- Conduct second-level reviews for all payor types to determine compliance status.
- Maintain effective communication with case management, utilization management, social work, and other healthcare team members to discuss selected cases and make recommendations.
- Engage with medical staff to discuss medical necessity and concurrent denial cases.
- Act as a consultant for the medical staff regarding their decisions for patient status through case reviews.
- Participate in the claims denial process by conducting discussions with commercial payor medical directors.
- Serve on the Utilization Review Committee, requiring non-clinical medical staff privileges application.
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Authorization Specialist
3 weeks ago
Only for registered members Pittsburgh $20.20 - $32.01 (USD)The University of Pittsburgh Physicians Department of Physical Medicine and Rehabilitation is hiring a full-time Authorization Specialist. · ...
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Sr. Authorization Specialist
1 month ago
Only for registered members PittsburghThe University of Pittsburgh Physicians Department of Physical Medicine and Rehabilitation is hiring a full-time Senior Authorization Specialist to join their team. This position will be based out of the UPMC Mercy Community Care office on Locust Street and will support the Neuro ...
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Authorization Specialist
1 month ago
Only for registered members PittsburghThe Authorization Specialist manages authorizations for inpatient,outpatient,and emergency patients, · Review and interpret medical records to pre-authorize insurance-determined procedures. · ...
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marketing specialist
3 weeks ago
Only for registered members Pittsburgh Full time $70,000 - $80,000 (USD)We are seeking a hospitality minded marketing professional to join our dynamic corporate dining team.We are looking for someone who can multi-task on various projects and assist in creating necessary signage for daily dining promotions and special events. · ...
- Only for registered members Pittsburgh
The UPMC Children's Hospital of Pittsburgh Department of Pediatric Cardiology is hiring a full-time Authorization Specialist. · Reviews and interprets medical record documentation for patient history, diagnosis, and previous treatment plans to pre-authorize insurance plan determi ...
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Authorization Specialist
1 month ago
Only for registered members PittsburghThis is a full-time Authorization Specialist position with flexible hours and potential for some remote work. · ...
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Sales, Senior Solution Specialist- MR
1 week ago
Only for registered members Pittsburgh, Pennsylvania, United States+We are seeking candidates located in the greater Cincinnati, Cleveland, Columbus or Pittsburgh areas to play a vital role in increasing market penetration and overall growth of our MR business.+ · ++Acting as knowledge expert on our MR technology to support the Account Managers/ ...
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Principal Siting Lead
2 weeks ago
Only for registered members Pittsburgh, PAArcadis is searching for an experienced Siting Lead to join our Energy Transition team to help support and grow our expanding Siting and Routing business across the United States. · ...
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marketing specialist
3 weeks ago
Only for registered members Pittsburgh $70,000 - $80,000 (USD)We are seeking a hospitality minded marketing professional to join our dynamic corporate dining team. · This is a fantastic opportunity to join a sizeable, NEWLY RENOVATED corporate account that is part of prestigous global portfolio. ...
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marketing specialist
3 weeks ago
Only for registered members Pittsburgh, PAWe are seeking a hospitality minded marketing professional to join our dynamic corporate dining team. This is a fantastic opportunity to join a sizeable corporate account that is part of prestigous global portfolio. · This position involves leading and owning all internal marketi ...
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Authorization Specialist
3 weeks ago
Only for registered members Pittsburgh, PAThis position will be based out of the UPMC Mercy Community Care office on Locust Street and will support the Neuropsychology and Rehabilitation Psychology department. · This role will require occasional cross coverage for the Pediatric Neuropsychology office. · ...
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Patient Access Specialist
5 days ago
Only for registered members Pittsburgh, PAWe are searching for the next Patient Access Specialist champion. This role is responsible for performing admitting duties for all patients admitted for services at the hospital. · ...
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Patient Access Specialist
3 weeks ago
Only for registered members Pittsburgh Full time $17 - $18.15 (USD)We are searching for the next Patient Access Specialist champion. This role is responsible for performing admitting duties for all patients admitted for services at the hospital. · ...
