- UPMC (Steubenville, OH)
- …is crucial? If so, we invite you to join our team as an Authorization Specialist at UPMC Hillman Cancer Center! At UPMC, we are dedicated to providing exceptional ... oncology care to our community. As an Authorization Specialist , you will play a vital role in ensuring patients have access to the care they deserve. We are looking… more
- New England Cancer Specialists (Westbrook, ME)
- …professional care and customer service to our customers. The Prior Authorization Specialist will handle non- clinical administrative aspects of patient care ... New England Cancer Specialists has an opportunity for a full-time Remote Prior Authorization Specialist . This position will join a varied team of staff that is… more
- UPMC (Pittsburgh, PA)
- …If so, we want you to be part of our team as an Authorization Specialist at UPMC Hillman Cancer Center! At UPMC, we're committed to providing exceptional oncology ... care to our community. As an Authorization Specialist , you'll play a vital role in ensuring that...laws and regulations to determine medical necessity or the clinical appropriateness for inpatient admissions, outpatient facility, office services,… more
- Prime Healthcare (Joliet, IL)
- …award winning hospitals through roles in supply chain, IT and cybersecurity, clinical engineering, capital procurement, medical coding , project management and ... specialist -ii imaging/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityPHS Bio-Medical Services LocationUS-IL-Joliet ID2025-222844 CategoryNon Clinical Tech Position TypeFull Time ShiftDays Job TypeNon-Exempt MinUSD… more
- Cleveland Clinic (Cleveland, OH)
- …respected healthcare organizations in the world. As a Utilization Management Specialist , you will perform UM activities, such as admission, concurrent, retrospective ... chart and clinical systems reviews to measure clinical performance...refer for resolution + Basic knowledge of medical records coding standards + Proficiency with Microsoft Office + Knowledge… more
- Highmark Health (Buffalo, NY)
- …not limited to: Advising primary care practices, physicians, nurses and other clinical staff to assist them on their conversion to value-based care; Dissemination ... relevant, dissemination and support of gap closures for STARS and improved coding for government populations. Identification of process improvement gaps in workflow… more
- Southeast Health (Dothan, AL)
- …to read and understand explanation of benefit files; + Works closely with clinical team for accurate charges and modifiers; + Verifies third party payer coverage; ... + Coordinates authorizations when appropriate; + Works closely with coding team for accurate submission on claim; + Process...+ Previous work in a business office, registration or clinical setting Minimum Experience Preferred + One (1) year… more
- University of Utah Health (Salt Lake City, UT)
- …of patient responsibility, as assigned by payer/contract/benefit. + Resolves clinical and/or authorization denials through CARC analysis and appeals - ... including clinical documentation review and coordination with UR and/or attending...Escalates claim issues internally to other key departments including Coding , Billing, Charging, Contracting, etc. **Knowledge / Skills /… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …Cross and Blue Shield of Minnesota Position Title: Health Plan Quality Assurance Specialist Location: Remote Career Area: Health Services About Blue Cross and Blue ... investigations. The associate works as a member of the care management clinical audit team to ensure compliant, effective and efficient investigations of quality… more
- Tufts Medicine (Lowell, MA)
- …reimagining healthcare. Ready to grow with us? The Quality Charge RN Specialist is an important member of the Emergency Department Team. **Responsibilities ... capture for the Emergency Department + Maintains a working knowledge of all coding and reimbursement resources. + Responds promptly and efficiently to charge capture… more