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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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Fax all information required to insurance companies to ascertain an authorization number for pre-certification. Assists in establishing policies and procedures specific to the financial aspects of the Concierge Services Program including indigent drug program, Patient Assistance Programs, and pre-certification standard operating procedures.
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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. Enter all information and authorization/referral numbers into the registration system. 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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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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The Inpatient Case Management Authorization Technician provides assistance to the Inpatient Case Management team under the direction of the ICM RN/MSW, or other team member to coordinate referrals for the purpose of expediting care.
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This position is responsible for confirming and satisfying all billing requirements by obtaining the appropriate pre-certification/authorization from all necessary payers to avoid payment penalties.
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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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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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Completes pre-authorization requirements and documents authorizations received in the electronic medical record. Answer incoming calls regarding admissions, referrals, community resources or general information related to clinical programming and ABHS inpatient or outpatient services.
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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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Pre-Certification & Billing Specialist confirms applicable insurance eligibility, communicates with insurance carrier or designee regarding pre-certification or pre-authorization and communicates this information and financial responsibility to all appropriate parties including the intake office, resource assignments, and patients when applicable.
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Verify insurance eligibility, benefits, and pre-authorization/pre-certification via telephone and internet. Initiate the process of obtaining prior authorization, if required, to maximize the opportunity for reimbursement.
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Preparing and sustaining Risk Management Framework (RMF) Security Authorization Packages (SAP) for Assessment and Authorization (A&A) decisions using eMASS. Experience with Assessment and Authorization (A&A) packages and related artifacts.
$80,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Develop and maintain an ISS (Individual Service Strategy) for each pre-apprentice. The instructor is responsible for implementation and documentation of the pre-apprentice program. Complete pre-apprentice assessment and intake.
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pre authorization jobs Title: clinician Company: Conifer Health Solutions in Forest-lake, Minnesota
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