Obtains clear referral information and authorization for VHA to treat those still on active ... duty, which will include the MTF Medical Records; VA Referral Form (entitled Military Treatment Facility Referral ...Liaison); Admission Sheet; Clinical and Consult Orders; or other authorization for VHA to provide services and bill TRICARE… more
- AdventHealth (Denver, CO)
- …ongoing, new, or altered. After gathering clinical information, responsible for obtaining prior authorization for infusion and injectable medications based on ... medication-based referrals as well as expiring medication-based referrals. + Verifies Prior authorization requirements based on patient's specific insurance… more
- Community Health Systems (Springdale, AR)
- …follows up with the insurance company until there is resolution of the prior authorization request - an approval, redirection, or denial. All activity ... linked to the referral requested. + Validates continuity of care and network integrity based on service line availability for quality patient care. + Sends all… more
- Colorado State University (Fort Collins, CO)
- …such as scheduling, information collecting, and medical records requests + Completes prior authorization insurance phone calls and medication refill requests + ... Medical Services The Medical Clinic at the CSU Health Network provides acute and chronic care to CSU students...mental health and primary care medical services on campus, referral for community specialty care, and comprehensive health education… more