insurance authorization specialist

61st Street Service Corporation

<div><p><b>Top Healthcare Provider Network</b></p>
<p>The 61st Street Service Corporation, provides administrative and clinical support staff for <b><i>ColumbiaDoctors</i></b>. This position will support ColumbiaDoctors, one of the largest multi-specialty practices in the Northeast. ColumbiaDoctors&rsquo; practices comprise an experienced group of more than 2,800 physicians, surgeons, dentists, and nurses, offering more than 240 specialties and subspecialties.</p>
<p><b>This position is primarily remote, candidates must reside in the Tri-State area (New York, New Jersey, or Connecticut).</b></p>
<p><b>Note: </b>There may be occasional requirements to visit the New York or New Jersey office for training, meetings, and other business needs.</p>
<p><b>Job Summary:</b></p>
<p>The Authorization Specialist III is responsible for verifying insurance policy benefit information, securing payer required authorization prior to the patient&rsquo;s visit, scheduled admission, or immediately following hospital admission. This position is responsible for obtaining accurate and timely pre-authorizations for professional services. The Authorization Specialist III is also responsible for assisting management with the daily work assignment, staff training, and quality audits.</p>
<p><b>Job Responsibilities:</b></p>
<ul><li>Verifies insurance coverage via system tools, payer portals (Electronic Query (Real-Time-Eligibility [RTE]/Insurance Payer Portal/Phone).</li>
<li>Upon verification of patient's insurance coverage, update changes in the billing system.</li>
<li>Confirms provider&rsquo;s participation status with patient&rsquo;s insurance plan/network.</li>
<li>Determines payer authorization requirements for professional services.</li>
<li>Research system notes to obtain missing or corrected insurance or demographic information.</li>
<li>Reviews clinical documentation to ensure criteria for procedure meets insurance requirements.</li>
<li>Initiates authorization and submits clinical documentation as requested by insurance companies.</li>
<li>Follows through on pre-certifications until final approval is obtained.</li>
<li>Manage faxes, emails, and phone calls. Responds to voicemails and emails.</li>
<li>Communicates with surgical coordinators regarding authorizations status or denials.</li>
<li>Submits appeals in the event of denial of prior authorizations or denial of payment following procedures.</li>
<li>Set up peer to peer calls with clinical providers and insurance companies, as needed.</li>
<li>Calculate and document patient out of pocket estimates and provide to patient.</li>
<li>Assists Supervisor with special projects and/or tasks.</li>
<li>Assists Authorization Specialist I and II with complex cases or questions pertaining to the clearance of payer authorization or insurance eligibility issues.</li>
<li>Assist supervisor/manager with distribution of daily work assignments.</li>
<li>Assist with new-hire training and staff refresher training materials.</li>
<li>Monitor and replenish the unit&rsquo;s office supply needs.</li>
<li>Assist management team with performing periodic quality audits.</li>
<li>Performs other job duties as assigned.</li>
</ul>
<p>Please note: While this position is primarily remote, candidates must be in a Columbia University approved telework state. There may be occasional requirements to visit the office for meetings or other business needs. Travel and accommodation costs associated with these visits will be the employee's responsibility and not be reimbursed by the company.</p>
<p><b>Job Qualifications:</b></p>
<ul><li>High school graduate or GED certificate is required.</li>
<li>A minimum of 2 years&rsquo; experience in a physician&rsquo;s billing or third payer environment.</li>
<li>Candidate must demonstrate the ability to understand and navigate managed care eligibility, insurance billing requirements, and obtaining pre-authorizations.</li>
<li>Candidate must demonstrate a strong customer service and patient focused orientation and the ability to communicate, adapt, and respond to complex situations. Including the ability to diffuse complex situations in a calm and professional manner.</li>
<li>Must demonstrate effective communication skills both verbally and written.</li>
<li>Ability to multi-task, prioritize, document, and manage time effectively.</li>
<li>Functional proficiency in computer software skills (e.g. Microsoft Word, Excel and Outlook, E-mail, etc.)</li>
<li>Functional proficiency and comprehension of medical terminology.</li>
<li>Certified Professional Coder certificate (CPC) is preferred.</li>
<li>Experience in Epic and or other of electronic billing systems is preferred.</li>
<li>Knowledge of medical terminology, diagnosis and procedure coding is preferred.</li>
<li>Previous experience in an academic healthcare setting is preferred.</li>
</ul>
<p><b>Hourly Rate Ranges: $27.88 - $36.06</b></p>
<p>Note: Our salary offers will fall within these ranges based on a variety of factors, including but not limited to experience, skill set, training and education.</p>
<p><b>61st Street Service Corporation</b></p>
<p>At 61st Street Service Corporation we are committed to providing our client with excellent customer service while maintaining a productive environment for all employees. The Service Corporation offers a competitive comprehensive Benefit package to eligible employees; including Healthcare and various other benefits including Paid Time off to promote a healthy lifestyle.</p>
<p>We are an equal employment opportunity employer and we adhere to all requirements of all applicable federal, state, and local civil rights laws.</p></div>

