![]() Work with the Payor Nurse Navigators to decrease delays in patients access to care. ![]() Provide supporting clinical information to insurance payors outcomes should decrease the need for peer-to-peer review. ![]() Obtain authorizations for add-on cases and procedures to ensure proper and timely claims payment follow-up on all cases to ensure procedures authorized were performed, update authorizations as needed. Navigate and address any payor COB issues prior to services being rendered to ensure proper claims payments obtain and ensure all authorizations are on file prior to services being rendered work collaboratively with assigned department (s)/service(s) of the Hospital to ensure all scheduled patients have undergone payor clearance prior to service pre-register patients, verify insurance eligibility and benefits, obtain pre-certification or referral status, and collect patient responsibility amounts for services provided throughout the health system meeting departmental standards for productivity and quality. Successful completion of all Patient Access training assessments required. Previous experience with Cerner, Experian, or other related software programs and EMRs preferred. Knowledge of insurance requirements and guidelines for Governmental and non-Governmental carriers. ![]() Knowledge of and compliance with confidentiality guidelines and policies and procedures. Strong verbal, interpersonal, and telephone skills.Įxperience in healthcare setting and computer knowledge necessary.Īttention to detail and ability to multi-task in complex situations.ĭemonstrated ability to solve problems independently or as part of a team. Superior customer service skills and professional etiquette. (Required)Ībility to communicate with physicians' offices, patients and insurance carriers in a professional and courteous manner. (Required)Ģ years Comprehensive medical and insurance terminology as well as working knowledge of medical insurance plans, and managed care plans. You will work directly with referring physician offices, payers, and patients to ensure full payor clearance prior to the provision of care.Ģ years Healthcare experience with payor navigation, claims and billing, healthcare registration, insurance referral and prior authorization processes. You will decrease payor-related barriers and increase financial outcomes for scheduled services. You will facilitate increasing patient's access into the care continuum. ![]() In this position, you will be a member of the Patient Access team dedicated to completing patient access workflows related to navigating insurance prior authorization processes for assigned services. To be qualified for this position, you must have 2 years of healthcare experience with payor navigation, claims and billing, healthcare registration, insurance referral and prior authorization processes. Is conducting a search for a Prior Authorization Specialist job located in the greater Washington D.C. The Agency is committed to providing healthcare services to protect the nation's health, reduce global disease and provide medical support for the law enforcement mission of the safe apprehension, enforcement and removal of detained individuals involved in immigration proceedings. Document all work performed to ensure that all information is properly recorded and tracked This position is in support of the ICE Health Services Corps (IHSC) whose mission is to provide medical care to maintain the health of individuals in the custody of ICE through an integrated health care delivery system, based on nationally recognized correctional, detention and residential health care standards. Verify that annual or other training/licensure is completed on a timely basis, and that credential files are updated to reflect the current status of all staff IHSC is committed to ensuring a system of care that is ethical, responsible, and accountable through rigorous surveillance and monitoring activities. ![]()
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