- Elevance Health (Costa Mesa, CA)
- …Management Representative I** is responsible for coordinating cases for precertification and prior authorization review. **How you will make an impact:** + ... eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization , and post service requests. + Refers cases… more
- Polaris Pharmacy Services, LLC (Covina, CA)
- … prior authorizations, step therapy, and specialty drug restrictions. . Determine whether prior authorization reviews are handled by the payer directly or by ... of Rx BINs, PCNs, Group numbers, and payer identification. . Understanding of prior authorization routing and third-party review processes. . Experience with… more
- Alameda Health System (Oakland, CA)
- …provide timely, accurate, and quality to care and services. Process and submit required authorization and prior authorization forms with Health Plans or ... Generate required correspondence/review notification of patients and providers of authorization determination or any barriers leading to scheduled services such… more
- Sharp HealthCare (San Diego, CA)
- …referrals for care and services are directed to appropriate network providers, and obtains prior authorization for in network and out of network services as ... RN CM II will document and initiate discharge plan including early referrals and authorization for LTAC, SNF, Rehab, homecare, DME and infusion services.The RN CM II… more
- Sharp HealthCare (La Mesa, CA)
- …referrals for care and services are directed to appropriate network providers, and obtains prior authorization for in network and out of network services as ... RN CM will document and initiate discharge plan including early referrals and authorization for LTAC, SNF, Rehab, homecare, DME and infusion services.The RN CM will… more
- Sharp HealthCare (San Diego, CA)
- …referrals for care and services are directed to appropriate network providers, and obtains prior authorization for in network and out of network services as ... RN CM I will document and initiate discharge plan including early referrals and authorization for LTAC, SNF, Rehab, homecare, DME and infusion services.The RN CM I… more
- Akumin (Roseville, CA)
- …responsibility. + May be responsible for verifying insurance coverage and obtain prior authorization . Patient Assistance: + May perform preliminary screening of ... patients prior to procedures, which may include medical history. +...May schedule patient appointments and obtain insurance verification and/or authorization . + May prepare medical records for physicians, patients… more
- J&J Family of Companies (Fresno, CA)
- …billing. + Reimbursement or relevant managed care experience (revenue cycle, buy-and-bill, prior authorization , coding, and appeals processes) + Ability to ... disease state experience + Advanced degree and/or relevant certifications in prior authorization and/or billing and coding + Strong market access acumen as… more
- University of Southern California (Pasadena, CA)
- …provider in EMR ensuring 7 rights of medication safety. Initiates and completes prior authorization requests for medication as needed. Assists with diagnostic ... authorization requests and same day insurance verification as needed....returning phone calls, receiving and sorting in-coming faxes, obtaining prior authorizations. Ensures patient's right to privacy, safety, and… more
- UCLA Health (Los Angeles, CA)
- …prescription management, fulfillment and patient outreach which also includes prior authorization , financial assistance and prescription coordination. Schedule: ... Technician license + PTCB Certification preferred + Experience in submitting prior authorization and financial assistance + 2-3 years of Pharmacy Technician… more