- US Tech Solutions (Orange, CA)
- …defined threshold languages (Arabic, Chinese, Farsi, Korean, Spanish, Vietnamese). + Prior authorization and utilization management process experience. **About ... 5:00 pm)** **Duties & Responsibilities:** + 85% - Medical Authorization + Receives referral requests via fax,...Contacts the health networks and Customer Service regarding health network enrollments. + Assists the Medical Case Managers in… 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
- Bassett Healthcare (Hamilton, NY)
- … appointment instructions to the patient. Communicates with clinicians to bring referral /insurance/ prior authorization updates. Acts as a liaison with ... network insurance deductibles and "co-insurance." Acquires medical necessity documentation. Obtains prior approval or prior authorization as required by… more
- Trinity Health (Rensselaer, NY)
- …documentation. + Works in collaboration with Billing Analyst on denied claims for missing prior authorization or referral within the EMR system. + Maintains ... up-to-date knowledge of referral /payer prior authorization requirements, eligibility...payers to complete pre-certification process. + Confirms payer is in- network with specialist. If not, contacts patient to discuss… more
- Ardon (Portland, OR)
- …Performing prescription data entry Processing prescriber refill requests Processing prior authorization notices Performing and reviewing claim submission ... to work in a fast-paced environment. Knowledge of pharmacy benefit investigation, prior authorization support, and patient financial assistance connection. … more
- Trinity Health (Grand Rapids, MI)
- …testing in timely fashion with proper documentation. + Works denied claims for missing prior authorization or referral within the EMR system. + Confirms ... a medical office required. + Extensive knowledge of the insurance market & prior authorization requirements. + Billing and coding knowledge and experience… 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 (Bowmanstown, PA)
- …Verifies benefits/ authorization requirements of patients accepted into the program prior to admission. + Registers patients according to hospital procedure. + ... AND RESPONSIBILITIES: + Maintains confidentiality of all materials handled within the Network /Entity as well as the proper release of information. + Complies with… 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
- Bassett Healthcare (Stamford, 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...meet Medicare regulations. Obtains prior approval or prior authorization as needed. Communicates referral… more
- Actalent (Tempe, AZ)
- REMOTE Pharmacy Technician Job Description Join our Prior Authorization Operations team to process prior authorization requests with accuracy, ... on demonstrated skill and performance levels. Responsibilities + Process and finalize prior authorization (PA) requests within clients' turnaround time (TAT) and… more
- Actalent (Tempe, AZ)
- Pharmacy Technician Remote Position Hiring Now Job Description As a member of the Prior Authorization Operations team, you will process prior ... applications (MedAccess, FileNet, RightFax, etc.) to analyze, obtain information, and enter prior authorization data necessary for claims adjudication. You will… more
- Actalent (Tempe, AZ)
- Job Title: Pharmacy Technician 100% Remote Job Description Join our Prior Authorization Operations team as a Pharmacy Technician. In this role, you will process ... prior authorization requests accurately and timely, ensuring...match, life and disability insurance, tuition reimbursement, and employee referral bonus. Pay and Benefits The pay range for… 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 regards to referrals,… more
- Community Health Systems (Bentonville, 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
- Actalent (Oakland Park, FL)
- …and processing new pharmacy referrals, verifying insurance coverage, facilitating prior authorization requests, accurately transcribing prescriptions, generating ... and process new pharmacy referrals. + Verify insurance coverage and facilitate prior authorization requests. + Accurately transcribe prescriptions and generate… more