Source Job

US

  • Secures outpatient accounts by performing insurance verification and obtaining prior authorization before services are rendered.
  • Works with physicians, nurses, clinic managers, and financial advocates to resolve issues during the prior authorizations process.
  • Ensures accurate ICD, CPT codes and related medical records are submitted in the authorization request.

Insurance Verification Communication Critical Thinking

7 jobs similar to Prior Authorization Rep II

Jobs ranked by similarity.

US

  • Contacts insurance companies to determine pre-certification requirements.
  • Obtains pre-authorization prior to the scheduled complex service.
  • Liaisons with physicians to obtain additional information.

Piedmont Healthcare is a company focused on healthcare services. They appear to be a large corporate entity, offering a range of opportunities within the revenue cycle and healthcare sectors.

US

  • Conduct insurance verification for new referrals and ongoing patients.
  • Initiate and obtain prior authorizations for home health services.
  • Maintain insurance, authorization, and eligibility information in real-time.

VitalCaring is a leading provider of home health and hospice services. Founded in 2021, they have over 65 locations across the country and are committed to fostering a culture of support, growth, and excellence for their team, ensuring exceptional patient care.

US

  • Makes decisions supported by policy based on confidential financial information.
  • Utilizes scheduling and registration information to verify coverage and authorization.
  • Acts as a liaison between the patients, physicians, patient clinics, case management, centralized billing office, third party Medicaid eligibility vendor and community agencies.

CommonSpirit Health has more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services. They are committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.

US 4w PTO

  • Receive and resolve patient correspondence regarding insurance billing.
  • Answer all correspondence relating to billing questions.
  • Verify insurance status, eligibility and general account information.

MANA Administration provides support services for 27 physician-owned medical practices in Northwest Arkansas. Their Administrative team are independent and work together, to help their physicians and clinics provide compassionate, comprehensive, quality health care while maintaining a healthy work-life balance.

US

  • Monitor incoming faxes for authorization requests, enter UM authorizations review requests, and verify eligibility and claims history.
  • Ensure all necessary documentation is submitted, contact providers for required medical records, and generate correspondence for notifications.
  • Initiate appeal cases, meet deadlines, assist UM Nurses, and handle inquiries from call centers and other sources.

Jobgether uses an AI-powered matching process to ensure applications are reviewed quickly and fairly. While the company size is not mentioned, they seem to have a modern approach by utilizing AI tools in the hiring process to identify top-fitting candidates for their client companies.

US

  • Inputs and updates insurance information in appropriate screens.
  • Verifies insurance eligibility online or by phone and identifies primary and secondary insurance.
  • Obtains claim numbers and verifies claims for Workmen’s Comp and Auto Insurance.

Munson Healthcare is a healthcare provider. They require all employees to be vaccinated or have lab-confirmed immunity for certain diseases and to receive a flu vaccine annually, with medical or religious exemptions available.

US

  • Responsible for collecting and verifying demographic, guarantor and insurance information, educate patients, physicians, staff, etc. on the financial process.
  • Will be involved in extensive utilization of the Hospitals revenue systems and constant interaction with patients, physicians, insurance companies, donors and other members of the Hospitals' staff.
  • Advise and counsel patients and guarantors regarding patient rights, responsibilities and procedures as it relates to payment for Hospital and ProFee care

They are a comprehensive academic medical center. They have many employees and maintain a collaborative culture.