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.
Work with ABA/behavioral health providers to collect patient information and communicate authorization decisions
Verify patient eligibility and benefits with insurers and complete prior authorizations via portals or calls
Manage multiple authorizations and collaborate with product team to automate parts of the process
Silna Health is obsessed with optimizing the broken healthcare system by automating prior authorizations and eligibility checks. Backed by Accel and Bain Capital Ventures, they are a fast-growing company working across behavioral health, physical health, ambulatory care, and post-acute care.
Perform clinical review and evaluation of pharmacy prior authorization requests to determine medical necessity and appropriateness.
Coordinate appeals and provide clinical consultation to providers, members, and internal stakeholders.
Support utilization management initiatives, develop clinical criteria, and drive quality improvement across clinical programs.
FairosRx is an innovative company striving to reduce the cost of healthcare. They have a tight-knit culture based on an outward mindset and are growing quickly.
Verify insurance eligibility, benefits, and network status, and create pre-service liability estimates.
Secure prior authorizations for outpatient imaging and office services, following up on delayed or denied requests.
Act as a liaison between payers and clinic schedulers, ensuring accurate documentation and issue resolution.
University of Utah Health enhances health and well-being through patient care, research, and education. With five hospitals and eleven clinics, it is nationally ranked and fosters a culture of collaboration, excellence, leadership, and respect.
Communicate with insurance companies and clinician offices to facilitate medication prior authorizations.
Assist patients with financial assistance resources and navigate pharmacy systems for claims processing.
Support medication adherence through direct patient communication and accurate documentation.
Shields Health Solutions is a healthcare solutions company specializing in specialty pharmacy services. The company fosters a collaborative culture focused on patient care and operational excellence.
Facilitate medication approvals by communicating with insurance companies and healthcare providers regarding prior authorizations.
Navigate pharmacy systems to enter data, adjudicate claims, process refills, and document patient interactions.
Assist patients with insurance claims, medication access challenges, and promote adherence through phone support.
Shields Health Solutions is a healthcare company dedicated to helping patients access life-changing medications through prior authorization and financial assistance support. They foster a collaborative, patient-focused culture with opportunities for professional growth in a fully remote setting.
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 insurance authorizations for clients in PHP and IOP programs, including pre-certifications and concurrent reviews.
Verify benefits, obtain Single Case Agreements, and build medical necessity cases using ASAM, LOCUS, and CALOCUS criteria.
Maintain accurate authorization, denial, and SCA records and prepare appeals on denied authorizations.
AWA and PRC are dual behavioral health organizations operating PHP and IOP programs across South Florida. They exist to serve clients and families at their most critical moments.
Verify patient insurance eligibility and benefits prior to services and document findings accurately.
Post insurance and patient payments, research variances, and follow up on outstanding claims.
Perform provider documentation and coding audits to ensure CPT, ICD-10-CM, and modifier accuracy.
Brightline is a premier national youth mental health provider delivering high quality virtual and in-person care to families. Founded in 2019, Brightline has delivered care to tens of thousands of families and is backed by investors including Google Ventures and KKR.
Manage an assigned accounts receivable portfolio, prioritizing accounts by age, balance, and recovery potential
Follow up on unpaid and underpaid claims through payer portals and by phone
Submit appeals and reconsiderations with supporting documentation when appropriate
Raventra Health is a medical services company providing outsourced billing, coding, and claims processing solutions for provider groups and hospitals. The company values independence, persistence, and attention to detail in a remote work environment.
Provide medication prior authorization support for assigned clinics using the Epic In Basket system.
Manage prior authorizations from clinic to pharmacy, including submission, tracking, and follow-up.
Communicate with clinics, pharmacies, and insurance payers to ensure timely approvals and patient access.
UnityPoint Health is a healthcare system delivering medical services across the Midwest. Recognized as a Top 150 Place to Work in Healthcare, it fosters a culture of belonging and supports team members with development and well-being.
Manage charge entry, claim submission, and payment posting for assigned clients
Work first-pass denials and resubmit or appeal claims as appropriate
Monitor and report on denial rates and billing performance for your assigned accounts
Raventra Health is a medical services company providing outsourced billing, coding, and claims processing solutions for provider groups and hospitals. The company is an equal opportunity employer committed to diversity and inclusion.
Proactively monitor patient insurance eligibility and authorization status to prevent therapy interruptions.
Work directly with patients, sales teams, and physicians to obtain updated insurance or clinical documentation.
Serve as primary point of contact for patients, providers, and field partners, answering benefits and authorization questions.
LUX Infusion reimagines infusion care to be more human, supportive, and connected. It is a clinician-led, U.S.-based organization committed to inclusion, diversity, equity, and advancement.