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Serves as a resource for staff and physicians regarding prior authorization and pre-certification policies and procedures. The Prior Authorization/Pre-Certification Coordinator is responsible for performing prior authorizations, pre-certifications for surgeries, pre-collecting funds as appropriate, and other office procedures as necessary.
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The Prior Authorization Specialist (PAS) is an essential role responsible for facilitating exceptional patient experience, by securing authorizations for all scheduled services related to medical and surgical admissions across entities, including BWH OR procedures, BWFH OR procedures, FXB OR procedures and BWH/BWFH Endoscopy Suite procedures in accordance with standards established by the Department, Hospital, Medical Staff, and outside regulatory and accreditation agencies.
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Support healthcare providers and UM reviewers with prior authorization requests for post-acute care services. Includes manually entering authorization requests into healthcare system, following rules and algorithms embedded in the care management system to administratively approve prior authorization requests.
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Under direction from the Supervisor, Specialty Pharmacy Services, and pharmacists in the Specialty Pharmacy, the Prior Authorization Specialist I is primarily responsible for obtaining information and assisting providers and insurance companies in triaging prior authorizations for patients of the specialty pharmacy.
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Job DetailsDescription Mountain View Hospital is looking for a Prior Authorization Specialist to join our team! Plans and directs prior authorization processes, patient insurance, and monitors all aspects of insurance authorizations for accurate and complete processing of authorizations to include follow-up on pended cases, as well as denials.
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For patients who do not receive insurance coverage, the prior authorization specialist refers accounts to the financial counselor and/or identifies the patients who need to receive a Medicare Advance beneficiary Notice of Noncoverage (ABN.
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If you are qualified and interested in the Prior Authorization Specialist role, please apply today! Gather additional clinical and or coding information, as necessary, in order to obtain prior authorization.
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Conducts decision review for services requiring prior authorization in LTSS leveraging technology and guidelines as available. The LTSS Service Authorization Specialist provides accurate, prompt, and appropriate medical authorizations to requests from CCA Clinicians, Vendors and Providers for LTSS. The LTSS Service Authorization Specialist reports to the LTSS Service Authorization Team Lead.
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Utilization review, prior authorization, Care management, Case management, interqual, ncqa, ncqa standards. Utilization review,prior authorization,Care management. - One to three (1-3) years recent care management prior authorization experience - Graduate of an accredited school of nursing (Bachelors of Science in Nursing and/or Master's level degree preferred) - Experience working with health plan auditors preferred.
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Registered Sonography Tech specializing in Cardiac credentialed from the Cardiovascular Credentialing International (CCI) obtained prior to hire date or job transfer date. Registered Sonography Tech specializing in Vascular Sonography credentialed from the American Registry for Diagnostic Medical Sonography (ARDMS) obtained prior to hire date or job transfer date.
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Neighborhood Support - Internal Medicine, Nesconset, Long Island, New York, Full Time, Days, Offsite
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May acquire insurance pre-authorization/referrals from managed care plans for all required services, admissions, procedures, diagnostic tests and medications. Job Title: Neighborhood Support Provides front line contact as a patient liaison within the access center, check-in/check-out, appointment scheduler, triage, prior authorizations and referrals and neighborhood administrative and physician support.
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Neighborhood Support - Internal Medicine, Nesconset, Long Island, New York, Full Time, Days, Offsite
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Formed in September 2013, The Mount Sinai Health System combines the excellence of the Icahn School of Medicine at Mount Sinai with seven premier hospital campuses, including Mount Sinai Beth Israel, Mount Sinai Beth Israel Brooklyn, The Mount Sinai Hospital, Mount Sinai Queens, Mount Sinai West (formerly Mount Sinai Roosevelt), Mount Sinai St. Luke's, and New York Eye and Ear Infirmary of Mount Sinai.
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Under the direction of the Manager, a Prior Authorization Specialist performs all clerical duties required to obtain insurance prior authorizations for all in office procedures, medications, and any surgical services in a timely manner.
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Insurance verification and authorization including all private insurances and Medicaid via EQ health. Welcome to the Hearing and Speech Center of Florida, an 87 year old non for profit serving educational and special needs throughout Miami Dade County.
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This position is also responsible for verifying patient insurance, confirming benefits eligibility, performing pre-authorization, pre-certification, and/or notification as required by third party providers.
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prior authorization jobs Title: pharmacy tech Company: Minnesota Visiting Nurse Agency in Laramie, Wyoming
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