- Corewell Health (Kentwood, MI)
- …experience in related field Preferred + Basic understanding of medical terminology + Prior Authorization experience + Epic experience + Payor portal experience ... by way of obtaining accurate and timely authorizations. Crucial to obtaining an authorization is the ability to read and understand basic insurance information as… 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,...any outside records needed for patient appointment. **QUALIFICATIONS:** + Associate ' s degree in Medical, Secretarial or related field… more
- University of Rochester (Rochester, NY)
- GENERAL PURPOSE: Serves as the prior authorization specialist, with oversight of data and compliance to enterprise standards prior authorization ... to the denial and will be patient specific. + Prior authorization functionality required for testing and...system tracking mechanisms to ensure all renewals/approvals are obtained prior to patient arrival. **QUALIFICATIONS:** + Associate ?s… more
- Fairview Health Services (Minneapolis, MN)
- …requirements are met per payor guidelines. They will provide support and process prior authorization appeals and denials, when necessary, in conjunction with ... service departments if medical necessity fails. Follow up with insurance payors on prior authorization denials. Process authorization denial appeals, when… more
- University of Rochester (Rochester, NY)
- …an authorization for medical information/PHI to evaluate for HIPAA compliance prior to processing. Determines if the authorization contains all of the ... completion and accuracy as well as compliance with State and Federal guidelines prior to release. Collaborates with internal and external parties in person, verbally… more
- Carle (Urbana, IL)
- Business Service Rep + Department: Registration Center - CFH_10_20 + Entity: Champaign-Urbana Service Area + Job Category: Clerical/Admin + Employment Type: Full - ... appropriate reimbursement for both the patient and the hospital. Performs prior authorizations for patients admission/surgeries to ensure reimbursement for services… more
- TEKsystems (Rochester, NY)
- Description: The Pharmacy Prior Authorization Technician performs functions as permitted by law including the initial level processing and review of prior ... leadership and expertise in the intake area of the prior authorization process for medications processed either...highly preferred not required. + High School Diploma required, Associate degree and higher education is preferred . Experience… more
- University of Rochester (Rochester, NY)
- …but is not limited to demographic, co-pay/deductibles, benefit information, referrals/ authorization , PCP information and Self Pay recovery. Responsible for ... contacting patient/ representative regarding registration, insurance coverage or lack of to...**_Weight_** **_=45%_** Responsible for pre-verification of insurance five days prior to sched appointments, real time verification (urgent care,… more
- Intermountain Health (Ogden, UT)
- …orders are proposed, signed off and sent for hospital orders. + Obtains authorization for surgeries/hospital procedures by researching coverage and obtain prior ... go out of network. Point of contact for surgery authorization questions. Obtain proper CPT code from provider for...includes pre-op labs, tests, or any pre-requisite that needs prior attention. Coordinates with Providers and Medical Staff any… more
- Dignity Health (Bakersfield, CA)
- …+ Familiarity with third party administrator operations such as eligibility, prior authorization , claims administration and provider network administration. ... that put patient care first. **Responsibilities** As a Provider Relations Representative with the Dignity Health Management Services Organization (DHMSO), now part… more