- Rush University Medical Center (Chicago, IL)
- …and is able to communicate coverage-related concepts to the patients, ie pre - certification and out-of-network. 7. Proficient in navigating their own EPIC ... WQs, as well as assisting in other team members WQs in order to maximize department's ability to move performance of registration duties. 8. Ability to function as a preceptor for new hire orientation by assisting the supervisors in monitoring the new hire's… more
- Elevance Health (Columbus, GA)
- …with issues concerning contract and benefit eligibility for requested continuing pre - certification and prior authorization of inpatient and outpatient services ... outside of initial authorized set. + Assisting management by identifying areas of improvement and expressing a willingness to take on new projects as assigned. + Handling escalated and unresolved calls from less experienced team members. + Ensuring UM Reps are… more
- Texas Health Resources (Arlington, 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
- Texas Health Resources (Plano, 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
- Banner Health (Glendale, AZ)
- …the payors and documents appropriately. Assists in obtaining or validating pre - certification , referrals, and authorizations 3. Calculates and collects patient ... liability according to verification of insurance benefits and expected reimbursement. Explains and provides financial policies and available resources for alternative payment arrangements to patients and their families. 4. Enters payments/charges for services… more
- Elevance Health (Columbus, GA)
- …network services, and clinical guidelines within scope of license. + Conducts pre - certification , concurrent review, and appeals of Behavioral Health OP services. ... + Mentors Behavioral Health Care Management staff by assisting in training, attending utilization management rounds, and serving on interdepartmental initiatives; assists in developing a program around psychological and neuropsychological testing. **Minimum… more
- Banner Health (Phoenix, AZ)
- …the payors and documents appropriately. Assists in obtaining or validating pre - certification , referrals, and authorizations 3. Calculates and collects patient ... liability according to verification of insurance benefits and expected reimbursement. Explains and provides financial policies and available resources for alternative payment arrangements to patients and their families. 4. Enters payments/charges for services… more
- Elevance Health (Grand Prairie, TX)
- …services, and clinical guidelines within scope of license. + Conduct pre - certification or prior authorization of psychological testing and neuropsychological ... testing services. + Partners with Behavioral Health Management staff by assisting in training, attending utilization management rounds, and serving on interdepartmental initiatives; assists in developing a program around psychological and neuropsychological… more
- University of Rochester (Rochester, NY)
- …system along with all third-party payer systems. + Obtain benefits; pre - certification requirements and/or completes notification of admissions. + Document ... demographic and insurance information in a timely, accurate manner in the hospital computer system following department and hospital standards. + Identify and confirm uninsured and underinsured patients for appropriate referral to Medicaid Enrollment &… more
- Texas Health Resources (Flower Mound, 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