- US Tech Solutions (RI)
- **Job Summary:** + The Tech I Prior Auth . takes in-bound calls from providers, pharmacies, members, etc providing professional and courteous phone assistance to ... needed to include but not limited to: outbound calls, reviewing and processing Prior Auth 's received via fax and ePA, monitoring and responding to inquiries via… more
- University of Rochester (Rochester, NY)
- GENERAL PURPOSE: Serves as the patient referral and prior authorization specialist, with oversight of data and compliance to enterprise standards and referral and ... prior authorization guidelines. Communicates regularly with patients, families, clinical...up. Adheres to approved protocols for working referrals and prior authorizations. Makes decisions that are guided by protocols… more
- University of Rochester (Rochester, NY)
- POSITION SUMMARY: Serves as the patient referral and prior authorization specialist, with oversight of data and compliance to enterprise standards and referral and ... prior authorization guidelines. Communicates regularly with patients, families, clinical...up. Adheres to approved protocols for working referrals and prior authorizations. Makes decisions that are guided by protocols… more
- University of Rochester (Rochester, NY)
- POSITION SUMMARY: Serves as the patient referral and prior authorization specialist, with oversight of data and compliance to enterprise standards and referral and ... prior authorization guidelines. Communicates regularly with patients, families, clinical...up. Adheres to approved protocols for working referrals and prior authorizations. Makes decisions that are guided by protocols… more
- University of Rochester (Rochester, NY)
- …With minimum direction and considerable latitude for independent judgement, obtains prior authorizations for both standard and complex requests. Provides multiple ... details and facts to insurance carriers and Worker's Compensation to obtain prior authorizations for both standard and complex requests such as take-home medications… more
- Molina Healthcare (Charleston, SC)
- …we are seeking a (RN) Registered Nurse with previous experience in Prior Authorizations, Utilization Review / Utilization Management and knowledge of Interqual / ... and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina Healthcare… more
- University of Rochester (Rochester, NY)
- Responsibilities **Summary:** Oversees and provides direction to Prior Authorization and Referral Coordinator Associates and Specialists. Trains new employees. ... in problem identification, quantification and resolution. + Provides training to Prior Authorization and Referral Coordinator Associates and Specialists on all… more
- Molina Healthcare (Phoenix, AZ)
- …and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina Healthcare ... members. + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests additional information… more
- University of Rochester (Rochester, NY)
- …procedures and testing, in alignment with department and enterprise standards. Obtains prior authorizations as needed and assists the team with other assistance as ... management when medical assessment is needed. + Manage and oversee the prior authorization process for procedures, specialty office visits, VA (Veterans Affairs)… more
- University of Rochester (Rochester, NY)
- …Ensure that an accurate and complete full registration of the patient is completed prior to the discharge of the patient including insurance verification for new and ... self-pay patients. Follow up on hold bill report to facilitate reimbursement for Emergency Department services. Collect co-pays. **Customer Interaction:** + Triage patient calls, assess the urgency of a situation and determine the appropriate action, serves as… more
- University of Rochester (Rochester, NY)
- …Using excellent customer service skills and exercising thorough knowledge of hospital policy and procedures as they relate to inpatient, outpatient, or ancillary ... intake, financial, credit and charity policies throughout the continuum of care: arranges for admission of patients to inpatient and outpatient beds and services, schedules and assigns accommodations or service locations; determines financial eligibility,… more
- Fallon Health (Worcester, MA)
- …letters and rollout of new letters. Collaborates closely with the UM Clinical and Prior Auth staff to ensure appropriate and applicable language is captured for ... + Completion of all denial letters and special approval letters for Prior Auth requests + Perform spell check and grammar check for appropriate sentence… more
- St. Luke's University Health Network (Allentown, PA)
- …Department, and patient, to relay precertification information + Notify ordering physician of any prior auth denials and peer to peers to be scheduled + Review ... regardless of a patient's ability to pay for health care. The Network Prior Authorization and Referral Specialist is responsible for the coordination of prior… more
- US Tech Solutions (May, OK)
- …+ How many years of prior -authorization experience do you have? + Haw many Prior Auth cases have you handled in your last role? + Do you have ... Description:** + Responsible for reviewing and completing criteria based on prior authorization as per policy and procedure. **Responsibilities:** + This individual… more
- US Tech Solutions (RI)
- …as needed to include but not limited to: outbound calls, reviewing and processing Prior Auth 's received via fax and ePA, monitoring and responding to inquiries ... **Job Title: Prior Authorization Specialist** **Location: Fully remote** **Duration: 12...Fully remote** **Duration: 12 months contract** **Job Description:** + Prior Authorization Specialist takes in-bound calls from providers, pharmacies,… more
- US Tech Solutions (May, OK)
- …(NLNAC)) at the time the program was completed by the applicant.** **Skills:** LPN, Prior auth **About US Tech Solutions:** US Tech Solutions is a global ... data entry, data management, and reporting. **Experience:** + * Review criteria-based prior authorizations following policy and procedure. + * Provide on-call after… more
- US Tech Solutions (May, OK)
- …as needed to include but not limited to outbound calls, reviewing and processing Prior Auth 's received via fax and ePA, monitoring and responding to inquiries ... courteous phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of reviews.… more
- HonorHealth (Scottsdale, AZ)
- …are not met. Maintain a productivity PA case load of an average of 10-15 prior auth processing per day. Requests additional information from medical office staff ... across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Prior Authorization (PA) Specialist is responsible for the review of requests… more
- Carle (Urbana, IL)
- …Now Position Summary: The Pre-Authorization Specialist is responsible for identifying prior auth requirements by insurance/payer and processes and completes ... to address and resolve. + Other duties as assigned. + Identifying prior auth requirements by insurance/payer and processes and completes prior authorizations… more
- Arnot Health (Elmira, NY)
- …Sign on Bonus for qualified Case Managers! MAIN FUNCTION: The Case Management (denial/ prior auth ) will review and appeal as appropriate for concurrent and ... Assists in tracking/trending by payer for denial reason items such as prior authorization, untimely filing, coordination of benefits, services type issues, and… more