- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** The Manager of Payer Connectivity for Prior Authorization plays a pivotal role in optimizing how healthcare providers and payers ... internal stakeholders at all levels. + Deep understanding of healthcare administration, payer operations, and prior authorization processes. + Familiarity… more
- Carle Health (Urbana, IL)
- Overview Manages the daily activities of Patient Access Medical Insurance and Prior Authorization departments to ensure high quality customer service and improve ... policies consistently + Manages daily activities of the Medical Insurance and Prior Authorization departments + Ensure quality and quantity of work… more
- University of Miami (Miami, FL)
- …CORE FUNCTIONS: + Adhere and perform timely prospective review for services requiring prior authorization as well as timely concurrent review for continuation of ... conducts initial, concurrent and retrospective chart reviews for clinical utilization and authorization . The Utilization Review Case Manager coordinates with the… more
- Caris Life Sciences (Irving, TX)
- …**Position Summary** Caris Life Sciences is seeking a full-time **Billing Operations Manager ** to lead and manage the **Eligibility** function within our Billing ... eligibility processes are compliant, efficient, and patient-focused. The Eligibility Manager provides leadership, training, and performance management to staff,… more
- Rush University Medical Center (Chicago, IL)
- …Offers may vary depending on the circumstances of each case. **Summary:** The Prior Authorization Specialist I is responsible for obtaining and resolving ... referral, precertification, and/or prior authorization to support insurance specific plan...background and clinical information that is required for the payer to issue a referral or an authorization… more
- Saint Francis Health System (OK)
- … Specialist II ensures accuracy of insurance information and obtains prior authorization and predetermination requirements for non-oncology infusions, oncology ... Current Procedural Terminology (CPT) and diagnosis code information to support authorization and precertification according to payer guidelines. Monitors,… more
- Saint Francis Health System (Tulsa, OK)
- …the revenue cycle by ensuring accuracy of insurance information and procuring prior authorization and predetermination for scheduled patient appointments as well ... Reviews clinical documentation for CPT/diagnosis code information to support authorization /precertification according to payer guidelines. Accurately monitors,… more
- Hartford HealthCare (North Haven, CT)
- …and more than 30 different specialties. *_Job Description_* Under the direction of the Manager , a Prior Authorization Specialist performs all clerical duties ... payer and or federal regulatory guidelines to their manager , providers and other clinical departments, as applicable. ....clinical departments, as applicable. . Monitors and reviews the prior authorization work queue daily to verify… more
- J&J Family of Companies (Flint, MI)
- …billing. + Reimbursement or relevant managed care experience (revenue cycle, buy-and-bill, prior authorization , coding, and appeals processes) + Ability to ... + Immunology disease state experience + Advanced degree and/or relevant certifications in prior authorization and/or billing and coding + Strong market access… more
- J&J Family of Companies (Grand Rapids, MI)
- …billing. + Reimbursement or relevant managed care experience (revenue cycle, buy-and-bill, prior authorization , coding, and appeals processes) + Ability to ... + Immunology disease state experience + Advanced degree and/or relevant certifications in prior authorization and/or billing and coding + Strong market access… more
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