The Provider Services Department provides a single point of contact for questions, problem solving, and access to care, for providers on behalf of members of the Senior Care Options (SCO) and One Care Programs. The Provider Services Representative II (PSR) position is responsible for providing accurate, prompt, and courteous service in response to written, electronic and

Interface with CCA's provider departments including credentialing, PDM, Provider Relations and Contracting Answer critical incoming phone calls from providers and respond to inquiries, concerns and questions about coverage, benefits, eligibility and authorization status Navigate through multiple, complex systems and screens while maintaining caller engagement Thoroughly d

Why This Role is Important to Us The Privacy Analyst will play a key role in building, operationalizing and sustaining an effective and robust Privacy Program. Reporting to the Manager, the role will ensure that the organization complies with relevant and applicable privacy laws, regulations, contractual requirements, and standards. The role will be responsible for develo

You'll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges. Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources

Help process provider credentialing and enrollment applications and re applications including initial mailing, review and loading into the database tracking system Conduct audits and provide feedback to reduce errors and improve processes and performance Demonstrate great depth of knowledge/skills in own function and act as a technical resource to others Solve complex pro

Process provider applications and revalidation applications through verifications, credentialing, and site visits Accurately input enrollment data into database system Conduct quality assurance functions to reduce errors and improve processes and performance Demonstrate great depth of knowledge / skills in own function and act as a technical resource to others Educate and

Love + medicine is who we are, it's what we do, it's why people want to work here. If you're looking for a job to love, apply today. Scheduled Weekly Hours 40 Job Description This position will be responsible for performing detailed audits of guarantor accounts to identify and rectify billing issues/problems. They will be responsible for follow up with Third Party Payors

This position is responsible for processing insurance claims for assigned facilities in a timely manner. This position ensures review and collecting of payments from insurance agencies and patients for the assigned facilities. This position requires collaboration between the insurance agencies, the facility, and the patient in resolving any problems that may occur during

EXCELLENT LOCAL OPPORTUNITY!

Obtains insurance prior authorization for patient prescriptions, treatments, services, or procedures for new orders and re authorization for additional units including performing any retro authorization requests as allowed by payers; appeal prior authorization denials and help facilitate peer to peer reviews as needed Appropriately document authorization details in the pa

Obtains insurance prior authorization for patient prescriptions, treatments, services, or procedures and re authorization for additional units including performing any retro authorization requests as allowed by payers; appeal prior authorization denials and help facilitate peer to peer reviews as needed. Appropriately document authorization details in the patient's medica

RAYUS Radiology, formerly Center for Diagnostic Imaging and Insight Imaging, is looking for an Insurance Specialist to join our team. We are challenging the status quo by shining light on radiology and making it a critical first step in diagnosis and proper treatment. Come join us and shine brighter together! As an Insurance Specialist, you will provide expertise in insur

Western Region CBO The Western Region Consolidated Business Office provides business office services including billing, collections, cash posting, pre access management, variance and customer service to our affiliated UHS facilities. We are seeking dynamic and talented individuals to join our team. Job Description Responsible for the maintenance and processing of patient

The Commercial Account Manager is responsible for assisting clients with service needs and making changes to existing accounts, meeting service, and sales delivery standards, and performing essential functions to achieve the quality and service standards developed by the agency. This position will assist Producers and Account Executives in the handling and processing of n

Utilization Management Specialist Case Management Full Time 8 Hour Days (Non Exempt) (Non Union) Keck Medicine of USC Hospital Los Angeles, California The Utilization Management Specialist coordinates communication with admitting financial counselors, case management, patient financial services, and payers to ensure all inpatient services provided by the hospital are auth