The UR Authorization (Auth) Coordinator is the key position for reviewing admissions and utilization authorizations... and complete follow up to ensure review was received by appropriate party and authorization is obtained. Pulls admit/discharge...
Nurse to review provider-submitted service authorization requests and evaluate medical necessity, with a primary focus... concurrent review and prior authorization according to internal policies Identify appropriate benefits and determine...
and dental plan inquiries, and services of staff such as utilization review, prior authorization, billing and contract management...
. Through the utilization of assigned team leaders, complete all daily activities (work load) and execute according to schedule... tools is preferred. Working knowledge of Blue Yonder WMS is preferred. Candidates must already have a work authorization...
. Align families, Behavior Technicians, and Supervising Clinicians to start new cases and confirm authorization, ensuring... and manage non-billable Behavior Technician hours and utilization of Behavior Technician hours to stay within budget. Identify...
clinical functions to meet regulatory requirements. Includes: IP Utilization Review, Care Management, retrospective review... processes, Intake and Prior Authorization clinical elective case review processes, Transition of care program, Justice Reach...
clinical functions to meet regulatory requirements. Includes: IP Utilization Review, Care Management, retrospective review... processes, Intake and Prior Authorization clinical elective case review processes, Transition of care program, Justice Reach...
and tracks traveler completion and the efficient utilization of production technician time. Provide training in safety... as applicable to the job tasks and function. Review, revise and approve standard operating procedures (SOPs) and Job Safey Analysis...
, including document gathering, document review, case analysis, case drafting, etc. Oversee status of cases through utilization... of case management and billing systems, run reports as needed, and assist with review of cases. Act as a Subject Matter...
through utilization of case management and billing systems, run reports as needed, and assist with review of cases. Work... with government agencies, including document gathering, document review, case analysis, case drafting, etc. Oversee status of cases...
are met for our wholly owned and delegated plans in the areas of prior authorization, census management, prospective/concurrent/retro review... to: Utilization management: Leading teams and partnering with Senior leaders to ensure appropriate levels of health care utilization...