- Applied ABC (Valley Stream, NY)
- …notes on or before given deadlines (all billing and date to be finalized PRIOR TO/BEFORE deadlines set forth. Maintain an open line and chain of communication via ... and due dates to allow for continuation of care (avoidance of gaps in authorization ). Review your patients' behavior data and note any discrepancies (eg, lack of… more
- SUNY Upstate Medical University (Syracuse, NY)
- …and medical necessity of medication use based on established criteria. Obtain prior authorization from intermediaries and payers, including managed care ... of activities that maximize revenue capture for high-cost medications. Conduct prospective prior authorization services to expedite clinic workflow and enhance… more
- LaSante Health Center (Brooklyn, NY)
- LaSante Health Center is seeking a Referrals and Prior Authorization Specialist to join our team. The ideal candidate will help ensure patients have seamless ... access to medications, diagnostic imaging, and specialty care by managing prior authorization requests for insurance and guiding patients through the referral… more
- Catholic Health Services (Melville, NY)
- …whether authorization is required and utilize payer-specific requirements to secure authorization . + Submit prior authorization requests to payers on ... behalf of the hospital or physician. + Ensure the required prior authorization clinical documents are complete and timely to ensure submissions are complete. +… more
- Northwell Health (Lake Success, NY)
- …Bronx, NY. Requirements: * Advanced knowledge of medical insurance verification, prior authorization processes, and reimbursement methodologies. * Strong ... seeking a Senior Medical Office Administrator with experience in _Healthcare Insurance Authorization and Revenue Cycle Operations_ for our Client, a Prosthetics and… more
- Rochester Regional Health (Rochester, NY)
- …to patient via phone call, email, or MyCare channels * Obtain prior - authorization on both internal and external department orders for procedures/treatments ... system * Complete other duties as assigned Oncology Specific * Obtain prior - authorization on internal department orders for medications administered at oncology… more
- Highland Hospital (Rochester, NY)
- …insurance eligibility and coverage verification using the three patient identifiers, confirming prior authorization is on file for correct level of care, ... **16795BR** **Title:** Health Insurance & Authorization Specialist I **Department/Cost Center:** 846 - Business...inquires on prior auth denials and works with the Provider's office… more
- University of Rochester (Rochester, NY)
- …internal equity considerations._ **Responsibilities:** Serves as the patient referral and prior authorization specialist, with oversight of data and compliance ... to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non-clinical staff,… more
- University of Rochester (Rochester, NY)
- …data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical ... follow up. Adheres to approved protocols for working referrals and prior authorizations. **ESSENTIAL FUNCTIONS** + Responsible for managing department referrals.… more
- Trinity Health (Syracuse, NY)
- …This role focuses on monitoring expirations of referrals, verifying insurance updates prior to procedure, and supporting authorization and denial processes. ... 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
