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The primary purpose of the Office Generalist/Prior Authorization Specialist is to communicate with administrative staff and insurance companies to obtain authorizations to coordinate upcoming visits for our Home Health division.
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The Prior Authorization Coordinator will collaborate with the Harbor Care and outside pharmacy's, Harbor Care providers, clinic staff, clients, commercial payers and other outside entities to coordinate care.
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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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Job DetailsDescription Mountain View Hospital is looking for a Prior Authorization Specialist to join our team! Plans and directs prior authorization processes, patient insurance, and monitors all aspects of insurance authorizations for accurate and complete processing of authorizations to include follow-up on pended cases, as well as denials.
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2 to 5 years prior experience in managed care, sales, customer service or related experience preferred. In-depth knowledge of all Fidelis Care products, including “metal” products offered through the New York State of Health (NYSOH), Medicaid Managed Care, Child Health Plus, Medicare, MLTC, FIDA and HARP. Ability to answer product feature and benefit questions; compare and contrast Fidelis Care products and provider network of competing plans in assigned territory.
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Possess a Degree, Diploma or Certificate of Completion from an accredited Medical Assistant training program (or accredited nursing program) or have a minimum of 1-year prior experience functioning as a Medical Assistant in a clinic/hospital setting, or completion of Medical Assistant type training in the armed services.
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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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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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Sentara Martha Jefferson Hospital is hiring an Authorization Coordinator II - Full Time Day schedule. Validates accuracy of active insurance enrollment in the system prior to authorizing services.
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Non-supervisory – Two (2) years of Alaska Medicaid experience AND two (2) years of customer centric OR one (1) year working for ANMC Travel Management Office as a Prior Authorization Specialist I. An equivalent combination of relevant education and/or training may be substituted for experience.
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Castle Biosciences Inc. is growing, and we are looking to hire a Pre-Billing Prior Authorization Specialist working from our Friendswood, TX office location, with a preferred start date of April 16, 2024.
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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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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.
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Review contractor estimates, inspection reports, and prior invoices to make proper claim coverage decisions based on multiple subscription products. Super closed an oversubscribed $51M Series C funding round in early 2021, led by Wells Fargo, with participation by Asahi Kasei, AAA - Auto Club Group, Gaingels, Second Century Ventures, the NATIONAL ASSOCIATION OF REALTORS®' strategic technology investment fund.
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Wilson Health is looking for a direct hire Patient Access Prior Authorization Specialist- PRN for our location in Sidney, Ohio (North Dayton, Ohio) area. The Prior Authorization Specialist will provide appropriate information to third party payers and communicate with department clinicians when additional information is required to assure prior authorization is completed appropriately.
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Title: prior authorization Company: Centene Corporation
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