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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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Compares system report of unbilled claims requiring prior approval to QuickBase tracking system to ensure any claim requiring prior authorization is being followed up on. Ensure accurate and timely completion of client prior authorization and/or change of therapy paperwork by collaborating with prescribers and facility contacts.
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Obtain pre-authorization if required by an insurance carrier and process physician orders to insurance carriers for approval and authorization when required. Some tools may include but are not limited to Authorization Guidelines, Insurance Guidelines, Fee Schedules, NPI (National Provider Identifier), PECOS (the Medicare Provider Enrollment, Chain, and Ownership System) and "How-To" documents.
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The Pre-Access Specialist will be responsible for verifying accurate insurance and demographic information, obtaining or verifying authorization, referrals or precertification, checking medical necessity, creating patient estimates and having financial clearance conversations with patients for outpatient procedures.
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The Payer Services Specialist will be cross trained in coordinating residents' access to services by gathering information to obtain verification and authorization from various insurance payers.
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The Benefits Specialist works in a dynamic and compassionate customer service role providing telephonic and web-based, where applicable, customer service support. When you join the team as the Benefits Specialist, you'll have the opportunity to make a difference in the lives of our patients each day as they look to you as part of their dedicated support team for helping them navigate the tricky process to getting access to their complex medication.
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Family Allergy & Asthma is seeking a highly organized and detail-oriented individual to join our team as an Biologic Inventory Specialist for our Biologics (Specialty Medications) department at our Clinic.
Full-timeExpandApply NowActive JobUpdated 23 days ago - UpvoteDownvoteShare Job
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Apply basic coding knowledge and proficiency in medical terminology to translate orders to appropriate CPT and Diagnosis information required to provide to third party payers for prior authorization.
$19 - $26 an hourTemporaryExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Customer Service Specialist. Answer questions about products and services, retail stores, general service line information and other information as necessary based on customer call needs. The Customer Service Specialists works in a fast-paced environment answering inbound calls and making outbound calls.
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The Precertification Specialist sets the precedence to ensure a positive patient experience for upcoming surgical procedures and diagnostic tests by accurately and efficiently completing all necessary steps related to prior authorization, medical necessity determination and financial clearance for the hospital system and physician services for clinics, adult acute facilities and diagnostic centers.
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Collects all necessary documentation to complete timely and accurate submission of prior authorizations for biologics and specialty medications, as necessary
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