Authorization Specialist III #Full Time #Remote

Integral Care-Austin, TX

<div>
 <strong>
  Job Number:
 </strong>
 26-11098
 <br/>
 <br/>
 <strong>
  Job Summary:
 </strong>
 The Authorization Specialist is responsible for daily oversight of authorization request and approvals requiring interface with internal and external persons/entities and any other activities related to reimbursement for services of Crisis residential/respite programs. Performs regular updates and verification of insurance coverage. Other regular work duties may also involve meeting and greeting clients, facilitating client information, requesting payment for services rendered, handling various types of payments, issuing receipts for payment, retrieving message off facility voicemail, provide continuity of care email info for court related collaborators, building schedules in the Electronic Health Record for the providers, scanning client docs, supplies inventory/ordering/stocking, submission of work order requests, etc. and other duties as requested/assigned. This position provides a variety of moderately complex clerical work in support of the unit operations. Assignments involve difficult and responsible work in office, business, or fiscal operations with moderate latitude for the use of initiative and independent judgment. The Authorization Specialist works under the direct supervision of the unit Practice Manager and in collaboration with the multi-disciplinary team to help meet and assist clients' needs.
 <br/>
 <br/>
 Regular, predictable attendance is considered to be an essential requirement for this position. Other duties may be assigned. May require a flexible work schedule.
 <br/>
 <br/>
 Integral Care employees are to strive to maintain a trauma sensitive workplace, to embrace trauma sensitive and informed practices, and to foster a supportive and welcoming environment of care.
 <br/>
 <br/>
 <strong>
  Education
  <br/>
  <br/>
 </strong>
 Required:
 <br/>
 <br/>
 <ul>
  <li>
   High School Diploma or GED equivalent required.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  License
  <br/>
  <br/>
 </strong>
 Required:
 <br/>
 <br/>
 <ul>
  <li>
   Current and valid driver's license and a clean driving record.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Hours:
 </strong>
 Full-Time.
 <br/>
 <br/>
 <strong>
  Workdays:
 </strong>
 Monday - Friday.
 <br/>
 <br/>
 <strong>
  Workhours:
 </strong>
 8:00AM - 5:00PM.
 <br/>
 <br/>
 <strong>
  Salary:
 </strong>
 $23.02 an hour plus an additional 10% crisis stipend.
 <br/>
 <br/>
 <strong>
  Why join us:
 </strong>
 Integral Care has proudly served Travis County residents for the past 50 years. As the largest provider of behavioral health services in Travis County, we are dedicated to improving the lives of adults and children living with mental illness, substance use disorder, and intellectual and developmental disabilities.
 <br/>
 <br/>
 By joining our team, you will find rewarding work every day alongside people who have as much compassion as you. Join us and together we can help improve the quality of life for the people we serve. Imagine your career at Integral Care!
 <br/>
 <br/>
 <strong>
  Employee Benefits
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Medical, Dental, and Vision insurance
  </li>
  <li>
   Generous vacation/holiday/sick leave
  </li>
  <li>
   Life and Short-term/Long-term Disability Insurance
  </li>
  <li>
   Employee Assistance Program (EAP)
  </li>
  <li>
   403(b) retirement account
  </li>
  <li>
   Gold's Gym membership discount
  </li>
  <li>
   Mileage reimbursement
   <br/>
   <br/>
  </li>
 </ul>
 All qualified applicants will receive consideration for employment without regard to race, creed, color, religion, national origin, sexual orientation, gender identity, disability, veteran status, sex or age.
 <br/>
 <br/>
 For specific positions, additional compensation may be offered to candidates who are bilingual in English and another language deemed necessary for the role.
</div>


