Prior Authorization Coordinator
3 days ago
Spectrum Health Services, Inc is seeking a skilled Prior Authorization Specialist to join our team. As a vital member of our healthcare team, you will be responsible for managing the pre-approval process for patient treatments and medications with insurance companies.
Key Responsibilities- Review and Interpret Physician Orders: Assess the necessity and accuracy of prior authorization requests by reviewing physician orders and patient medical records.
- Verify Patient Coverage: Contact insurance providers to verify patient coverage and benefits for prescribed medications and treatments.
- Submit Authorization Requests: Submit authorization requests through electronic health records (EHR) systems, online portals, or via telephone.
- Collaborate with Healthcare Providers: Work with healthcare providers to gather additional information or clarification needed for prior authorization submissions.
- Monitor and Track Authorizations: Monitor and track the status of submitted authorizations, following up as necessary to resolve delays or issues.
- Communicate with Patients: Communicate effectively with patients regarding the status of their authorization, including any additional information or action required on their part.
- Ensure Regulatory Compliance: Adhere to healthcare regulations, including HIPAA, to ensure patient privacy and confidentiality of medical information.
- Medical Billing Software Proficiency: Proficiency in medical billing software and electronic health records systems.
- Medical Terminology Knowledge: Familiarity with medical terminology and understanding of ICD-10 and CPT codes.
- Organizational Skills: Strong organizational skills and the ability to prioritize tasks in a fast-paced environment.
- Communication Skills: Excellent communication and customer service skills, with an empathetic regard for patient needs.
- Experience: A minimum of two years' experience in a medical business office or healthcare setting involving customer service or patient-facing responsibilities.
- Medical, Vision, and Dental Insurance
- Paid Time Off
- Sick Time
- 403B Plan
-
Clinical Pharmacist
1 week ago
Philadelphia, Pennsylvania, United States vTech Solution Full timePosition Overview: As a licensed healthcare professional within the Pharmacy Prior Authorization Department, your primary role involves evaluating prior authorization and coverage requests for pharmaceutical products. This includes making determinations based on medical necessity and benefit criteria, all while adhering to established pharmacy guidelines,...
-
Pharmacy Technician
4 days ago
Philadelphia, Pennsylvania, United States TalentBurst, Inc Full timeJob SummaryTalentBurst, Inc is seeking a skilled Pharmacy Technician to join our team as a Prior Authorization Specialist. As a Pharmacy Technician, you will play a crucial role in ensuring seamless medication management for patients.Key ResponsibilitiesProcess prior authorizations for medications, collaborating with healthcare providers to ensure accurate...
-
Pharmacy Authorization Specialist
2 weeks ago
Philadelphia, Pennsylvania, United States vTech Solution Full timePosition Overview: As a licensed healthcare professional in the Pharmacy Prior Authorization Department, your main duty is to evaluate prior authorization and coverage requests for pharmaceutical products. This involves making determinations regarding medical necessity and benefit eligibility. These decisions are guided by established pharmacy protocols,...
-
Pharmacy Authorization Specialist
1 week ago
Philadelphia, Pennsylvania, United States vTech Solution Full timePosition Overview: As a licensed healthcare professional within the Pharmacy Prior Authorization Department, your main role is to evaluate and decide on prior authorization and coverage requests for pharmaceutical products. These evaluations encompass assessments of medical necessity and benefit determinations, adhering to established pharmacy protocols,...
-
Authorization Specialist for Medical Procedures
2 weeks ago
Philadelphia, Pennsylvania, United States Beacon Hill Full timePosition Overview:We are currently seeking a meticulous and skilled Precertification Coordinator to become a vital part of our team. The successful candidate will possess significant experience in securing authorizations for chemotherapy and outpatient surgical interventions. This role is essential in facilitating timely access to necessary medical...
-
Authorization Specialist
3 days ago
Philadelphia, Pennsylvania, United States Care and Help Home Care Full timeAbout Care & Help Home CareCare & Help Home Care is a trusted home healthcare provider committed to delivering transparent, professional, and excellent home care services to seniors in the Philadelphia area.Job Summary:The Authorization Specialist plays a critical role in obtaining and managing authorizations for home care services provided to clients. This...
-
Neurology Administrative Coordinator
2 weeks ago
Philadelphia, Pennsylvania, United States Thomas Jefferson University & Jefferson Health Full timePosition OverviewThe Administrative Coordinator plays a crucial role in providing essential administrative assistance to the Neurosurgeon(s) and their clinical teams, aiming to ensure a streamlined and efficient patient journey. By fostering relationships with patients, families, and colleagues, the Coordinator acts as a vital member of the interdisciplinary...
-
Scheduling Coordinator
19 hours ago
Philadelphia, Pennsylvania, United States Cardiology Consultants of Philadelphia, PC Full timeJob SummaryCardiology Consultants of Philadelphia, PC is seeking a highly organized and detail-oriented Scheduling Coordinator to join our team. As a Scheduling Coordinator, you will play a critical role in ensuring the smooth operation of our medical office.Key ResponsibilitiesScheduling and CoordinationSchedule tests and follow-up appointments for patients...
