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Collaborate with practices to facilitate redesign efforts, support care teams, introduce population health management and support achievement towards improved financial, process and clinical outcomes.
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Position Purpose: Perform care management duties for adult members with serious and persistent mental illness (SPMI) including assessing, planning and coordinating all aspects of physical and behavioral health services across the continuum of care to promote quality, cost effective care.
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Schedules doctor appointments on behalf of the practitioner and assists member with wraparound services such as arranging transportation, connecting them with community-based resources and other affinity programs as available.
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You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team.
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Position Purpose - Field Based Cortland County, NY.The Health Benefit Representative (HBR) sells Fidelis Care products and services by first identifying membership growth opportunities in an assigned territory and then meeting or exceeding production goals by enrolling individuals in the appropriate Fidelis Care product.
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Medical billing/coding experience or pre-authorization experience preferred. Wondering what a day in the life of a Pre-Authorization Specialist at The Iowa Clinic might look like? Obtain insurance pre-authorization for procedures, imaging exams, injections and specialty medication prescriptions.
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The Prior Authorization Coordinator is responsible for striving to complete either approval for pharmacy claims requiring prior authorization or by coordinating with prescribers and or facility contact to have therapy changed to a preferred alternative due to insurance not covering the treatment in question.
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You must gather necessary details insurance providers require, submit for pre-authorization and follow up to ensure timely approval with patients scheduled procedures. Opportunities to have fun with your colleagues, including TIC night at the Iowa Cubs, employee appreciation tailgate party, Adventureland day, State Fair tickets, annual holiday party, drive-in movie night we could go on and on.
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Opportunities to have fun with your colleagues, including TIC night at the Iowa Cubs, employee appreciation tailgate party, Adventureland day, State Fair tickets, annual holiday party, drive-in movie night.
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Sentara Martha Jefferson Hospital is hiring an Authorization Coordinator II - Full Time Day schedule. Responsible to secure semi complex, difficult authorization work as determined by payer behavior, time needed to authorize, opportunity research and key performance indicators.
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Overview Working in a fast-paced, high volume, dynamic environment, the Clinical Authorization Specialist will bring clinical expertise to the prior authorization and appeals processes and serve as a liaison and patient advocate between Dana Farber Cancer Institute and various health plans.
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Covenant Physician Partners is hiring for a Fulltime Prior Authorization Specialist to join our team at De La Pena Eye Group located in Commerce, California. The primary function of the Prior Authorization Specialist position is to provide premier customer service to the patient, physician and their office staff by obtaining facility authorizations for patient(s) scheduled.
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Position Purpose Responsible for members gaining access to needed services through coordination and integration of medical and long term care services for the purpose of orientation, care plan development, assessment, and care coordination.
$21.93 - $37.3 an hourFull-timeExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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The Pre-Authorization Specialist is a member of the Pre-Authorization Department who is responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of outpatient and ancillary services.
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The Prior Authorization Specialist (PAS) is an essential role responsible for facilitating exceptional patient experience, by securing authorizations for all scheduled services related to medical and surgical admissions across entities, including BWH OR procedures, BWFH OR procedures, FXB OR procedures and BWH/BWFH Endoscopy Suite procedures in accordance with standards established by the Department, Hospital, Medical Staff, and outside regulatory and accreditation agencies.
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Title: authorization Company: Centene Corporation
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