referrals prior to patient appointments. Utilizes Epic Referral Work Queues, Experian Real Time Authorization (RTA), phone..., payer websites and fax to complete prior authorizations for imaging and specialty services. Communicates authorization...
cooperatively with Centralized Prior Authorization Team and referring office staff to ensure timely pre-authorizations... and or prior images as required or confirms appropriate labs or images have been ordered or requested. Calls patients to confirm...
preferred Utilization management experience preferred Prior experience working for a health insurance company... and increase member program engagement. 20% Performs medical or behavioral review/authorization process. Ensures coverage...
, supporting the entire reimbursement journey through payer prior authorization to appeals/denials requirements and forms Review..., including formulary coverage/utilization management criteria, insurance forms & procedures, benefits investigation, prior...
o Utilization management experience preferred. Prior experience working for a health insurance company and/or with Medicare... and increase member program engagement. Performs medical or behavioral review/authorization process. Ensures coverage...