- Actalent (Sunrise, FL)
- …patient satisfaction, safety, and appropriate length of stay. Responsibilities + Review prior authorization requests for medical necessity and ... the Medical Director, physicians, and office staff to resolve authorization issues. + Communicate denial determinations to providers when indicated. + Perform… more
- Molina Healthcare (Miami, FL)
- …and its members. + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests ... benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina… more
- AdventHealth (Maitland, FL)
- …in scheduling peer to peer requests with the office and the payer to ensure an authorization decision is made prior to date of service. + Obtains initial and ... **The role you'll contribute:** The Pre-Access Infusion Benefits and Authorization Specialist, under general supervision, maintains performance standards appropriate… more
- HCA Healthcare (Trinity, FL)
- …healthcare experience is required, scheduling preferred. + Insurance verification and gaining prior authorization experience preferred. + Medical terminology ... and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low… more
- University of Miami (Medley, FL)
- …a timely manner in support of patient satisfaction and allow for referral and authorization activities prior to the patient's date of service + Verification of ... + Contact Primary Care Physician offices and/or Health Plans to obtain authorization or referral for scheduled services according to authorization guidelines… more
- University of Miami (North Miami, FL)
- …a timely manner in support of patient satisfaction and allow for referral and authorization activities prior to the patient's date of service + Verification of ... is responsible for the verification of insurance eligibility, benefits and obtaining authorization for all insurance carriers for all outpatient office visits and… more
- General Dynamics Information Technology (Fort Walton Beach, FL)
- …and the Delegated and/or Authorizing Official (DAO/AO) on any assessment and authorization issues. + Evaluate Authorization packages and make recommendation to ... the AO and/or DAO for authorization . + Evaluate IS threats and vulnerabilities to determine...of regulations identified in the description of duties. + Prior performance in the role of ISSO and ISSM.… more
- Molina Healthcare (Orlando, FL)
- …team in providing physician leadership and expertise in the performance of prior authorization , inpatient concurrent review, discharge planning, case management ... and interdisciplinary care team activities. + Ensures that authorization decisions are rendered by qualified medical personnel, without hindrance due to fiscal… more
- Humana (Tallahassee, FL)
- …health outcomes of our members. + _Outcomes_ : Characterize the impactable drivers of prior authorization and look at appeals rate with denials and overturns. ... be a key enterprise leader, with responsibility for evolving Humana's Utilization Management of medical review by physician or nurse, with a focus on our 5+ million… more
- University of Miami (Miami, FL)
- …MMF/UPAC and sent to OR front desk. + Confirm with Faculty surgical case order prior surgery date. + Ensures that essential medical records for surgery are ... manner. + Schedule PAT appointment 3 to 4 days prior to surgery if pre-testing at JMH/UPAC. + Give...if pre-testing at JMH/UPAC. + Give surgical package to Authorization Coordinator to obtain necessary authorizations. + Check request… more