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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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2 years of prior authorization experience. 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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Responsibilities for this Prior Authorization Specialist will include insurance processing for healthcare, prior authorization and insurance investigation and appeals. Great Pay $17 / Hour Incredible Prior Authorization Specialist position available in growing organization.
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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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Under the direction of the Manager, a Prior Authorization Specialist performs all clerical duties required to obtain insurance prior authorizations for all in office procedures, medications, and any surgical services in a timely manner.
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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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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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Processes administrative and financial components of financial clearance including, validation of insurance/benefits, medical necessity validation, routine and complex pre-certification, prior-authorization, scheduling/pre-registration, patient benefit and cost estimates, as well as pre-collection of out of pocket cost share and financial assistance referrals.
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Posted job title: Cat Scan Technologist Part-Time Newark Campus. ARRT registry in CT Scan required. ChristianaCare's Newark Hospital Imaging Department is currently recruiting for a Part-Time (Per Diem) CT Technologist to work flexible hours.
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Verifies insurance benefits and checks for the necessity of pre-certification, authorization, and/or referral for elective patients prior to the service date to ensure proper authorizations, pre-certifications, and verification of benefits are obtained.
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Contacts patients to update medication reconciliation lists; supports management of prescription refills; pre/post procedure questions and handles insurance prior authorization of medications.
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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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If pre-certification/authorization/notification of admission is required and has not been obtained, initiate via Passport, on-line or phone call. Verify insurance benefits and determine pre-certification/authorization status via online or other resources.
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prior authorization jobs Title: pharmacy technician Company: A Line Staffing Solutions
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