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.
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.
Conduct benefit investigations, insurance verification, and prior authorizations to secure timely patient access to therapies.
Manage patient case files, coordinate product ordering and shipment with pharmacies and prescribers.
Handle inbound inquiries, report adverse events, and educate stakeholders on program requirements.
Jobgether is a platform that uses AI-powered matching to connect candidates with hiring companies. They focus on efficient, objective candidate screening and share top-fitting shortlists with employers.
Design and configure prior authorization criteria, decision trees, and authorization parameters within the PA system.
Perform quality assurance and quality control reviews to ensure clinical intent and regulatory compliance.
Collaborate with internal teams and external clients to support delegated PA services and system optimization.
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans. The company is a public benefit corporation focused on rebuilding trust in healthcare in the U.S., with a culture that emphasizes collaboration and client support.
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.
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.
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.
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.
Interpret, evaluate, and summarize information and datasets of varying sizes.
Determine benefit limits and secure insurance approvals for specialty infusion, oral chemotherapy and high-cost medications.
Serve as a resource to patients and staff regarding insurance and drug coverage questions.
Fred Hutchinson Cancer Center is an independent, nonprofit organization providing adult cancer treatment and groundbreaking research focused on cancer and infectious diseases. Based in Seattle, it is the only NCI-designated cancer center in Washington, employing a diverse workforce that values collaboration, compassion, and innovation.
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.
Review and interpret clinician assessments for prior authorization approvals and care plan recommendations.
Monitor patient adherence across all sites and disease categories, focusing on oncology and specialty states.
Provide medication therapy management including regimen review, drug therapy changes, and patient coaching.
Shields Health Solutions provides integrated support to improve patient care quality. The company employs a team of licensed pharmacists and support staff, focusing on medication adherence and evidence-based care.
Ensure timely processing of paperwork for insurance authorizations and billing to prevent delays.
Conduct daily touch points with central operations teams to address therapy placement or appeals.
Manage multiple accounts, handle complaints professionally, and train staff on medical documentation processes.
Advanced Oxygen Therapy, Inc. (AOTI) transforms wound care with breakthrough technologies like Topical Wound Oxygen (TWO2) therapy and the NEXA NPWT system. They are a growing company with a global team, backed by a world-class leadership team and robust infrastructure.