Manage prior authorization workflows with vendors, providers, patients, and payors.
Develop processes and training materials for offshore teams to resolve authorization issues.
Own Prior Authorization outcomes and KPIs for your region or payors.
Alpaca Health enables clinicians to become entrepreneurs, starting in autism care. We've raised over $14M in funding and are growing 30% - 50% month over month, serving thousands of patients.
Provide expertise in prior authorization and implement the Inspire Prior Authorization Program.
Support patient intake, verify insurance, and manage prior authorization requests.
Train sites on program requirements and assist with appeals through External Medical Review.
Inspire Medical Systems is a medical device company dedicated to treating Obstructive Sleep Apnea with an innovative FDA-approved device. The company values a people-first culture, offering excellent benefits, 401k matching, and flexible time off, and is committed to diversity and patient outcomes.
Verifies patient insurance coverage and submits prior authorizations to insurance plans.
Troubleshoots prior authorization submissions and prescription processing with healthcare providers.
Documents activities and works with Customer Support team to ensure patient success.
PHIL is a health-tech startup pioneering the first Software Therapy Deployment Platform for Specialty Pharmaceuticals. The company employs over 120 individuals and expects to double its employee base in the coming year.
Manage the full Authorization process, from initial notification to determination and discharge, with detailed documentation in EMR and payer systems.
Verify patient eligibility and benefits, act as a liaison between hospital staff and health payers, and track pending authorizations for timely responses.
Maintain HIPAA compliance, escalate issues causing delays or denials, and manage workloads through accurate record keeping.
CorroHealth is a partner to healthcare providers, solving revenue cycle challenges through a mix of services, consulting, and technology. The company focuses on scalability and clinical expertise, building long-term careers by investing in employee development.
Review and process prior authorizations for biologics, oncology, and specialty therapies with timely and accurate completion.
Manage clinical documentation, submit and track authorization requests, and resolve issues with insurance providers.
Communicate effectively with patients, clinical staff, and insurance representatives to ensure compliance and workflow efficiency.
IVX Health is a national provider of infusion and injection therapy for individuals managing chronic conditions like Rheumatoid Arthritis, Crohn's Disease, and Multiple Sclerosis. They are a rapidly growing company focused on patient comfort and employee empowerment, with core values of kindness, integrity, and continuous improvement.
Verify patient insurance eligibility, benefits, and referral requirements prior to services.
Communicate coverage and financial responsibility to patients in a clear and empathetic manner.
Collaborate with cross-functional teams to improve patient access and reduce claim denials.
Oshi Health is a virtual digestive health practice that provides multidisciplinary care for chronic digestive conditions. It is a remote-first, mission-driven company focused on transforming GI care.
Review and verify insurance coverage, obtain authorizations, and create patient liability estimates while working closely with internal and external stakeholders.
Serve as a liaison between patients, providers, and insurance companies to ensure accurate financial services and resolve managed care issues.
Provide backup support and cross-coverage for the Centralized Managed Care & Price Estimates Department, including handling trauma admissions and third-party liability.
OHSU is Oregon's only public academic health center, providing patient care, leading groundbreaking research, and training the next generation of healthcare professionals. As Portland's largest employer, it offers a diverse and inclusive culture with opportunities for growth and advancement.
Manage insurance authorization workflows from initial request through final approval.
Verify insurance eligibility, benefits, and authorization requirements.
Collaborate with clinical and billing teams to ensure timely processing.
The company is a healthcare operations organization focused on managing insurance authorization processes to support patient care. They offer a collaborative remote work environment with cross-functional teams.
Communicate directly with insurance companies to facilitate medication approvals and prior authorizations.
Navigate pharmacy systems to enter data, adjudicate claims, and document patient interactions across multiple databases.
Provide compassionate phone support to patients, helping them manage refills, medication adherence, and pharmacy-related questions.
Shields Health Solutions partners with health systems to provide specialty pharmacy services, helping patients access complex medications. As a growing organization, they emphasize a collaborative culture and patient-centered care, employing pharmacy professionals dedicated to improving medication adherence and health outcomes.
Manage referral management portals and process incoming referrals.
Perform insurance benefit verifications and coordinate admissions.
Respond to inquiries about facilities within policy timeframes.
Acadia Healthcare is a national leader in treating individuals with acute co-occurring mood, addiction, and trauma. They emphasize admissions and intake functions to help every possible person in need.
Act as a patient and family advocate to obtain necessary information and fulfill payer authorization requirements.
Collaborate with providers and staff to ensure successful referral and authorization processes.
Track, follow up, and resolve authorization issues to minimize financial risks.
Lucile Packard Children's Hospital Stanford provides world-renowned pediatric care combining advanced technologies with family-centered care. It is a major children's hospital dedicated to caregiver education and state-of-the-art facilities.