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The RN Pre Op provides safe, effective, and quality patient-family centered care in the perioperative services for all patient populations. The TOPS Surgical Specialty Hospital N Pre Op is a Registered Nurse that provides quality patient care using the nursing process, the medical plan of care, and organizational policies.
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Under the management of the Manager, Patient Access, the Pre-Certification Representative I is responsible to determine insurance eligibility and, as appropriate benefits, pre-authorization / pre-certification and medical necessity requirements based on patient specific insurance.
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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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Experience: 2 years of working knowledge of pre-certification/prior authorization procedures, advanced medical terminology, reimbursement and regulatory issues, insurance functions and terminology, and utilization of charity care programs.
$25.05 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Strong knowledge in security fundamentals: authentication/authorization frameworks (e.g., SSO, SAML, Oauth), secure transport (e.g., SSL, TLS), identity management (e.g., certificates, PKI) Network security architectures and implementations in public clouds (e.g., AWS, Azure, GCP, Alibaba Cloud.
$265,200 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Long Term Care (LTC) Pre-tax Health Savings Account (HSA) Pre-tax Flexible Spending Accounts (FSA) Aflac Hospital, Critical Illness and Accident plans Identity Protection Employee Assistance Program (EAP) *Part Time Regular employee classifications also receive this benefit.
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The contracts support functions are: IA Management, Federal Information Security Management Act (FISMA) coordination and reporting, Risk Management Framework (RMF) application, IA compliance measurements and metrics, Assessment and Authorization (A&A), Vulnerability Management, and Cyber Defense support.
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Identifies all patients requiring pre-certification or pre-authorization at the time services are requested or when notified. Additionally, the Pharmacy Business Coordinator may be responsible for securing registration data based upon comprehensive data elements, financial education/counseling, insurance verification, provision of clinical information for pre-certification, authorization and third party claims management.
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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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Insurance verification and pre-authorization. Must be willing to float/travel into St. Louis County and surrounding counties, including Jefferson county, St. Charles county and Warren county.
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Ensures verification of primary payor including Medicare A via Dorado or Census Pro, Medicare C via Pre-Authorization, and Managed Care via Pre-Authorization. Effective Reporting; maintains accurate daily reports, pre-planned sales call log, account management tool, admissions/inquiry tracker, TCI reports, PCC reports, and Census Pro. PREREQUISITES, SKILLS, & ABILITIES Associate degree in related field or equivalent experience required; Bachelor's degree preferred.
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In addition, the Prior Authorization Specialist I may be responsible for pre-appointment registration and insurance review to maximize the submission of a clean claim. The Prior Authorization Specialist I is responsible for obtaining and resolving referral, precertification, and/or prior authorization to support insurance specific plan requirements for all commercial, government and other payors across hospital (inpatient & outpatient), ED, ancillary and clinic/ambulatory environments.
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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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TravelNurseSource is working with Core Medical Group to find a qualified PACU/Pre-Post Op RN in Olympia, Washington, 98502 Pay Information $1,890 per week About The Position Client in WA seeking Registered Nurse - PACU (RN) to work 12H Mids Washington is a state in the Pacific Northwest with terrain from snow-covered mountains to forested islands.
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At least 2 years of experience in SailPoint IIQ At least 1 end-to-end design and implementation project executed for SailPoint IdentitNow Excellent Knowledge on IGA Fundamentals: Identity and Access Management Lifecycle Access Management Authentication and Authorization integrations Application Onboarding Entitlement Catalog Roles, Reports and Rules Tasks (Aggregation/Refresh/Perform Maintenance.
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pre authorization jobs Title: clinician Company: Tenet Healthcare in Forest-lake, Minnesota
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