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Succinctly abstracts fact based clinical information to support pre-authorization utilizing applicable nationally recognized and payer-specific criteria; communicates timely the clinical information supporting the medical necessity of an ordered test/treatment/procedure/surgery as applicable to the patient’s health plan and documents the outcome of the task.
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If pre-certification/authorization/notification of admission is required and has not been obtained, initiate via Passport, on-line or phone call. Verify insurance benefits and determine pre-certification/authorization status via online or other resources.
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Verify all insurance and obtain pre-certification/authorization. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing.
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The Department of Preventive and Restorative Dental Sciences conducts multidisciplinary instruction, research, and patient care programs through its seven divisions: Behavioral Sciences and Community Dental Education; Biomaterials and Bioengineering; Clinical General Dentistry; Endodontics; Oral Epidemiology and Dental Public Health; Pre-Clinical Simulation; and Prosthodontics.
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Obtains benefit verification and home health or hospice pre-certification/pre-authorization on all patients in a timely manner. Acts as liaison between OMSI and health plans or HMOs to ensure compliance with pre-certification or authorization to facilitate reimbursement.
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The Pre-Authorization Coordinator will support our mission by assuming responsibility for facilitation of all aspects of pre-authorization process for medications prescribed by primary care and psychiatric providers.
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The ICM Authorization Technician will prepare documents, personal health records, and referral packets for submission to post-acute facilities and agencies. Sentara Health Corporate Office is hiring an Inpatient Case Management Authorization Technician to work full-time/day shift.
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POSITION SUMMARY: Obtains pre-certification for all inpatient admission and pre-authorization for all outpatient diagnostic tests and performs an administrative support function. Demonstrates skill in the proficient use of PC and UVA software systems to ensure that all pre-certification/pre-authorization information is entered into required computer systems in an accurate and timely manner.
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Obtains insurance authorization and pre-certification specifically for chemotherapy services. The US Oncology Network is looking for an Insurance Authorization Specialist to join our team at Texas Oncology.
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Come and join our team as a Pre-Authorization Specialist I for a Full-Time position at our outpatient imaging center located in Louisville, KY. This career ladder shows your point of entry into our team, as well as the growth and promotional opportunities available to you within our business office department: Pre-Authorization Specialist I.
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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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The Department of Public Health (DPH) is recruiting for Pre-Registered Dietitians who plan, develop, implement, and evaluate community nutrition programs for targeted populations. ( IMPORTANT: The Authorization to Test email received from Pearson VUE, CDR's testing agency, confirming that CDR has validated your eligibility requirements and has approved you to take the RD examination, must be submitted with the application if qualifying under option 2.
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In conjunction with Home Office Health Policy counsel, clarify with appropriate agencies (for example, State Medicaid agencies) regulations that pertain to utilization and denials. Onboarding Process: Please be advised that candidates must successfully complete a background check and pre-employment health screening which includes a drug screen.
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The individual is responsible for coordinating all the functions and activities related to patient pre-certification/authorization including, but not limited to accurate and complete patient registration, on-site insurance verification, pre-service testing coordination and assisting in billing denial resolution.
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Verifies benefits, obtains pre-certification, pre-authorization, referral and second opinions for all services where applicable. Serving as a Pre-Registration Representative: Pre-registers patients by obtaining and verifying all demographic and financial information.
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pre authorization health policy jobs Title: clinician in Forest-lake, Minnesota
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