Medication Prior Authorization Specialist
2 weeks ago
GENERAL STATEMENT OF DUTIES: We are seeking a highly organized and detail-oriented Medical Prior Authorization Specialist to join our outpatient clinic team. The ideal candidate will have a strong background in healthcare administration, particularly in handling prior authorizations for medical procedures, tests, and treatments. This role requires efficient communication skills, analytical thinking, and the ability to navigate insurance requirements to ensure timely approvals for patient care. * * ESSENTIAL FUNCTIONS: Review and process prior authorization requests for medical procedures, tests, medications, and treatments according to insurance guidelines and clinic protocols. Verify patient insurance coverage and eligibility for requested procedures or treatments. Communicate with insurance companies to obtain necessary authorization and resolve any coverage issues. Maintain accurate records of prior authorization requests, approvals, denials, and appeals. Document all communication with insurance companies and healthcare providers regarding authorization status. Communicate with patients regarding prior authorization requirements, status updates, and any financial responsibilities associated with their care. Provide assistance and guidance to patients in navigating insurance coverage and appeals processes. Collaborate with healthcare providers, nurses, and administrative staff to ensure timely submission and processing of prior authorization requests. Communicate effectively with other departments to coordinate patient care and ensure compliance with insurance requirements. Assist in the preparation and submission of appeals for denied prior authorization requests. Gather necessary documentation and information to support the appeal process and advocate for patients' medical needs. Stay updated on changes in insurance policies, regulations, and industry trends related to prior authorization processes. Identify opportunities for process improvements and efficiency enhancements in prior authorization management. QUALIFICATIONS High school diploma required, Associates degree preferred Detail-oriented with strong organizational and time management skills Excellent communication skills, both verbal and written, with the ability to interact professionally with patients, healthcare providers and staff, and insurance representatives ```{=html} ``` - Minimum of 2 years of experience in prior authorization management in a healthcare setting, preferably in an outpatient clinic or medical office - Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment - Familiar with medical billing processes, and revenue cycle management is a plus CMU is an AA/EO institution, providing equal opportunity to all persons, including minorities, females, veterans, and individuals with disabilities.
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Medication Prior Authorization Specialist
6 days ago
Saginaw, United States CMU Medical Education Partners Full timeWe are seeking a highly organized and detail-oriented Medical Prior Authorization Specialist to join our outpatient clinic team. The ideal candidate will have a strong background in healthcare administration, particularly in handling prior authorizations for medical procedures, tests, and treatments. This role requires efficient communication skills,...
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Medical Office Receptionist
1 month ago
Saginaw, United States Kevin Roy, MD Full timeCompany DescriptionFamily Medicine physician office with two medical practitioners.Role DescriptionThis is a full-time on-site role as a Medical Office Receptionist located in Saginaw, MI. The Medical Office Receptionist will be responsible for communicating with patients, verifying patient information, scheduling appointments, greeting and directing...
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Medical Office Receptionist
3 weeks ago
Saginaw, United States Kevin Roy, MD Full timeCompany DescriptionFamily Medicine physician office with two medical practitioners.Role DescriptionThis is a full-time on-site role as a Medical Office Receptionist located in Saginaw, MI. The Medical Office Receptionist will be responsible for communicating with patients, verifying patient information, scheduling appointments, greeting and directing...
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Medical Office Receptionist
1 month ago
Saginaw, United States Kevin Roy, MD Full time? Company Description Family Medicine physician office with two medical practitioners. Role Description This is a full-time on-site role as a Medical Office Receptionist located in Saginaw, MI. The Medical Office Receptionist will be responsible for communicating with patients, verifying patient information, scheduling appointments, greeting and directing...
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Physician Integration Specialist
4 days ago
Saginaw, United States Covenant Healthcare Full timeCovenant HealthCare US:MI:SAGINAW 8:00 AM - 4:30 PM, MONDAY - FRIDAY FULL TIME BENEFITED - 80 HOURS PER PAY Summary: The Physician Integration Specialist - Primary Care will report to CHP Finance Manager and PHO Director of Covenant HealthCare Partners (CHP) and will work as a key member of the CHP team to ensure business practices and policies are...
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Medical Technologist
5 days ago
Saginaw, United States Covenant Healthcare Full timeCovenant HealthCare US:MI:SAGINAW NIGHT SHIFT PART TIME BENEFITED Summary: The Medical Technologist demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards contained in the Vision, Mission and Values of Covenant and the commitment to Extordinary care for Every Generation....
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RN Specialist
2 weeks ago
Saginaw, United States Ascension Full timeDetails Department: ACO OperationsSchedule: Full-time days, Monday - Friday, 8a - 5pHospital: Ascension St Marys RiverfrontLocation: Saginaw, MIBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance...
