- Trinity Health (Syracuse, NY)
- …denial coordination with Patient Business Service (PBS) centers; including analysis of clinical documentation, assist in appeals as needed, root cause analysis ... including but not limited to, appending modifiers and checking clinical documentation. Provides feedback to intra-departmental Revenue Integrity colleagues including… more
- US Tech Solutions (May, OK)
- …with other internal groups regarding determination status and results (seniors, pharmacists, appeals , etc). + Identify and elevate clinical inquiries to the ... Maintains complete, timely and accurate documentation of reviews. Transfers all clinical questions, escalations and judgement calls to the pharmacist team.… more
- Montrose Memorial Hospital (Montrose, CO)
- … clinical documentation for medical necessity requirements, utilizing available clinical resources for documentation improvement, and facilitating appeals for ... highest standards of healthcare. About The Career: + The Hospital Prior Authorization Specialist is an advocate for the patient's medical needs and financial health… more
- Robert Half Accountemps (Milwaukee, WI)
- Description We are looking for a skilled Medical Billing Specialist to join our team on a 12-week contract in Milwaukee, Wisconsin. In this role, you will play a ... government guidelines, including Medicare and Medicaid policies. * Collaborate with clinical and administrative staff to obtain necessary information for accurate… more
- Omaha Children's Hospital (Omaha, NE)
- …coverage, obtaining prior authorizations, and managing denials by collaborating with clinical , administrative, and financial teams. The Authorization Specialist ... make a difference where it matters most. **A Brief Overview** The Authorization Specialist plays a critical role in ensuring patients receive timely and appropriate… more
- Dana-Farber Cancer Institute (Brookline, MA)
- The Drug Authorization Specialist , with direct supervision of the Prior Authorization Supervisor, is responsible for managing all work related to drug authorizations ... to all aspects of drug prior authorization work. The Drug Authorization Specialist creates accurate, thorough, and concise prior authorization requests to all payers… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Depending on the specific tasks assigned, the Medical Services Coordination Specialist provides administrative support for any of the programs of Utilization ... Plan Essential Accountabilities: Level I + Review / prep clinical case for clinical staff. + Navigates...programs + Provides administrative support to the grievance and appeals process within the + Medical Services department Level… more
- UNC Health Care (Goldsboro, NC)
- … denials for validity and probability to overturn, proactively gathers required clinical documentation and formulates appropriate appeals . Coordinates the denial ... Advisors and subject matter experts for all audit and appeals work activities. Assists with documentation review to support...win rates. 12. Assists in documentation review in the clinical documentation specialist role when needed. Working… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- **42204BR** **Extended Job Title:** Prior Authorization Specialist **Org Level 1:** Texas Tech Unv Hlth Sci Ctr El Paso **Position Description:** Responsible for ... residents and staff. + Assist in the preparation and submission of appeals for denied authorizations, including but not limited to providing additional information… more
- North Carolina State University (Raleigh, NC)
- …UTS/UNC Partnership Location: Chapel Hill, NC Essential Job Duties: This Insurance Specialist position offers both dental and medical insurance services . The ... Insurance Specialist works in all areas of billing and reimbursement,...estimates for privately insured patients; obtaining and providing the clinical documentation necessary for claims processing, such as x-rays,… more