Verify insurance, obtain benefits, calculate estimates, and secure prior authorizations for outpatient services.
Act as liaison between payers and clinic staff; follow up on denied or delayed authorizations.
Maintain detailed documentation and resolve issues with physicians, nurses, and financial advocates.
University of Utah Health is a patient-focused organization enhancing health through care, research, and education. It operates five hospitals and eleven clinics with a culture of collaboration, excellence, leadership, and respect.
Process referrals and prior authorizations, ensuring accurate and timely documentation.
Collaborate with clinical teams, physician offices, and insurance companies to resolve authorization issues.
Monitor denial reports, manage referral tracking, and communicate decisions to providers, staff, and patients.
Baystate Health is an integrated healthcare system serving western Massachusetts. With 12,000 employees and a community-focused culture, it includes five hospitals and offers career growth.
Review and process prior authorization requests for various medications.
Communicate prior authorization criteria to providers and act as a help desk.
Process requests via phone, fax, and web submission while maintaining HIPAA compliance.
Lumicera Health Services is a specialty pharmacy focused on optimizing patient well-being through transparency and stewardship. It fosters a diverse and creative work environment as part of the Navitus organization.
Verify insurance eligibility, coverage, and behavioral health benefits for new and existing patients.
Coordinate prior authorizations, referrals, and coverage resolution with insurance carriers and internal teams.
Manage high-volume requests through EHR systems with strong attention to detail and problem-solving.
Blackbird Health is a clinician-founded provider of virtual and in-person mental health services for children across Pennsylvania, Virginia, New Jersey, and Maryland. The team is collaborative, supportive, and innovative, taking a whole-child approach to care.
Review and respond to phone and fax inquiries from members, providers, and pharmacies for prior authorization.
Use multiple applications and follow procedures to accurately document and resolve inquiries.
Provide excellent customer service and meet or exceed call center metrics.
The Cigna Group is dedicated to improving the health and vitality of those we serve through Cigna Healthcare and Evernorth Health Services. We are a major healthcare organization focused on enhancing the lives of our clients, customers, and patients.
Prepare, review, and submit accurate prior authorization requests to PBMs and health plans for anti-obesity medications.
Act as an escalation point to resolve complex coverage inquiries from Medical Providers, Member Services, and Client Success.
Maintain HIPAA compliance and accurately document hours using designated ADP pay codes.
Vida is a virtual, personalized obesity care provider that uses evidence-based treatment to help patients manage obesity and related conditions. It is trusted by Fortune 100 companies and fosters a diverse, inclusive culture.
Coordinates utilization review and prior authorization requests, ensuring accurate entry into the UM platform.
Provides customer service to providers and members, confirming benefits and answering authorization questions.
Facilitates communication between reviewers, hospitals, and physicians to ensure timely decisions.
University of Utah Health Plans is a patient-focused organization that enhances health through patient care, research, and education. It is part of a nationally ranked academic medical center with five hospitals and eleven clinics, fostering a culture of collaboration and excellence.
Leads enterprise authorization operations with direct impact on revenue protection, patient access, and reimbursement performance.
Manages a team responsible for insurance verification, pre-authorization, and timely processing of assigned services.
Collaborates with billing, registration, revenue cycle, clinical, and administrative teams to reduce preventable payment denials.
The partner company is a healthcare organization focused on revenue protection, patient access, and reimbursement performance. They provide a collaborative and mission-driven environment for teams working across complex healthcare operations.
Obtain managed care authorizations and verify patient insurance benefits prior to services.
Review office schedules daily and update EHR systems with authorization and insurance details.
Coordinate with staff and providers on denials, peer-to-peer reviews, and monthly re-verification of coverage.
Surgery Partners operates a network of surgical facilities and provides healthcare services across the United States. The company fosters a diverse and inclusive workplace, offering comprehensive benefits and professional development opportunities.
Help members navigate US health insurance, including billing questions, denied claims, and appeals.
Coordinate with providers, insurers, and members to resolve coverage issues and prior authorizations.
Translate complex insurance benefits into clear guidance and identify trends to improve the member experience.
This company provides a global safety net for remote workers, offering health, income, and travel coverage. It operates as a remote-first organization with a culture of empathy, integrity, and a mission to improve access to healthcare worldwide.
Monitor clearinghouse portals and resolve rejected medical claims daily.
Investigate rejection causes including coding errors and eligibility issues.
Correct claim information and resubmit to insurance payers for reimbursement.
Our partner is a healthcare revenue cycle management company focused on optimizing medical claims processing for providers. They offer a collaborative, inclusive work culture with opportunities for professional growth in a remote environment.
Manage referral workflows from intake through closure, ensuring accurate and efficient progress.
Coordinate the full prior authorization lifecycle including submission, tracking, follow-up, and appeals.
Facilitate patient scheduling and care coordination across providers, clinics, specialists, and payers.
Indigenous Pact is committed to improving access to quality healthcare services through innovative, patient-centered care coordination. They are an equal opportunity employer dedicated to fostering an inclusive and barrier-free work environment.