Review incoming referral orders to assess patient’s needs based on diagnosis, insurance coverage or lack thereof, and previous treatments.
Verify patient information including demographics, insurance coverage and financial status; confirm patient eligibility for health care coverage and clarify any managed care arrangements.
Contact the patient prior to service to inform them of their estimate and collect any pre-payments at that time.
Manage provider schedules and prepare charts for upcoming home visits.
Conduct outreach for scheduling, appointment confirmation, and wellness checks for high-risk members.
Obtain medical records, submit referral authorizations, and coordinate lab orders and transportation for members.
Alignment Health is dedicated to reshaping senior care, empowering members to age gracefully and live vibrantly. Their mission-driven team strives to deliver high-quality, affordable care to members daily.
Maintains current information regarding surgery schedules for service site providers.
Triages and documents accurately telephone calls from patients including requests for medication refills, complaints, general information inquiries, and urgent health care concerns.
Schedules new patient appointments on line, and manually if necessary.
OHSU is Oregon's only public academic health center, caring for patients and leading groundbreaking research. As Portland's largest employer, they offer opportunities to learn and advance in a system of hospitals and clinics across Oregon and Southwest Washington.
Provides non-clinical administrative support to Case Managers and Care Coordinators.
Obtains and manages medical documents, ensuring accurate record retrieval.
Prioritizes tasks based on expedited requests with attention to detail.
Spectrum Healthcare Resources (SHR) delivers systems and processes designed to meet the unique needs of Military and VA Health Systems. They provide physician and clinical staffing and management services to United States Military Treatment Facilities, VA clinics and other Federal Agencies.
Track and manage prior authorization requests, renewals, and extensions.
Verify member eligibility and benefits to confirm coverage requirements.
Upload, organize, and maintain member records and clinical documentation accurately and timely.
Leap is a benefits solution company focused on reshaping how life-changing therapies are delivered and financed. They are a fast-growing company that partners with Fortune 500 companies and leading TPAs, focusing on lower costs, improved access, and better care.
Build trusting relationships with patients, families, and providers, addressing health questions and care needs.
Identify medical, behavioral, social, emotional, and financial needs to support whole‑person care.
Strengthen the connection between patients and healthcare providers by addressing barriers and facilitating communication.
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence, with the goal to make great healthcare affordable, improve patient health, and restore fulfillment for providers. They leverage remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers.
Acts as initial service ambassador to referral sources, physicians, patients, caregivers and other external customers providing the highest quality service.
Responsible for the initial entry, verification, and maintenance of information regarding new patients in all applicable software programs.
Processes private insurance verifications, verifies eligibility of Medicare, Medicaid and third party payers and any other duties as directed.
CommonSpirit Health at Home is a full-service health care organization that believes the best place for someone to get better is in their own home. As a faith-based organization, they are committed to finding new ways to improve the health of their patients and the health of the communities they serve.
Performs complex secretarial and administrative duties.
Responsible for all clinic preparations and optimizing provider patient schedule.
Triages incoming calls, schedules patient appointments, and obtains pertinent medical information.
The University of Rochester is committed to education, research and making the world ever better. One of the world’s leading research universities, Rochester has a long tradition of breaking boundaries—always pushing and questioning, learning and unlearning.
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.
Own high-volume inbound patient and provider communication queues.
Serve as the first point of contact for patients, resolving inquiries in real time.
Act as a reliable liaison between patients and their care teams.
Oshi Health is revolutionizing GI care with a digital clinic model, providing convenient access to an integrated and multidisciplinary care team. They are dedicated to creating a workplace that prioritizes their team and fosters inclusivity, reflected in their "Best Place to Work" awards.
Under the direction of the Patient Accounts Manager, the Patient Accounts Specialist is involved in medical billing and follow-up.
Participates in training and auditing of Patient Account Representatives.
Identifies delinquent accounts to expedite resolution.
Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. They are committed to transforming the health care experience with high-quality care for every stage of life.
Take inbound calls from patients, providers and members
Support members with their insurance needs, questions or concerns
Provide 24/7 Triage Support and assign priority for a Registered Nurse to provide health advice
Carenet Health pioneers advancements in healthcare consumer experience, interacting with 1 in 3 Americans daily. They integrate human touch with data-driven technology to improve healthcare, offering best-in-class clinical expertise and personalized solutions.
Accountable for making decisions supported by policy based on confidential financial information to determine qualification for CICP, Charity programs, or payment arrangements.
Verify coverage and authorization for all scheduled procedures using scheduling and registration information; populate price estimate tool to decide patient portion.
Act as a liaison between patients, physicians, patient clinics, case management, centralized billing office, third party Medicaid eligibility vendor and community agencies.
CommonSpirit has over 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services and is accessible to nearly one out of every four U.S. residents. 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.
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.
Build trusting, ongoing relationships with patients, families, caregivers, and medical/behavioral health providers.
Engage high‑risk or targeted patient populations using bi-directional communication to address health questions, concerns, and care needs.
Accurately and promptly document all interactions, assessments, and interventions in the electronic health record (EHR) and Guidehealth documentation systems.
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers.
Consistently practices Patients First philosophy and adheres to high standards of customer service.
Correctly identifies and collects patient demographic information in accordance with organization standards.
Uses effective service recovery skills to solve problems or service breakdowns when they occur.
At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace, setting it apart as a leader in the healthcare industry. As an integral part of the team, you'll have the opportunity to join our quest for better health care, with competitive benefits from tuition reimbursement and loan forgiveness to 401(k) matching.
Contact patient and complete a thorough assessment, including physical, psychosocial, emotional, spiritual, environmental, and financial needs.
Develop treatment plan for standard and catastrophic cases in collaboration with the patient, caregivers or family, community resources and multi-disciplinary healthcare providers that include obtainable short- and long-term goals.
Advocate for the patient by facilitating the delivery of quality patient care, and by assisting in reducing overall costs; provide patient/family with emotional support and guidance.
Personify Health created the first and only personalized health platform—bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one place. They serve employers, health plans, and health systems with data-driven solutions that reduce costs while actually improving health outcomes and have a mission to empower people to lead healthier lives.
Processes acute and post-acute inpatient medical and select intensive outpatient higher level of care requests through clinical review.
Interprets and applies InterQual criteria, CMS-issued guidelines, Capital Blue Cross Medical Policies to requests.
Collaborates with UM department staff and Medical Directors to make a final determination, and with Care Management staff on discharge planning.
Capital Blue Cross is an independent licensee of the Blue Cross Blue Shield Association. At Capital, employees work alongside a caring team of supportive colleagues and are encouraged to volunteer in their community.
Receiving phone calls and fax requests to schedule patients for outpatient tests.
Completing pre-registration of scheduled patients.
Ensuring a valid provider order is obtained.
CommonSpirit is a healthcare organization with more than 700 care sites across the U.S. They are committed to building healthy communities and advocating for those who are poor and vulnerable.
Contacts insurance companies for status on outstanding claims.
Processes and follows up on appeals to insurance companies.
Works outstanding accounts receivable from assigned work queues.
US Anesthesia Partners is dedicated to providing high-quality anesthesia services. They offer equal employment opportunities to all employees and applicants.