Prior Authorizations Rep (30486)
GI Alliance
Description Academic Urology & Urogynecology of Arizona is a premier urology practice offering compassionate patient care to individuals throughout Arizona. Responsibilities Review EMR chart messaging and review schedules daily for upcoming surgical & in-office procedures Review chart documentations to ensure patient meets medical policy guidelines Prioritize authorization requests according to urgency Obtain authorization via payer website or by phone and follow up regularly on pending cases Verify coverage and benefits and calculate any out-of-pocket portions due Contact patients to review any out-of-pocket portions due prior to surgery Qualifications Minimum 1 year prior authorization experience Understanding of payer medical policy guidelines to manage authorizations effectively Proficient use of CPT and ICD10 codes Detail-oriented and above-average organizational skills Plans and prioritizes to meet deadlines Ability to multitask and remain focused while managing a high volume, time-sensitive workload Urology experience helpful Physical Requirements Requires sitting for extended periods. Some bending, stretching, and stooping required. Manual dexterity enough to use a keyboard and calculator. Normal range of hearing and vision and verbal communication is required. Use of a telephone is required. Performance Requirements Knowledge of billing and insurance practices and procedures as well as regulations including Medicare, Medicaid, and third‑party insurance companies including managed care contracts. Knowledge of current ICD-10 and CPT codes is required. Strong communication skills are required. #J-18808-Ljbffr GI Alliance
$15.51 - $16 per hour
...Services is seeking a dedicated and empathetic Front Office Rep who can help us fulfill our mission. “Delivering compassionate... ...clinically necessary/appropriate. Processes medication issues and prior authorizations. Processes and monitors lab results. Schedules medication,...SuggestedTemporary workLocal areaMonday to Friday- ...Services is seeking a dedicated and empathetic Front Office Rep who can help us fulfill our mission. "Delivering compassionate... ...will be responsible for processing medication refill requests, prior authorizations, and lab results. In addition, manages prescriber schedules...SuggestedFull timeTemporary work
$20 - $23 per hour
...member and provider experiences all while reducing cost. The Prior Authorization Representative I is responsible for processing incoming... ...data entry component of the prior authorization request. The PA Rep I works closely with all UM Staff, Prior Auth Supervisor, and...SuggestedWork at office- ...Basic Brightree Functions Proper Intake Procedures Insurance Verification and Eligibility CMN Requirements and Prior Authorizations Documentation Requirements of the Equipment Patient's Financial Responsibilities (Deductible, Co-Insurance, Co-Pay, ABN...SuggestedTemporary workWork at officeShift work
- ...Responsibilities Handling patients, referral sources, and administrative Customer inquires Communicating with insurance companies and/or prior authorization requests Entering patient information into a customer information system Ensuring customer satisfaction and assisting them...SuggestedWork at office
$18 - $22.19 per hour
...wpm Excellent written and interpersonal communication skills Computer skills Preferred Minimum of one (1) year experience in prior authorization precertification insurance benefits and how they apply to hospital registration or medical office setting. Medical terminology...Hourly payWork at office- ...commercial plans. Verifies insurance eligibility and coverage and executes appropriate insurance notification procedures. Obtains prior authorization in order to avoid non-compliance, denials and/or penalties to the patient, hospital and physician(s). Initiates notifications...Full timePart timeWork at office
- ...wpm Excellent written and interpersonal communication skills Computer skills Preferred Minimum of one (1) year experience in prior authorization precertification insurance benefits and how they apply to hospital registration or medical office setting. Medical terminology...Work at office
- ...patient communications. To be successful in this role, you will have previous clerical experience, with a minimum of one year in prior authorization, precertification, and insurance benefits within a hospital registration or medical office setting. Proficiency in medical...Work at office
$18 - $22.19 per hour
...wpm Excellent written and interpersonal communication skills Computer skills Preferred Minimum of one (1) year experience in prior authorization precertification insurance benefits and how they apply to hospital registration or medical office setting. Medical terminology...Full timeWork at office$18 - $22.19 per hour
...patient communications. To be successful in this role, you will have previous clerical experience, with a minimum of one year in prior authorization, precertification, and insurance benefits within a hospital registration or medical office setting. Proficiency in medical...Work at office$68k - $71.03k
...provides a work culture that affords employees flexibility, autonomy, and trust. Remote work is available within Arizona subject to prior authorization. Responsibilities Conduct Pre‑Payment Claim Reviews for medical necessity, appropriateness of services, quality of care, and...Full timePart timeWork at officeRemote workLong distance$18k
...signatures and documents. Responsible for the verification and authorization of insurance benefits on all patient accounts through... ...Computer skills Preferred Minimum of one (1) year experience in prior authorization precertification insurance benefits and how they...Full timePart timeWork at officeLocal areaRelocation packageFlexible hours$20 per hour
...banking or similar customer service experience. The Admitting Reps perform duties to admit patients to the hospital, including... ...executes appropriate insurance notification procedures. Obtains prior authorization in order to avoid non-compliance, denials and/or penalties to...Daily paidPrice workReliefWork at officeShift workNight shiftWeekend workAfternoon shift$17.85 - $25.48 per hour
...inquiries related to eligibility, benefits, claims, and service authorizations. The role involves handling incoming calls, accurately... ...with a Pharmacy or provide additional information needed for a prior authorization. Research and communicate member information such...Local areaFlexible hours- ...POSITION SUMMARY The Prior Authorization RN is responsible for reviewing and processing medical prior authorization requests to ensure services are medically necessary, meet evidence-based guidelines, and align with the health plan’s policies. This RN plays a critical...
