- Eastern Connecticut Health Network (Manchester, CT)
- …preferred. EXPERIENCE: + 2 years Hospital or medical office insurance/ authorization /precertification/ referral work experience. + 2 years customer service. ... are prevented. + Verifies insurance policy benefit information and obtains Authorization /Precertification prior to the patient's visit, scheduled surgery,… more
- LaSante Health Center (Brooklyn, NY)
- LaSante Health Center is seeking a Referrals and Prior Authorization Specialist to join our team. The ideal candidate will help ensure patients have seamless ... to medications, diagnostic imaging, and specialty care by managing prior authorization requests for insurance and guiding... requests for insurance and guiding patients through the referral process. This position offers the opportunity to be… more
- Highmark Health (Monroeville, PA)
- …and overseeing referral screening/management. **ESSENTIAL RESPONSIBILITIES** + Prior Authorization & Utilization Management: Reviews pharmacy utilization ... **Company :** Allegheny Health Network **Job Description :** **JOB SUMMARY** This position...administration of effective and efficient processing for pharmacy benefits prior authorization processes, insurance evaluations, addressing patient… more
- St. Luke's University Health Network (Bethlehem, PA)
- …Acquire and submit all necessary clinical information to insurance company needed to obtain prior authorization in a timely fashion + Obtains knowledge of any ... we serve, regardless of a patient's ability to pay for health care. The Referral Scheduling Specialist is a liaison between the providers and the patients. They are… more
- 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 ... incredible work. What Will You Do?As an Assessment & Referral Clinician at Pine Rest, you'll be part of...including interfacing with insurance and managed care companies for authorization . + Refer patients to outpatient services, either within… 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 (Oneonta, 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 (Oneonta, 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...urgent referrals same day. Processes electronic or written routine referral requests within 24-72 hours + In regard to… more
- Henry Ford Health System (Troy, MI)
- …not limited Evicore (CareCore National) exception reports, which relate to the authorization and processing of outpatient referral activity. + When indicated, ... PRINCIPLE DUTIES AND RESPONSIBILITIES: + Researches, assesses, and processes all requests for authorization that are initiated through the call center as well as the… more
- Humana (Olympia, WA)
- …assisting providers in determining whether a specific service for a member requires prior authorization or referral , ensuring compliance with established ... medical record and documentation programs + Experience with Utilization Review and/or Prior Authorization , preferably within a managed care organization +… more