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Patient Access Specialist
6 days ago
Only for registered members PittsburghThis is an onsite registration role at hospital system located in Pittsburgh, PA . We are searching for the next Patient Access Specialist champion. This role is responsible for performing admitting duties for all patients admitted for services at the hospital. · Patient Access s ...
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Sales, Clinical Measurements
3 weeks ago
Only for registered members Pittsburgh $170,000 - $205,000 (USD)The Clinical Measurements Account Manager is responsible for driving sales growth and expanding market presence for Philips' Clinical Measurements portfolio. · Demonstrate deep product expertise by effectively selling medical consumables and sensors. · Drive end-to-end contract d ...
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Sales, Clinical Measurements
3 weeks ago
Only for registered members Pittsburgh, PAThe Clinical Measurements Account Manager is responsible for driving sales growth and expanding market presence for Philips' Clinical Measurements portfolio, · This role is ideal for a consultative sales professional who excels at building strong customer relationships and transl ...
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Sr. Authorization Specialist
1 month ago
Only for registered members Pittsburgh, PAThis Senior Authorization Specialist position will be based out of the UPMC Mercy Community Care office on Locust Street and will support the Neuropsychology and Rehabilitation Psychology department. · ...
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Clinical Education Delivery Consultant
3 weeks ago
Only for registered members Pittsburgh Full time $88,000 - $140,000 (USD)Lead the delivery of Image Guided Therapy (IGT) clinical education to Philips customers providing basic through intermediate application training in hospitals and clinics throughout the specific geography. · ...
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Case Manager
1 day ago
Only for registered members Pittsburgh, Pennsylvania, United StatesWe seek a compassionate individual to engage with Medical Insurance Payers and Pharmacy Benefit Managers. · Takes the lead to manage the Care Coordination process within an assigned territory. · Assesses physicians' needs and develops action plans that proactively mitigate delays ...
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Lead Event Specialist Part Time - 6678
1 month ago
Only for registered members Pittsburgh, PA Part timeThe Associate is responsible for completing in-store food and non-food demonstrations. Assists other Event Specialists with event kits, materials and tools as needed. · ...
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Case Manager
2 days ago
Only for registered members Pittsburgh, PA+We seek a compassionate individual to engage with Medical Insurance Payers and Pharmacy Benefit Managers. The Case Manager assists customers with chronic illnesses in their assigned territory by gaining access to their wellbeing needs. · +Takes the lead to manage the Care Coordi ...
Medical Necessity Specialist - Pittsburgh - beBeePhysicianAdvisor
Job title: Onsite Physician Advisor
Description
Job Summary
The onsite physician advisor role requires expertise in medical necessity, documentation best practices, and concurrent denial payor peer-to-peer interactions.
Main Responsibilities:
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Authorization Specialist
Only for registered members Pittsburgh
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Sr. Authorization Specialist
Only for registered members Pittsburgh
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Authorization Specialist
Only for registered members Pittsburgh
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marketing specialist
Full time Only for registered members Pittsburgh
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Authorization Specialist- Pediatric Cardiology, Children's
Only for registered members Pittsburgh
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Authorization Specialist
Only for registered members Pittsburgh
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Sales, Senior Solution Specialist- MR
Only for registered members Pittsburgh, Pennsylvania, United States
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Principal Siting Lead
Only for registered members Pittsburgh, PA
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marketing specialist
Only for registered members Pittsburgh
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marketing specialist
Only for registered members Pittsburgh, PA
-
Authorization Specialist
Only for registered members Pittsburgh, PA
-
Patient Access Specialist
Only for registered members Pittsburgh, PA
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Patient Access Specialist
Full time Only for registered members Pittsburgh
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Patient Access Specialist
Only for registered members Pittsburgh
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Sales, Clinical Measurements
Only for registered members Pittsburgh
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Sales, Clinical Measurements
Only for registered members Pittsburgh, PA
-
Sr. Authorization Specialist
Only for registered members Pittsburgh, PA
-
Clinical Education Delivery Consultant
Full time Only for registered members Pittsburgh
-
Case Manager
Only for registered members Pittsburgh, Pennsylvania, United States
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Lead Event Specialist Part Time - 6678
Part time Only for registered members Pittsburgh, PA
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Case Manager
Only for registered members Pittsburgh, PA