$50 - $52 per hour
...to initiate it. Do not obtain on own FPCC. Knowledge Service Authorization concepts, principles, and strategies. Advanced knowledge of... ...to AHCCCS programs. AHCCCS program design and implementation, prior authorization functions and responsibilities, provider network...Part timeWork at officeRemote workLong distance10 hours per week$65k - $76k
...are processed quickly and efficiently throughout the workflow process Assists operations staff and prescriber offices with prior authorizations by following up on outstanding issues and assisting with coordination and communication Ensure that prescription renewal...Temporary workWork at officeLocal areaRemote workMonday to Friday- ...being submitted Keep and update active reports for billing and billable items Utilization review (submitting and monitoring prior authorizations) Reviewing denials for reprocessing Posting insurance payments against claims in billing software Verifying eligibility...Temporary workWork at office
- ...Administer injections, vaccinations, and perform phlebotomy as directed Process and manage lab specimens, referrals, and prior authorizations Educate patients on treatment plans, medications, and follow-up care instructions Maintain compliance with HIPAA, OSHA, and...
- ...submitted. Keep and update active reports for billing and billable items. Utilization review (submitting and monitoring prior authorizations) Reviewing denials for reprocessing Posting insurance payments against claims in billing software Verifying...Temporary workWork at office
- ...prompt, courteous, and helpful manner, responding to routine requests for information. Register patients to include, obtaining prior authorization, eligibility and benefits, scanning patient ID and insurance card, taking patients pictures in EMR, confirming patient...Full timeWork at office
- ...responds to inquiries including medication refills and general questions Makes timely outbound calls as needed Processes prior authorizations and communicates with insurance providers Orders and organizes medical supplies to maintain inventory levels Attends...Full timeWork at office
- ...(PSLF) program. General Description The Hospital Admitting Rep is responsible for greeting incoming patients and visitors, performing... ...and scan into patients account Verify insurance eligibility prior to services rendered Explain and obtain signatures on all...Work at office
- ...respond to daily requests for information from plan documents. Entry level position with prior client service or related experience preferred. Applicants must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the...H1bWorldwideFlexible hours
- ...Generate financial statements and reports detaining accounts receivable status. Serve as the liaison to therapist and AHCCCS Prior Authorization Department Tracking and organizing insurance information, following up on all claim denials. Effectively communicating billing...Work at office
$41.04k - $61.56k
...benefits. Northern Trust also provides a discretionary bonus program that may include an equity component. Applicants must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Northern Trust will not sponsor...Work experience placementH1bWorldwideFlexible hours- Jamba Software is seeking a motivated sales representative to join our Pittsburgh office. This role involves actively engaging prospective customers to drive sales for our products and services. The right candidate will have 1-2 years of sales experience, a bachelor's degree...Work at office
- CVS Health Corporation in Arizona is seeking a Pharmacy Care Representative for a fully remote, full-time role. You will handle inbound/outbound calls, verify insurance, enroll new patients, and process medication orders while delivering education and maintaining high-quality...Remote jobFull time
- ...vendors or employment agencies ("Recruiting Vendors"). Recruiting Vendors must have a valid written agreement and received prior written authorization from an authorized Brown & Brown representative before submitting candidates for any publicly posted role. Any...
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