- Healthfirst (PA)
- …such as: Pre -existing Conditions, Prior Approval, Medical Necessity, Pre - certification , Continued Stay, Reduction, Termination, and Suspension of services. ... The end-to-end process requires the Specialist to independently: + Research issues + Quality of Care Experience + Reference and understand HFs internal health plans policies and procedures to frame decisions + Interpret regulations + Resolve cases and make… more
- Penn Medicine (Philadelphia, PA)
- …and Tuition Assistance at University of Pennsylvania! **_ Summary: + Obtain pre - certification and referrals for inpatient and same day encounters. Verification ... of benefits and pre -certify all elective, urgent and emergency admissions. Provide specialized support in the areas of insurance and billing information. Support the… more
- Penn Medicine (Limerick, PA)
- …doctor availability . Obtains accurate insurance information for insurance verification and pre - certification as needed . Assists patient with and verifies ... patient . Notifies all necessary departments of upcoming surgery using pre -established communication channels . Contacts insurance company for patient's eligibility… more
- Trinity Health (Philadelphia, PA)
- …professional manner, verify insurance benefits and check for the necessity of pre - certification , authorization and referral. + Perform medical necessity checks ... where needed. Secure patient signatures for required hospital forms and collection of patient's financial responsibility when required. + Responsible for providing professional, quality customer service, timely resolution to customer problems, and coordination… more
- Guthrie (Tunkhannock, PA)
- …by the providers. + Assists with obtaining and processing referral and pre ‐ certification requirements. + Maintains confidentiality, respect and consideration of ... by performing routine duties in caring for patients. Education, License, Certification : High School Diploma or equivalent. Experience: Knowledge of medical… more
- Penn Medicine (Philadelphia, PA)
- …all necessary checks for accuracy of the prescription * Obtaining pre - certification /authorization if required by individual insurance companies, Soarian order ... Radiologic Technologists, ARRT requiredCertification in Mammography is requiredCurrent AHA CPR certification required We believe that the best care for our patients… more
- Penn Medicine (Radnor, PA)
- …pharmacist direction. **Responsibilities:** + Determines patient insurance requirements for pre - certification , patient payments and coverage limitation and the ... entity, and health system organization **Credentials:** + Pharmacy Technician certification (CPhT) is **required** . **Education or Equivalent Experience:** +… more
- UPMC (Pittsburgh, PA)
- …all levels of the continuum, and for providing any and all required pre - certification , continued stay and/or discharge reviews; service authorization, and care ... with special needs or priority populations and in public sector systems. + Certification as a Certified Addiction Counselor (CAC) or Certified Alcohol and Drug… more
- Penn Medicine (Philadelphia, PA)
- …understanding of managed care plans and protocols for referrals, co-payments, and pre - certification . + Readily adopts and is engaged in practice operation ... changes + Is proficient in the use of all system applications necessary for practice operations, including, but not limited to: + IDX (and its applications) + ONTRAC + EPIC + MEDVIEW + NAVICARE + CHART ONE + Other + Performs duties in accordance with Penn… more
- KidsPeace Childrens Hospital (Bethlehem, PA)
- …and submit all medication prior authorization requests. + Complete and submit any pre - certification or registration as needed. + Prepare and complete with the ... client all intake documentation. + Prepare and complete all necessary Releases of Information including tracking when individuals turn 14 years of age. + Collect height, weight and blood pressure for individuals attending prescriber appointments. + Ensure… more