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42A Human Resources Specialist
4 days ago
Saginaw, United States Army National Guard Full timeJob Description When a Soldier has a question about benefits, policy, or needs help with a sensitive issue, the Army National Guard's Human Resources Specialist is the primary go-to person. As an HR Specialist, you will help Soldiers develop their Guard careers and provide personnel support and assistance to all divisions within the Guard. Specific...
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Member Services Specialist/Teller
3 days ago
Saginaw, United States Dow Credit Union Full timeJob DescriptionJob DescriptionMember Services SpecialistDow Credit Union in Saginaw, MI is seeking a dedicated and customer-oriented individual to join our team as a Member Services Specialist/Teller. In this role, you will serve as the primary point of contact for our credit union members, assisting them with their inquiries, account transactions, and...
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Medical Biller
4 days ago
Saginaw, United States Yeo & Yeo Full timeDescriptionCome grow with us. Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We have devoted ourselves to helping clients maximize their reimbursement and assist in educating them with the ever-changing rules and guidelines of...
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Customer Experience Specialist
3 days ago
Saginaw, United States Best Buy Full time**Customer Experience Specialist (Advisor) - Job Details** **Customer Experience Specialist (Advisor)** Share Job **Overview** Part Time Entry Level Store Associates You are in for some awesome perks (Part-time and Full-time benefits based on your role and tenure) * Backup childcare * Tuition assistance for yourself and dependents * Generous employee...
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Customer Service Specialist
4 days ago
Saginaw, United States Rollins Full time** Customer Service Specialist** **Job Category****:** Customer Service **Requisition Number****:** CUSTO022883 Showing 1 location **Job Details** **Description** $17.00 PER HOUR If you are organized, efficient, accurate and accountable with a strong ability to multi-task, this may be the position for you. **What Were Looking For** You set high standards for...
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Child Life Specialist
4 days ago
Saginaw, United States Covenant Healthcare Full timeCovenant HealthCare US:MI:SAGINAW VARIABLE SHIFT FULL TIME BENEFITED Summary: The Certified Child Life Specialist (CCLS) is responsible, accountable and has the authority for patient and financial outcomes that result from the quality of care within an assigned pediatric patient population and siblings or children of current patients when consulted....
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Pharmacy Technician
3 weeks ago
Saginaw, United States LanceSoft Full timeRemote position, but candidate may be required to come into a facility to work in the event of technical issues. With this in mind, we prefer candidates reside south of Saginaw, MI.Top 3 Required Skills/Experience 2-4 years Specialty and/or Retail Pharmacy Experience in provider/member call center or helpdesk Process prior authorization requests Required...
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Dietitian, Specialist
4 days ago
Saginaw, United States TouchPoint Full timeTouchPoint **Position Title: DIETITIAN, SPECIALIST - HRLY** **Pay Grade: 1** **Reports To**: CNM **TouchPoint, Support Services,** provides customer focused support services. As specialists, we perform services including healthcare housekeeping, management in laundry processing, patient transportation, and food service. TouchPoint is a compilation of the...
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Diagnostic Medical Sonographer
1 month ago
Saginaw, United States Ascension Full timeDetails Department: UltrasoundSchedule:PRN(Work as needed)Hospital: Ascension St MaryLocation: Saginaw, MIBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance programs (EAP) Parental leave & adoption assistance Tuition...
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Lead Clin Doc Specialist
4 days ago
Saginaw, United States Covenant Healthcare Full timeCovenant HealthCare US:MI:SAGINAW DAY SHIFT FULL TIME BENEFITED Summary: The Lead Clinical Documentation Specialist demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards contained in the Vision, Mission and Values of Covenant HealthCare and the commitment to Extraordinary...
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Medical Assistant
2 weeks ago
Saginaw, United States CMU Medical Education Partners Full timeJob DescriptionJob DescriptionGENERAL STATEMENT OF DUTIES:The Medical Assistant (MA), under direction from a Registered Nurse, Nurse Practitioner, or physician, performs routine clinical and clerical functions to assist providers in the delivery of patient centered medical services for assigned departments within the CMU Health faculty group practices...
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Medical Assistant
2 weeks ago
Saginaw, United States CMU Medical Education Partners Full timeJob DescriptionJob DescriptionGENERAL OVERVIEW:The Medical Assistant (MA), under direction from a Registered Nurse, Nurse Practitioner, or physician, performs routine clinical and clerical functions to assist providers in the delivery of patient centered medical services for assigned departments within the CMU Health faculty group practices (Family Medicine,...
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Medical Assistant
2 weeks ago
Saginaw, United States CMU Medical Education Partners Full timeJob DescriptionJob DescriptionGENERAL STATEMENT OF DUTIES:The Medical Assistant (MA), under direction from a Registered Nurse, Nurse Practitioner, or physician, performs routine clinical and clerical functions to assist providers in the delivery of patient centered medical services for assigned departments within the CMU Health faculty group practices...