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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.
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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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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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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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The adjunct faculty for CS Authorization courses will be in charge of teaching the courses that have been approved in a hybrid modality. LCOE has developed a 4-course series to fulfill the California Commission on Teacher Credentialing (CTC) requirements to obtain a Computer Science Authorization.
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In an effort to secure reimbursement for the Hospital, verifies insurance benefits and obtains pre-certification or authorization for Hospital admissions and outpatient procedures. Obtains referrals, authorization or pre-certification number if necessary to insure reimbursement in a timely fashion and avoid loss of revenue.
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The Prior Authorization Specialist serves as a key resource in supporting the prior authorization request process, ensuring all requests are managed and addressed within the contractual timelines.
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Utilizes Epic Referral Work Queues, Experian Real Time Authorization (RTA), phone, payer websites and fax to complete prior authorizations for imaging and specialty services. Thoroughly reviews patient charts in Epic, submits the appropriate clinicals for authorization to the correct payer/third party vendor, obtains final determination from payer and enters information into EPIC. Utilizes Experian RTA system to obtain authorization and verifies authorization completion within system.
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It is the largest investor-owned water utility in New England and among the seven largest in the U.S. Based in Bridgeport, CT, it has been in the public water supply business since 1857.
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PBM/Health Plan experience evaluating and reviewing Prior Authorization preferred Specialty Pharmacy experience preferred MTM certification or other specialty certifications preferred Why Join Us: EmpiRx Health is on an extraordinary journey where excellence meets innovation.
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KNOWLEDGE, SKILLS, & ABILITIES:Ability to understand and analyze lab and clinical data within the patient’s EMR.Ability to understand third party payer and insurance complexities.
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Premier Medical Resources (77040) is hiring for a Full-Time Pre-Authorization Specialist is primarily responsible for oversight in obtaining the required pre-certifications, pre-authorizations, and referrals for all services accurately and timely.
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Communicate with patients, insurance companies, credit/collections for payment acquisition, pre-authorization and to resolve patient account inquiries. The Pharmacy Prior Authorization Revenue Cycle Representative works to support patients in obtaining insurance coverage for outpatient pharmacy medications.
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The Advanced Authorization Specialist is responsible for reading and interpreting various complex medical records to obtain authorizations for requested services and treatment plans. Primary PurposeThe Advanced Authorization Specialist is responsible for all aspects involved in obtaining highly complex authorizations for a multitude of In-patient and Out-patient Services.
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Sponsorship for work authorization, now or in the future, is unavailable. This position reports to the Senior Product Engineer, Chief Engineer, Manager, or Director of Product Development. Job Segment: Mechanical Engineer, Industrial Design, Project Manager, Engineer, Electrical, Engineering, Manufacturing, Technology.
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Title: authorization Company: San Diego Orthopaedic Associates Medical Group
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