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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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Blue Ridge Health is currently seeking a Prior Authorization Specialist to be part of our Medical team in Polk County. The Prior Authorization Specialist collaborates with patients, internal staff, other medical center representatives, and third-party payers to facilitate the smooth exchange of information related to obtaining timely prior authorizations for pharmaceutical and imaging patient needs.
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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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Texas Oncology is looking for an Insurance Authorization Specialist to join our team! What does the Insurance Authorization Specialist do? Minimum three (3) years medical insurance verification and authorization and two (2) years clinical review experience required.
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Prior Authorization Specialist’s Qualifications A High School Diploma or GED is required. Prior Authorization Specialist’s Responsibilities Generate, verify, and oversee the complete procedure authorization/referral process.
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MGH Gastroenterology has an opening for a Medication Prior Authorization Specialist. The Medication Prior Authorization Specialist is responsible for obtaining all medication prior authorizations.
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Trend reporting to supervisor to assure accurate capture of services needing authorization. Responsible for providing all required medical information to insurance companies as necessary to facilitate the authorization process.
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The Hospital Authorization Specialist reviews databases and other pertinent documentation to ensure all needed pre-certifications and/or authorizations are completed for medical services.
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The Insurance Verification & Authorization Specialist may function as a billing specialist and will follow uniform billing procedures and practices according to Medicare, Medicaid, 3rd party payers, and private pay in accordance with the HIM-11 guidelines.
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As an Authorization Specialist, you'll verify insurance coverage, benefits, and obtain prior authorization for services. Contacts insurance plans to determine eligibility, obtains coverage, benefit information, and prior authorization for services.
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Job Summary: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 inpatient, outpatient, and ancillary services.
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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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Minimum of 3-5 years as a pre-authorization or utilization review nurse in a payer or acute care setting; preferably medical-surgical or critical care/ED. All clinical pre-authorization activities associated with patients financially cleared through the Patient Access Support Unit (PASU) and/or the Center for Patient Access Services (CPAS.
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In general the Authorization Specialist is responsible to ensure proper Authorizations are obtained to corresponding CPT codes and ICD-10 codes to ensure prompt payment from insurance carriers.
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The Prior Authorization Nurse is to promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to prior authorization specialty referral requests.
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Title: authorization specialist Company: Christian Family Solutions
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