-
Administrative Coordinator I
2 weeks ago
Philadelphia, Pennsylvania, United States Septa Full timeSecure your FUTURE with SEPTA today The Southeastern Pennsylvania Transportation Authority (SEPTA) stands as the sixth largest transportation system in the United States, operating an extensive network of fixed route services such as bus, subway/elevated, trackless trolley, light rail, and commuter rail across a 2,200 square mile service area. SEPTA plays...
-
Scheduling Coordinator
6 days ago
Philadelphia, Pennsylvania, United States Cardiology Consultants of Philadelphia, PC Full timeJob SummaryWe are seeking a highly organized and detail-oriented Scheduling Coordinator to join our team at Cardiology Consultants of Philadelphia, PC. As a Scheduling Coordinator, you will play a critical role in ensuring the smooth operation of our cardiology practice.Key ResponsibilitiesSchedule tests and follow-up appointments for patients in a timely...
-
Patient Care Coordinator
4 days ago
Philadelphia, Pennsylvania, United States Thomas Jefferson University & Jefferson Health Full timeJob SummaryWe are seeking a highly skilled and compassionate Patient Navigator to join our team at Thomas Jefferson University & Jefferson Health. As a Patient Navigator, you will play a critical role in coordinating the care of patients in our university-based outpatient specialty practice and research projects.Key ResponsibilitiesScheduling and...
-
Surgical Appointment Coordinator
2 weeks ago
Philadelphia, Pennsylvania, United States Thomas Jefferson University Full timeKey Responsibilities The Surgical Appointment Coordinator plays a vital role in enhancing the patient experience by professionally managing the scheduling of both inpatient and outpatient surgical procedures. This position is essential in fostering a welcoming environment by prioritizing the courteous treatment of all patients. Core Duties Include: ...
-
Surgical Appointment Coordinator
2 weeks ago
Philadelphia, Pennsylvania, United States Thomas Jefferson University Full timeKey Responsibilities The Surgical Appointment Coordinator plays a vital role in enhancing the patient experience by professionally managing the scheduling of both inpatient and outpatient surgical procedures. This position is essential in ensuring that patients receive timely and courteous service, aligning with the values of Thomas Jefferson...
-
Surgical Appointment Coordinator
2 weeks ago
Philadelphia, Pennsylvania, United States Thomas Jefferson University Full timeRole Overview The Surgical Appointment Coordinator plays a crucial role in enhancing the patient experience by efficiently and professionally organizing inpatient and outpatient surgical procedures. This position is integral to ensuring that all patients receive the exceptional service that aligns with the values of Thomas Jefferson University. Key...
-
Surgical Coordinator
1 hour ago
Philadelphia, Pennsylvania, United States Thomas Jefferson University Full timeAbout the RoleThe Surgical Scheduler plays a vital role in enhancing the patient experience by professionally scheduling inpatient and outpatient procedures. This position supports the delivery of the Jefferson Experience by prioritizing prompt and courteous treatment of all patients.Key ResponsibilitiesInteract with colleagues, visitors, and other staff...
-
Patient Care Coordinator
5 days ago
Philadelphia, Pennsylvania, United States Jefferson Health Full timeAbout the RoleWe are seeking a highly skilled and compassionate Patient Care Coordinator to join our team at Jefferson Health. As a key member of our healthcare team, you will play a vital role in ensuring the seamless coordination of patient care.Key ResponsibilitiesCoordinate Patient Care: Work closely with patients, physicians, and support staff to...
-
Philadelphia, Pennsylvania, United States Beacon Hill Full timePosition Overview:We are currently seeking a meticulous and knowledgeable Precertification Coordinator to enhance our team. The successful candidate will possess substantial experience in securing authorizations for chemotherapy and outpatient surgical interventions. This role is vital in facilitating timely access to essential medical treatments by...
-
Care Management Coordinator RN
6 days ago
Philadelphia, Pennsylvania, United States Blue Cross and Blue Shield Association Full timeJob SummaryThe Care Management Coordinator RN is a critical role within the Blue Cross and Blue Shield Association, responsible for evaluating a member's clinical condition and determining medical necessity for patient services. This position requires advanced knowledge and independent analysis of medical records, as well as the ability to interact with...
-
Full Time Front Desk Coordinator
1 week ago
Philadelphia, Pennsylvania, United States Healogics Full timeJob SummaryWe are seeking a highly organized and detail-oriented Medical Office Administrator to join our team at Healogics. As a key member of our front office staff, you will be responsible for providing exceptional patient care and administrative support to our wound care centers.Key ResponsibilitiesCoordinate Patient Scheduling: Work closely with center...
-
Philadelphia, Pennsylvania, United States Blue Cross and Blue Shield Association Full timeAbout the RoleThe Care Management Coordinator RN is a critical position within our organization, responsible for evaluating a member's clinical condition and determining the medical necessity for patient services. This role requires advanced knowledge and independent analysis of medical records, as well as the ability to interact with providers to obtain...