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2 years of prior authorization experience. Insight Global is seeking a Pre-authorization specialist for a large hospital system in Virginia. Demonstrates skill in the proficient use of PC and UVA software systems to ensure that all pre-certification/pre-authorization information is entered into required computer systems in an accurate and timely manner.
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Become a part of our caring community and help us put health first The Pre-Authorization Nurse 2 reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder.
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The Pre-Authorization Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Pre-Authorization Nurse 2 completes medical necessity and level of care reviews for requested services using clinical judgment, and refers to internal stakeholders for review depending on case findings.
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Travel: Meet quarterly in Louisville office for meetings Work At Home Requirements WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. About Us Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company.
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Responsibilities for this Prior Authorization Specialist will include insurance processing for healthcare, prior authorization and insurance investigation and appeals.
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Monitor work queues (through EPIC), work with insurance companies for predetermination and authorization, verifies patient insurance, monitors reports related to denials and other processes. Working knowledge of EPIC is preferred About Us CentraState Healthcare System, a partner of Atlantic Health System, is a fully accredited, not-for-profit, community-based health system that provides comprehensive health services in the central New Jersey region.
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GENERAL SUMMARY: The Insurance Verification and Authorization Specialist is responsible for verifying patient insurance and benefits and obtaining prior authorization for scheduled medical services and hospital admissions following payer specific guidelines.
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Support providers and reviewers with prior authorization requests for post-acute care services. Includes manually entering authorization requests into Care Management systems, following rules and algorithms embedded in the care management system to administratively approve prior authorization requests.
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Verifies insurance pre-authorization as defined by departmental protocols prior to scanning patient. Posted job title: Cat Scan Technologist | Weekend Incentive Program | Wilmington Campus About ChristianaCare Delivering health, not just healthcare, is our promise to our community.
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They will be responsible for communication with insurance carriers and/or providers for purposes of obtaining approval for services requiring authorization, pre-certification, and prior approval for admissions to Beacon or Epworth Center by using web based tools, other electronic means where possible, or by telephoning and faxing when necessary.
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Utilizes Epic Referral Work Queues, Experian Real Time Authorization (RTA), phone, payer websites and fax to complete prior authorizations for imaging and specialty services. Duties & Responsibilities Partners with LMC departments and insurance companies to provide quality care to LMC patients through the authorization process prior to patients' date of service.
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Advanced degree and/or relevant certifications in prior authorization and/or billing and coding. Reimbursement or relevant managed care experience (revenue cycle, buy-and-bill, prior authorization, coding, and appeals processes.
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The Intake Counselor is responsible for the verification and prior authorization of insurance benefits as needed. Currently licensed to practice as a LPC-Intern, LPC, LMSW or LCSW in the State of Texas.
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Job Type Full-time Description Tempus Unlimited is looking for a support staff to answer phones, provide consumer support, and distribute calls to appropriate department for the Personal Care Management Prior Authorization Department.
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2 years of clinical experience with prior authorization and/or utilization review. Prior Authorization Registered Nurse. We are currently seeking a highly skilled and motivated Remote Clinical Review Nurse/Concurrent Review Nurse (RN) to join our dynamic team.
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prior authorization jobs Title: pharmacy technician billing specialist
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