- FlexStaff (Lake Success, NY)
- …and interacts with third party payers to obtain approval of hospital days, pre - certification and post-discharge eligibility in relation to clinical course + ... Ensures compliance with current state, federal, and third party payer regulations + Documents the case management process in the medical record; completes and documents a care coordination assessment on the patient + Serves as a liaison to patient, family,… more
- Texas Health Resources (Denton, TX)
- …correct network coverage and obtains and/or validates healthcare benefits and/or pre - certification for applicable tests and/or procedures. These efforts maximize ... reimbursement for services rendered. * Educates patients and/or families about applicable legal, ethical, and compliance documents; ensures regulatory consents are signed by the appropriate parties. * Engages with patients in understanding their financial… more
- Parsons Corporation (Richardson, TX)
- …PS&E). + Professional Engineer (PE) registration in Texas is preferred. + TxDOT pre - certification preferred. + Experience interfacing with TxDOT is preferred. + ... Solid foundational knowledge of basic software such as MicroStation, OpenRoads Designer, ProjectWise, Bluebeam, and Microsoft Office Suite. + Experience in Geometry design, corridor modeling, and plan production using Bentley OpenRoad Designer. **Security… more
- BJC HealthCare (St. Louis, MO)
- …in various radiology areas. **Responsibilities** + Obtains insurance information and pre - certification room referring physician or insurance company. + Maintains ... files and records on all patients, coordinates transportation for inpatients, and performs patient procedure follow-up as instructed. + Coordinates the flow of all examinations by working closely with the radiologists, technical staff and the referring… more
- BrightSpring Health Services (Colorado Springs, CO)
- …+ Home infusion experience a plus + Knowledge of insurance verification and pre - certification procedures + Solid Microsoft Office Suite skills + Strong verbal ... and written communication skills + Ability to independently obtain and interpret information + Knowledge of CPR+ software a plus + Working knowledge of medical terminology + Percentage of Travel: 0-25% **To perform this role will require frequently sitting,… more
- St. Luke's Health System (Boise, ID)
- …with insurance carriers to clarify policies, coverage limitations, and pre - certification requirements. Coordinates with clinical teams, insurance companies ... and Patient Financial Navigators to address insurance denials and manage appeals. + Educates patients on insurance benefits, financial responsibility, and alternative coverage options. + Provides updates on authorization status to clinical teams, oncologists,… more
- Texas Health Resources (Bedford, TX)
- …correct network coverage and obtains and/or validates healthcare benefits and/or pre - certification for applicable tests and/or procedures. These efforts maximize ... reimbursement for services rendered. Educates patients and/or families about applicable legal, ethical, and compliance documents; ensures regulatory consents are signed by the appropriate parties. Engages with patients in understanding their financial… more
- Owens & Minor (Springfield, IL)
- …via phone, fax, and web portal * Ability to submit authorizations or pre - certification request to multi-state payers over multiple platforms. * Communicate ... effectively and professionally with customers, teammates, healthcare professionals, and sales team * Reviews and approves documentation received by third parties for submission to payors for reimbursement * Effectively document activities in ERP system in an… more
- CVS Health (Austin, TX)
- …team. The Care Management Associate will review eligibility and benefits and open pre - certification cases and either approve or send to nursing staff for ... review. Additional responsibilities include but not limited to the following: - Evaluates patients using targeted intervention business rules and processes to identify needed medical services, make appropriate referrals to medical services staff, and… more
- US Physical Therapy (San Antonio, TX)
- …Carries out primary duties such as verifying insurance benefits and insurance pre - certification and authorizations for all patients. Assists in the management ... of patients by communicating to each clinic about every patient's benefits and anticipated, estimated costs for coming to therapy. Data entry of this important information must be done correctly, completely, and in a timely manner. Must also be flexible in… more