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Description :The Prior Authorization Specialist works with departments and insurance companies to obtain the necessary pre-certifications and authorizations for services ordered/scheduled by Gundersen Health System.
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Specifically for this position the Genetic Counselor Assistant will provider pre-and post-clinic support to genetic counselors and other healthcare providers that help clients understand and adapt to the implications of genetic contributions to disease.
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Assists in scheduling exams and ensuring pre-authorization is obtained prior to performing exams. About the Job Location: New Hanover Medical Group Department: NHMG-Myrtle Grove Radiology Full Time Equivalent: FTE: 0.1 Work Type: 1 to 31 Hours Pay Period Work Schedule: 8 HR Day Exempt from Overtime: Exempt: No What You'll Do Summary: Under the general direction of the Radiology Manager this individual performs Computerized Tomography, X-ray and bone density procedures to assist physicians in the diagnosis of disease and injuries.
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Resolves all outstanding Alerts on pending appointments within 48 hours of the scheduled appointment to minimally include: Missing Referral Missing Pre-certification/Authorization Self Pay Accounts Eligibility Verification Missing Demographic/Insurance Information.
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Utilization of clinical skills to support the documentation and communication of medical services and prior authorization determinations. Follow all prior authorization procedures to guarantee an accurate process on each prior authorization.
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You will oversee utilization management process including verification of insurance coverage, pre-authorization, resource management and overall management of patients within the continued stay criteria.
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Review clinical documentation and submit to insurance companies for initiation and obtaining authorization or pre-certification on OP diagnostic hospital services. Work closely with the physician office staff to ensure that pre-cert/authorization numbers are entered in the scheduling or registration system.
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Oversee utilization management process including verification of insurance coverage, pre-authorization, resource management and overall management of patients within the continued stay criteria.
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Communicates pre-authorization outcomes to appropriate individuals (hospital and CBO). Monitors and tracks the total hospital certified days of the patient for payers (commercial, managed care, and Medicaid) and communicates missing certifications to the DCM, Case Manager(s), and CBO. Initiates and completes insurance pre-certification for patients lacking certification.
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Requirments:Must have a high school diploma or equivelantMust have at least 6 months of prior authorization/pre certification experience Must have EPIC experience Schedule:This is a full time Monday-Friday 9am-5pm or 10am-6pm.
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RN – Pre-Op Registered Nurse - Health Advocates Network is urgently hiring Pre-Op RNs with at least 2 years of recent experience! Posted job title: RN - Pre-Op. Specialty: Pre-Op Registered Nurse (RN.
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Prior pre-authorization experience. Insurance pre-certification experience. Coordinates all procedure-related appointments for the patient i.e. pre-op teaching classes, post-op appointments, pre-op testing, and any additional follow up.
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We are seeking an Clinical Rockstar for a full time Pre-Op RN role with a new state of the Art Surgical Center in New Mexico! We are seeking an Clinical Rockstar for a full time Pre-Op RN role with a new state of the Art Surgical Center in New Mexico.
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Manage classroom activities while ensuring compliance with GA Dept of Early Care and Learning and the goals and objectives of the current GA Pre-K curriculum. Knowledge of GA Pre-K requirements, and GA Dept. of Early Care and Learning Requirements.
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Must have a current license or temporary authorization (interim approval not to exceed 120 days from date of issuance) as an Advanced Practice Registered Nurse (APRN) with authorization to practice as a Certified Registered Nurse Anesthetist (CRNA) by the Texas Board of Nursing.
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pre authorization jobs Title: clinician Company: Summit Bhc in Forest-lake, Minnesota
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