- Sharp HealthCare (San Diego, CA)
- …benefits and accurately follows Health Plan and/or Medicare Guidelines when issuing denials .Ensures that all denials for medical necessity are issued under ... issued accurately and served timely to members or responsible party.Ensures that all denials for medical necessity are issued under the direction of the appropriate… more
- TEKsystems (Emeryville, CA)
- Authorization Coordinator - Remote (Must Reside Within 60-70 Miles of Emeryville, CA) Schedule: Monday-Friday, 8:00 AM - 5:00 PM PST About the Role We are seeking a ... detail-oriented and experienced Authorization Coordinator to join a reputable healthcare organization. In this...needed + Submit retro authorizations and respond to no-authorization denials + Maintain detailed documentation in EMR and CRM… more
- TEKsystems (Emeryville, CA)
- Description The authorization coordinator position is responsible for performing the appropriate processes to verify patient eligibility, coordinate benefits, ensure ... regarding authorizations and referrals within turnaround standards. The authorization coordinator position is responsible for performing the appropriate processes to… more
- CommonSpirit Health (Rancho Cordova, CA)
- …Services, including but not limited to medical necessity reviews and denials management. Oversees Clinical Care Coordination functions within the facilities in ... aimed at improving patient Length of Stay (LOS), decreasing concurrent denials , streamlining patient authorizations, and enhancing care coordination quality of care.… more
- Alameda Health System (Oakland, CA)
- Pharmacy Services Coordinator -Specialty Pharmacy, Per Diem, Varied shift days, 8hoursFeatured Job + Oakland, CA + Highland General Hospital + HGH Pharmacy - Retail + ... of treatment; helps to support the appeal process to overturn insurance denials and/or benefit exclusions when needed. 8. Provides specialty medication inventory… more
- Sharp HealthCare (San Diego, CA)
- …assesses and select the appropriate denial reason. Maintain mandated TAT for denials .Obtains and gathers clinical information from multiple sources including use of ... Sharp and/or Hospital applications to retrieve patient medical records for review by Hospitalist Case Managers, SNF's or outpatient service providers.Verifies and documents eligibility and benefit details.Obtains prior authorizations for specific medications,… more
- Sutter Health (San Francisco, CA)
- …third-party payers as necessary to gather additional information and convey approvals, denials or appeals. + Provides excellent customer service by listening to ... provider, staff and patient concerns and assisting them in resolving issues in a courteous manner while documenting appropriately. + Cross-trains others to assure consistent coverage; provide back up support as needed. **EDUCATION:** HS Diploma or GED… more
- Dignity Health (Los Angeles, CA)
- … and Physician Advisor status recommendations to the appropriate Care Coordinator and documents any related authorizations, denials or status determinations ... **Responsibilities** The Care Coordinator Assistant provides clerical, secretarial and administrative support...forwarding of communications to the responsible party. The Care Coordinator Assistant may be assigned other duties within the… more
- Behavior Treatment & Analysis (Walnut Creek, CA)
- …the Billing Coordinator in Billing to Insurance companies and claim denials resolution. Key Responsibilities: + Prepare and submit claims to insurance companies, ... out the following spreadsheets: + "Billing projection Monthly" + Follow up with claim denials /unpaid claims- Via Emails or Phone calls + Submit Disputes in order to… more