- Stanford Health Care (Palo Alto, CA)
- …ASA + Knowledge of medical management statistics relating to UM/CM and prior authorization process management. + Extensive knowledge of risk stratification ... methods and complex case management criteria. + Working knowledge of regulatory entities and regulations (CMS, DMHC, NCQA, etc.) + Working knowledge of care management systems. + Time Management: the ability to organize and manage multiple priorities +… more
- Adecco US, Inc. (Irving, TX)
- …+ **Benefit & Access Education (25%)** - Educate providers on benefit verification, prior authorization , payer trends, and support center services. Document and ... report all interactions as required by the client. + **Reimbursement Support (20%)** - Assist offices with claims, billing and coding, appeals, medical benefit interpretation, and co-pay or patient assistance programs. Coordinate closely with case managers for… more
- UTMB Health (Galveston, TX)
- …of immunizations + Works with patients, providers, and payers to obtain prior authorization + Resolves billing/adjudication issues encountered in the processing ... of prescription + Proficient in the use of financial assistance software + Proficient in C2 safe operation and/or OR anesthesia narcotic reconciliation + Advanced skill in the use of technology within area of assignment + Works with leaders and team members to… more
- University of Washington (Seattle, WA)
- …+ Routing calls and taking complete, accurate messages + Referral coordination and prior authorization entry in Epic + Customer service and issue resolution ... with empathy and professionalism + Collaboration with clinics, Financial Counselors, and Interpreter Services + Patient portal support and inquiry resolution + Documentation and data updates during scheduling + Adherence to performance standards, compliance,… more
- Actalent (Marlborough, MA)
- …Additional Skills & Qualifications + Pharmacy degree (PharmD) + Experience in prior authorization + Retail pharmacy experience + Pharmaceutical knowledge Work ... Environment This role may use standard office and pharmacy equipment such as computers, phones, photocopiers, filing cabinets, rolling carts, and fax machines. The work environment includes shifts from 3:30pm-12am Monday to Friday, with rotating weekends and… more
- TEKsystems (Washington, DC)
- …doing pre auths, rooming patients, getting the charts prepped for Doctors and Nurses. + Prior - authorization 's is a large part of day to day responsibility + They ... may be bringing in information for Prescription Refills, and they will be putting that information into the system for the Nurse and Doctor. + They will be getting the patients through the first 30% of their visit. Candidate will be seeing around 30+… more
- Stanford Health Care (Palo Alto, CA)
- …Hour (United States of America) Strongly Preferred Qualifications: - Insurance knowledge - Prior Authorization experience **This is a Stanford Health Care job.** ... **A Brief Overview** As a foundational level, the PCC II, is expected to learn and apply job skills, policies, and procedures to complete moderate assignments and tasks. They should exercise judgment within defined guidelines to determine appropriate actions.… more
- University of Washington (Seattle, WA)
- …Contributes to patient referral workflows, ensuring timely referral processing, flag for prior authorization needs and scheduling for specialized services. o ... Enhances patient access and satisfaction through efficient referral management. 4. Quality Improvement (QI) Data Oversight o Supports QI-related data for both inpatient and outpatient services, chart reviewing, supporting A2E goals and departmental performance… more
- Moses/Weitzman Health System (Bethel, CT)
- …by laws in a timely manner, included by not limited to intake, prior authorization request, progress notes, treatment plan documentation, and discharge. + ... Completes and locks all treatment notes no later than the end of the next business day. + Completes reports as required for outside agencies such as DCF, Family Relations, probation, and others with appropriate releases signed by clients. + Participates as a… more
- Kennedy Krieger Institute (Baltimore, MD)
- …medical equipment and facilitating medication refill requests. 6. Assisting with obtaining prior authorization for the Spina Bifida and related medical program ... services as needed. 7. Assist in the maintenance and inventory of medical supplies. Restock and prepare exam rooms for the next day according to par levels. Notify staff member responsible for ordering supplies when appropriate. 8. Work within scope to answer… more
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