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Inform patients on any prior authorization approvals or denials and the next step. Kindbody is a leading fertility clinic network and global family-building benefits provider for employers offering the full-spectrum of reproductive care from preconception to postpartum through menopause.
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Fertility clinic experience is a plus. Communicate to the clinic about pre-authorization requirements and any updates. Many thousands more receive their fertility care directly from Kindbody throughout the country at signature clinics, mobile clinics, and partner clinics.
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Maintain positive relationships and clear communication with assigned Provider, Nurse and Clinic Manager to assist in moving patients through treatment. As the fertility benefits provider, technology platform, and direct provider of care, Kindbody delivers a seamless, integrated experience with superior health outcomes at lower cost, making fertility care more affordable and accessible for all.
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Kindbody is the trusted fertility benefits provider for 127 leading employers, covering more than 2.7 million lives. Manage assigned patients' financial matters throughout their Fertility Journey. Kindbody was named to the 2023 CNBC Disruptor 50 list for revolutionizing the way fertility care is delivered in the U.S.
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3+ years of healthcare front reception verification of benefits, prior authorization, and/or financial navigation experience in a fast-paced, customer-focused environment. A passion for women's health and fertility is a plus.
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Provide thorough data analysis of all A/R behavior, with particular attention to billing, collections/follow/up, denials management, credit balance reconciliation to identify payer trends & patterns.
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Maintain accurate records of pre-authorization requests, eligibility requests, pre-determination requests, approvals, denials, and follow-up actions. We are currently seeking a highly skilled Pre-Authorization Specialist with a minimum of 1 year of recent experience in handling pre-authorizations for a variety of surgical practices, particularly in orthopedics, pain management, and ambulatory surgical centers.
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Lead and demonstrate the ability to expand and build long-term key stakeholder relationships with assigned accounts by working closely with them to help remove access barriers and optimize adherence for Intercept patients; offer educational resources to support the entire patient access journey through payer prior authorization, appeals/denials procedures and forms to resolve any issues with access challenges.
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This includes payorpolicies, prior authorization requirements, denials, appeals, peer to peer and other education required to navigate access for coverage of Alexion therapies. The FRM also supports by providing general education and case-specific guidance in response to PA denials and post service reimbursement issues.
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Develop and support internal triage process in collaboration with field leadership around coverage concerns including denials or appeals with a plan to remediate. As Intercept continues to build its position as the leader in rare and serious liver disease, we are seeking a Field Reimbursement Manager (FRM.
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And the Physician Advisor (PA) provides second-level CDI reviews, educates providers on documentation, assists in developing templates to improve documentation/coding, and reviews payer coding denials.
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Completes review approvals and denials within CDOT's permitting system. Previous work experience with multiple government agencies / entities or municipalities (e.g., utilities, CDOT, IDOT, FHWA or other local transportation agencies.
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The auditor acts as liaison and works in conjunction with the Revenue Cycle teams reviewing claim denials with provider follow-up requests. Provides physician/clinical allied health providers with educational topics based on claim denials, trends, and external auditing outcomes.
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The Auditor will analyze and assess Sharp’s potential risks using SHC’s billing and coding claims data, risk assessment data, MDAudit risk analyzer software, OIG Work plan, CMS, PEPPER Reports, RAC Denials, industry experts, etc.
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Performs assigned charge reviews (governmental, corporate, insurance defense, patient requested, collections, denials, focused review, SPAEs, cosmetics, etc.) Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll, and physician billing.
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