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Applies clinical and pharmaceutical criteria for processing prior authorization requests in a timely manner for pharmacy needs. Blue Ridge Health is currently seeking a Prior Authorization Specialist to be part of our Medical team in Polk County.
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Prior Authorization Specialist. Knowledge of how prior authorization functions impact billing, clinical teams, the quality of care and the patient experience. Demonstrated knowledge of Prior Authorization operations and medical office and/or hospital procedures.
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Inform patients on any prior authorization approvals or denials and the next step. 3+ years of healthcare front reception verification of benefits, prior authorization, and/or financial navigation experience in a fast-paced, customer-focused environment.
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Manages pre-registration, insurance and benefit verification, prior authorization and financial counseling supervisors for efficiency and effectiveness, monitors, benchmarks, and performance statistics.
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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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Temporary/Relief Primary Care Physician shall agree that, as required by law, excluding emergency and primary care services, prior authorization must be obtained in writing from the respective CDCR/CCHCS Institution/Facility CEO/CME or designee, in accordance with CCHCS's Utilization Management Plan. Temporary/Relief Primary Care Physician shall complete and return all forms required by CDCR regarding treatment of patient/youth.
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Ability to meet and exceed departmental quality, production, and prior authorization standards. Responds to patient inquires and manages referral and/or prior authorization related issues in a timely manner.
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Analyze benefit requirements and initiate the request for authorization / prior approval for the transplant evaluation, admission, clinic visits, donor compatibility, work-up and testing, organ procurement, ventricular assist devices and follow-up appointments.
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Complete initial pre-authorization for treatment and admission prior to admission, when possible, and within payor timeframe guidelines. Ensure all clinical information from referral sources or patients (including medical comorbidity information) is received, when possible, prior to patient admission.
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This position is also responsible for verifying patient insurance, confirming benefits eligibility, performing pre-authorization, pre-certification, and/or notification as required by third party providers.
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Advise customer on Risk Management Framework (RMF) assessment and authorization issues. Prior performance in roles such as ISSO or ISSM. Develop and oversee operational information systems security implementation policy and guidelines of network security, based upon the Risk Management Framework (RMF) with emphasize on Joint Special Access Program Implementation Guide (JSIG) authorization process.
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This position will coordinate the scheduling, referral management, registration, prior authorization and insurance verification processes for patients. Laredo Medical Center is looking looking for dedicated Patient Registration/Admitting PRN Clerk to be a part of our team.
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Assures pre-authorization and completes appropriate consent forms (ABN) prior to collection of limited coverage tests. Texas Oncology is looking for a Medical Laboratory Scientist to join our team.
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Ensure all medical admission documentation is gathered from external sources prior to patient admission and secure initial pre-authorization for treatment and admission. TrustPoint is a state of the art hospital offering two specialty service lines; Acute Physical Medicine and Rehabilitation Services and Behavioral Health Services for Adult and Seniors.
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Stella Maris is looking for an Authorization Coordinator to join their growing Home Health team. Includes pre-authorization, extension authorizations and authorization related appeals and denial management.
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prior authorization jobs Title: pharmacy technician Company: Genoa Healthcare Company
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