- Pine Rest Christian Mental Health Services (Grand Rapids, MI)
- …behavioral health system in the country, our 220-acre main campus, and our network of clinical sites across Michigan. We are a tight-knit community of healers ... work. What Will you Do? As an Assessment & Referral Registered Nurse (ARRN) at Pine Rest, you'll be...including interfacing with insurance and managed care companies for authorization . + Refer patients to outpatient services within or… more
- St. Luke's University Health Network (Allentown, PA)
- …needs change, the services may be performed at any level within the Network 's continuum of services and/or sites. JOB DUTIES AND RESPONSIBILITIES: + Demonstrates ... care. + Arranges for community services (including short and long-term placement) prior to discharge to meet patient's needs with recognition and documentation of… more
- Bassett Healthcare (Hamilton, NY)
- …a go to person for coworkers. + Obtains prior approval or prior authorization as needed. Communicates referral appointment and appointment instructions ... point of contact for patients within the Bassett Healthcare Network . This is a key role in the patient...Medicare regulations. + Obtains prior approval or prior authorization as needed. Communicates referral… more
- Bassett Healthcare (Hamilton, NY)
- …Attends Patient Access Review Sessions (PARS)* Obtains prior approval or prior authorization as needed. Communicates referral appointment and appointment ... point of contact for patients within the Bassett Healthcare Network . This is a key role in the patient...urgent referrals same day. Processes electronic or written routine referral requests within 24-72 hours. + In regard to… more
- Bassett Healthcare (Cooperstown, NY)
- …Patient Access Review Sessions (PARS) + Obtains prior approval or prior authorization as needed. Communicates referral appointment and appointment ... point of contact for patients within the Bassett Healthcare Network . This is a key role in the patient...urgent referrals same day. Processes electronic or written routine referral requests within 24-72 hours + In regards to… more
- Community Health Systems (Brandon, MS)
- …follows up with the insurance company until there is resolution of the prior authorization request - an approval, redirection, or denial. All activity ... linked to the referral requested. + Validates continuity of care and network integrity based on service line availability for quality patient care. + Sends all… more
- Actalent (Tempe, AZ)
- …+ Conduct clinical review, analysis, recommendation, decision, and documentation of prior authorization requests, medical exception requests, and appeal requests ... + Offer drug information support and research clinical literature to support prior authorization decisions. + Prepare agendas and materials for Pharmacy… more
- University of Virginia (Charlottesville, VA)
- …out of network ' for services. b. Informs patients about the authorization status as necessary. c. Prepares patient financial liability estimates and takes ... staff is accomplished in a timely manner to ensure accurate pre-certification/ authorization information is aligned with accurate billing of services. i.… more
- Veterans Affairs, Veterans Health Administration (Albany, NY)
- …medical Referral Documents (REFDOC) as required for scheduling care. Enters CC authorization into Health Share Referral Manager (HSRM) database as per FGB ... consult management timeliness metrics. Ensures designation of patient desired in- network community provider and appointment date as appropriate, documents… more
- State of Connecticut, Department of Administrative Services (Hartford, CT)
- …+ 8:00am-4:30pm + Hybrid schedule The Role: + Oversee the claim and prior authorization review processes, dental regulations and procedure adherence, management ... with dental vendor to ensure the timely handling of prior authorization claim reviews; + Evaluate the...and changes from the Department to the vendors, provider network and community partners; + Conduct professional relations between… more