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.
Collaborate with a multidisciplinary team to manage referrals, prior authorizations, and medical records for whole-person member care.
Apply knowledge of CPT/ICD-10 codes and insurance requirements to obtain authorizations, appeals, and follow up for positive outcomes.
Assist members with accessing services, provide personalized customer service, and track data to refine operational processes.
Oshi Health is a virtual digestive health practice transforming GI care with compassionate, multidisciplinary care and innovative technology. It is a mission-driven, remote-first startup focused on personalized care plans and building a diverse team.
Serve as a liaison between OHSU providers and patients, scheduling clinic visits and ancillary procedures while managing referrals and authorizations.
Handle high-volume incoming calls, faxes, and mail, ensuring prompt and professional communication with patients and referring providers.
Verify patient insurance eligibility, process prior authorizations, and follow up on denied claims to ensure smooth care coordination.
OHSU is Oregon's only public academic health center, providing patient care, research, and education. As Portland's largest employer, it fosters a multicultural and anti-racist workplace.
Verify patient insurance eligibility, benefits, and coverage prior to treatment.
Secure prior authorizations from insurance companies for scheduled medical services.
Maintain accurate records of authorizations, approvals, denials, and follow-up activities.
A-DTS is a healthcare services company focused on supporting patient access to care through insurance verification and authorization processes. The company is detail-oriented and emphasizes timely coordination in a remote work environment.
Analyze benefit requirements and initiate authorization for transplant services.
Counsel patients on financial considerations and develop payment plans.
Coordinate with multidisciplinary team to ensure financial clearance.
Lucile Packard Children's Hospital Stanford provides world-renowned pediatric care with advanced technologies and family-centered care. The hospital values continuing education and state-of-the-art facilities, seeking caring and committed caregivers.
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.
Processes referrals and coordinates scheduling for orthopaedic patients.
Provides leadership, training, and oversight for PAS staff and resource specialists.
Manages managed care authorizations and ensures compliance with department procedures.
OHSU is Oregon's only public academic health center, providing patient care, groundbreaking research, and training for health care professionals. As Portland's largest employer, it fosters an inclusive, anti-racist culture and welcomes diverse backgrounds.
Collaborate with a multidisciplinary care team to ensure quality, member-centered care and assist members with navigating and applying for entitlement benefits.
Become an expert on available insurance and social service resources within assigned region, and provide cross-state coverage support as needed.
Maintain timely documentation in electronic health records and participate in ongoing continuing education.
Groups provides assistance to members in accessing Medicaid, Marketplace, and Medicare insurance and other entitlement benefits. The company values member-centered care and harm-reduction practices, with a team-oriented and entrepreneurial culture.
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.
Ensure acute hospital admissions have appropriate level of care and meet medical necessity.
Monitor patient progress in plan of care for continued stay.
Provide clinical information to payer to authorize acute hospital stay and continued services.
Piedmont Healthcare is a healthcare organization focused on patient outcomes. It offers a supportive culture with diverse teams, schedule flexibility, and comprehensive benefits, fostering employee growth and well-being.
Assists with patient medication management and facilitates medication renewal requests.
Acts as a liaison between providers, patients, and pharmacies for prescriptions and prior authorizations.
Monitors prior authorization status and updates relevant parties throughout the process.
Mass General Brigham is a not-for-profit integrated health care system supporting patient care, research, teaching, and community service. They employ a diverse team of professionals including doctors, nurses, and tech experts, fostering a collaborative culture focused on exceptional care.
Verify and update patient demographic and insurance information with high accuracy.
Perform benefits and eligibility verification, and initiate authorization and pre-certification processes.
Communicate clearly with patients regarding financial responsibility, next steps, and required documentation.
Advocate Health is a nonprofit integrated health system formed from the combination of Advocate Aurora Health and Atrium Health, providing care under multiple regional brands. They employ 155,000 teammates across 69 hospitals and over 1,000 care locations, with a focus on clinical innovation, equitable care, and community benefit.
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.