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Authorization Specialist
1 day ago
Summit Health Bend, United States Full timeDescription · Position Summary: · The Authorization Specialist is responsible for obtaining authorizations for surgical procedures, diagnostic testing, medications, DME, outgoing referrals, and other services as part of the daily operations of the Revenue Cycle Department. Auth ...
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Pre-Service Authorization Specialist
2 weeks ago
Trinity Health South Bend, United StatesEmployment Type: · Full time · Shift: · Day Shift · Description: · JOB SUMMARY · Obtains accurate authorization and billing information to effectively authorize/pre-certify all patients entering Saint Joseph Health System (SJHS). Provides third party benefit verification for iden ...
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Pre-Service Authorization Specialist
4 weeks ago
Trinity Health South Bend, United StatesEmployment Type: · Full time · Shift: · Day Shift · Description: · JOB SUMMARY · Obtains accurate authorization and billing information to effectively authorize/pre-certify all patients entering Saint Joseph Health System (SJHS). Provides third party benefit verification for iden ...
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Medical Prior Authorization Specialist
4 weeks ago
Human Resource Department South Bend, United StatesWHO WE ARE: · AC3 was founded by practicing oncologists along with data and practice analytics experts to support the business side of medicine. Our mission is to modernize and digitize the delivery of healthcare and improve countless lives along the way. · We combine the power ...
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Leidos Suitland, United States Full timeDescription · Leidos National Security Sector has a dynamic opportunity for a Security Controls Assessor/Assessment and Authorization Specialist to work at our customer site at the National Maritime Intelligence Center in Suitland, MD (all work is performed on site). · Great New ...
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Leidos Suitland, United StatesLeidos National Security Sector has a dynamic opportunity for a · Security Controls Assessor/Assessment and Authorization Specialist · to work at our customer site at the National Maritime Intelligence Center in Suitland, MD (all work is performed on site). · Great News Program i ...
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Leidos Suitland, United StatesDescription · Leidos National Security Sector has a dynamic opportunity for aSecurity Controls Assessor/Assessment and Authorization Specialistto work at our customer site at the National Maritime Intelligence Center in Suitland, MD (all work is performed on site). · Great News ...
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Coord Insurance Spec
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Beacon Health System South Bend, United StatesSummary · Reports to the Director/Manager of Oncology Service line. Coordinates the daily operational activities of Oncology Insurance Specialist associates (i.e., assigns work, facilitates department meetings and is responsible for associate scheduling, annual reviews and disci ...
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Transition Coordinator
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Adult Protective Services Specialist
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Court Operations Specialist
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Supervisory Civil Engineer
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Engineering Specialist
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Public Safety Officer
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Insurance Sales Advisor
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Patient Service Representative
3 days ago
Beacon Health System South Bend, United StatesFull-time · 615 N. Michigan Street · Clerical · Day · Reports to the Manager or Director. Is responsible for the coordination of services for patients at the assigned clinic or site, which includes: admitting and discharging patients, contacting third-party payers for authorizati ...
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Vascular Ultrasound Tech
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Beacon Health System South Bend, United StatesFull-time · 100 Navarre Place · Radiology Services · Day · Reports to the Practice Manager. Performs ultrasound scans and procedures requiring independent judgment and a high degree of precision and skill in the application of ultrasound equipment and high frequency ultrasound wa ...
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Financial Professional
1 week ago
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Respiratory Therapist
1 day ago
Lincare Mishawaka, United StatesThe Health Care Specialist performs equipment setups in a timely and professional manner. This employee is generally responsible for the setup of highly technical equipment such as ventilators, monitors, and CPAP units. The Health Care Specialist also provides technical assistanc ...
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CDL Driver
3 days ago
SRS Distribution Mishawaka, United StatesLocal CDL A or Local CDL B Driver w/ Knuckleboom or w/ Crane Certification · We are committed to the personal and professional growth of our team members and we show this by having a clear path of advancement for our Drivers with on-the-job and web-based training for you to move ...
Medical Prior Authorization Specialist - South Bend, United States - Human Resource Department
Description
WHO WE ARE:
AC3 was founded by practicing oncologists along with data and practice analytics experts to support the business side of medicine.
We combine the power of big data technology and people to enable easier frontline decisions about complex problems. AC3 offers its employees an exciting, fast-paced, and challenging work environment. To learn more about AC3, visit us at
COMPANY MISSION:
To simplify healthcare and reduce the cost of care, empowering care givers to focus on what matters most – fighting cancer.
POSITION SUMMARY:
This is a hybrid position; meaning there may be onsite requirements. Ideal candidate should reside within a - 3 hour commute radius from South Bend.
The prior authorization (also called "preauthorization" and "precertification") position obtains approval of a health care service or medication before the care is provided.
He/ She works with the client, insurance, and patientto evaluate whether care is medically necessary and otherwise covered.This position obtains prior authorization for radiology exams, radiation therapy, procedures, and chemotherapy drugs. They will be responsible for documenting and entering required information in our systems.
Essential Function and Job Responsibilities
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Understanding of insurance requirements for prior authorizationUnderstanding of payer processes (website, fax, contact number) to submit appropriate authorization requestUnderstanding of insurance billing procedures and practicesFinding and understanding clinical information from EMR regarding services to be renderedContacting payers to obtain prior authorizationFollowing policy and procedures on treatment therapies and substitutionsAdvising providers and their clinical staff when issues arise relating to obtaining prior authorizationNavigating and using national medical guideline toolsVerifying that all insurance requirements have been met before noting approvalsFollowing the workflow process on all pending casesServing as primary contact with outside facility request with our clientsResponding to all client emails and calls within the agreed upon policy timeframeNoting and applying all authorization correspondence in both PM and EMR systemsMaintains the practices and principles set forth by AC3 leadership with a strong commitment to service, excellence, and quality.
Maintains professional behavior, confidentiality, and discretion always, along with the ability to work with all levels of staff with a confident and professional demeanor.
Follows HIPPA rules and regulations.POSITION REQUIREMENTS
Minimal of a year of previous experience in a Prior Authorization roleHigh school diploma or equivalent (GED).Medical office experience/medical terminology preferred.
Must be detail oriented and have problem solving abilities.
Proficient in Microsoft Office preferred.
Working knowledge/experience in electronic medical records and/ or other medical software if applicable.
Must possess the ability to work with patients and family members in a confident, respectful, and socially professional manner.
Must rely on experience and judgment to plan and accomplish goals.
Excellent communication and organizational skills with the ability to work in a fast-paced environment; prioritize tasks and workloads.
Performs other duties as assigned.
This is a remote position with the expectation of travel to meet the needs of the position.
Work is completed in a general office environment, sedentary in nature but may require standing and walking for up to 10% of the time.
The work environment is favorable with adequate lighting and temperature, and no hazardous or unpleasant conditions caused by noise, dust, etc.
Must be able to operate standard office equipment and keyboards.Why Work at AC3?
When you become an AC3 Team member, you can expect ongoing training, support, and a work culture like no other.
We offer our Full-Time Team Members medical, dental and vision health and wellness benefits, along with employer paid life insurance, long and short-term disability policies.
Because our team's health and wellness are our priority, we start new hires off with an above average paid time out plan and offer a comprehensive wellness program, including onsite biometrics and ongoing mental and physical wellness support.
We also provide all Team Members with access to company sponsored financial wellness counselors, employee assistance services and the opportunity to enroll in our company-matched, 401k plan.
Come join our Winning Team#J-18808-Ljbffr
