- Highmark Health (Albany, NY)
- …history, clearly defines the medical necessity of non-formulary and prior authorization medication exception requests. Interacts with pharmacy network providers to ... Prioritize requests for drug authorizations or denials. + Review of prior authorization criteria for drug products. + Recommend staffing adjustments necessary to… more
- Trinity Health (Syracuse, NY)
- …referrals, verifying insurance updates prior to procedure, and supporting authorization and denial processes. **EDUCATION, TRAINING, EXPERIENCE, CERTIFICATION AND ... appropriate health care setting. Ideally, has a background in referrals, denials, and/or authorization processes. Working knowledge of ICD-9-CM, CPT & E & M coding… more
- Guthrie (Vestal, NY)
- …Coordinates with Home care, clinical staff and insurance companies in obtaining authorization for all home health and hospice admissions. Responsibilities: Obtains ... authorization on for admissions as required by health plans....Monitors and reviews the applicable schedule to ensure that authorization and initial length of stay is obtained and… more
- Highmark Health (Buffalo, NY)
- …fulfill the call, such as verifying benefit coverage, creation of a prior authorization case in Highmark's Utilization Management system for Prior Authorization ... inbound phone requests from providers or pharmacy for all inbound Prior Authorization requests.Use multiple software systems and various resource sites to determine… more
- Emerson (New York, NY)
- …domestic and international shipping + The ability to lift at least 60lbs + **Legal authorization to work in the United States - Sponsorship will not be provided for ... Speed up to break through. Let's go, together. **Work Authorization ** Emerson will only employ those who are legally...J or TN, or who need sponsorship for work authorization now or in the future, are not eligible… more
- City of New York (New York, NY)
- …essential. During emergency events, essential positions may require 24-hour availability. WORK AUTHORIZATION : Authorization to work in the Unites States is ... required for this position. Office of Chief Medical Examiner does not provide sponsorship for international employees for visa applications, extensions, or status changes, including STEM/OPT visas. Applicants are responsible for ensuring that they meet all… more
- Northwell Health (Lake Success, NY)
- …dispensing. + Resolves insurance related issues and coordinates prior authorization requirements. + Exhibits exceptional customer service during interactions with ... letters of medical necessity, and supervises team members with complicated authorization or financial assistance tasks. + Makes decisions regarding daily priorities… more
- Rochester Regional Health (Rochester, NY)
- …team members with questions and scheduling challenge + Completes pre-certification/ authorization with the patient's insurance company providing any necessary ... Schedules peer to peer with provider if necessary. + Document authorization /pre-certification once received along with contact information of the person spoken… more
- Owens & Minor (Plainview, NY)
- …to assist customers, confirming delivery appointments, verifying insurance, obtaining authorization of equipment based on payor guidelines, monitoring incoming ... faxes, and performing data entry. + Work with sales team, referrals and/or patients to gather documentation/information needed to meet insurance guidelines.Requests health plan authorizations/information as required; either electronically or verbally. + Review… more
- Highmark Health (Buffalo, NY)
- …the case (data entry) in Highmark's Utilization Management system for Prior Authorization clinical review. Ensures all accurate information is entered at the onset ... of the process to ensure adherence to all regulatory compliance requirements and service level agreements. The requests may come via fax, Predictal Availity portal and/or service form inquiry. At times may require follow-up communication with the requestor's… more
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