Authorization Specialist

USA Clinics Group

<div><p><b>Why USA Clinics Group?</b></p><p>
Founded by Harvard-trained physicians with a vision of offering patient-first care beyond the hospital settings, we&rsquo;ve grown into the nation&rsquo;s largest network of outpatient vein, fibroid, vascular, and prostate centers, with 170+ clinics across the country. Our mission is simple: deliver life-changing, minimally invasive care, close to home.</p><p>
We&rsquo;re building a culture where innovation, compassion, and accountability thrive. While proud of our growth, we&rsquo;re even more excited about what&rsquo;s ahead, and the team we&rsquo;re building to get there. We look forward to meeting you!</p><p><b>
Why You'll Love Working with us:</b></p><p>
Rapid career advancement Competitive compensation package</p><p>
Positive, team-oriented environment Work with cutting-ed technology</p><p>
Make a real impact on patients&rsquo; lives Join a fast-growing, mission-driven company</p><p></p><p>
USA Clinics Group is looking for an organized and motivated individual to join the team as our newest <b>Insurance Verification Specialist</b>! This position performs the function of obtaining referrals, and/or authorizations prior to the service date for test, procedures, and admissions into the clinics.</p><p></p><p><b>
Position Details:</b></p><ul><li>
Location: Northbrook, IL
</li><li>Schedule: Full-Time, Monday-Friday (on-site)</li><li>
Compensation: $23-$26hr based on experience and qualifications.</li></ul><p></p><p><b>
Responsibilities:</b></p><ul><li><ul><li>
Reviews referring physician and patient documentation for Medical Necessity against insurance protocol requirements for pre-certification purposes.</li><li>
Actively communicates with staff regarding status of authorization. Communicates the need for reschedule and/or cancellation if authorization not in-hand).</li><li>
Directs liaison to offices and patients regarding new, changed, or pending insurance authorizations, as well as on-going education of changes in authorization requirements.</li><li>
Responsible for scheduling STAT, emergent patients for outpatient diagnostic exams.</li><li>
Interacts with patients, their representatives, physicians, physician office staff, and others to gather and ensure accuracy of demographic, billing and clinical information.</li><li>
Produces and distributes required forms with accurate patient information.</li><li>
Respects and protects the patient&rsquo;s rights to confidentiality and privacy and discloses information only for the professional purposes which are in the patient&rsquo;s best interests with full consideration of their legal rights.</li><li>
Displays a positive attitude when interacting with provider&rsquo;s office staff, providers and fellow employees.</li><li>
Performs additional duties as assigned</li></ul></li></ul><p></p><b><br>
Requirements</b><br>
<ul><li>
High school graduate <b><i>required</i></b>. Advanced education <b><i>preferred</i></b>.</li><li>
Bilingual in English &amp; Spanish <b><i>required</i></b></li><li>
At least 2 years of prior experience in a health care setting handling benefit verification and prior authorizations, <b><i>required</i></b>
</li><li>Billing and Coding or other related certifications a plus</li><li>
Strong computers skills and excellent typing skills</li><li>
Immaculate attention to detail and excellent proofreading skills</li><li>
Excellent Customer Service skills</li><li>
Strong data entry skills</li><li>
Excellent organizational skills</li></ul><br>
<b>
Benefits</b><br>
<ul><li>
<b>Health insurance</b> (medical, dental, vision)
</li><li><b>Retirement Plan</b>
</li><li><b>Paid time off (PTO)</b> (vacation, sick)</li></ul><p></p><p>
INDM2</p></div>

Insurance Verification Specialist - Spanish Speaking

Navani

<div><p><b>Base Pay Range:</b></p><p></p><p><b>
Job Description:</b></p><h2 class="jobSectionHeader"><b>
The Prior Authorization Specialist is a Full Time, Regular position working Monday-Friday 10:30am-7pm CST </b><b>at the Navani Business Center, a wholly owned Inland Imaging company in Arlington, TX.</b></h2><p></p><p><b>
Summary:</b> Prior Authorization Specialists are responsible for assisting patients, referring physicians and their staff in scheduling exams at an Inland Imaging Clinical Associates facility. The Prior Authorization Specialist provides support by processing Insurance verification and ensuring a pre-authorization is in place prior to an exam. The position requires a highly organized, motivated and a skilled problem solver. Attention to detail and strong customer service skills to ensure all necessary steps are taken to accurately identify or process a request for a prior authorization.</p><p></p><p><b>
Essential Duties / Responsibilities:</b> To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</p><p></p><ul><li>
Provides high quality customer service by:<ul><li>
Communicates by asking the appropriate questions to get information necessary to verify if an authorization is required and if so enough information to help process the request.</li><li>
Reviews and provides exam specific information as needed to ensure exam and authorization match.</li><li>
Completes phone call with a professional closing</li></ul></li><li>
Determines when an authorization/referral is required</li><li>
Obtains any information necessary to assist with the authorization process<ul><li>
Call patients and/or referring offices on self-pay accounts that may require prior authorization to identify the appropriate insurance.</li></ul></li><li>
Understands the billing process to identify and communicate the codes and forms that may be required to ensure reimbursement.</li><li>
Identifies and communicates any changes, when necessary, in the patient schedule, status (STAT), in-patient add-ons, etc. to appropriate parties</li><li>
Communicates with appropriate person for any follow-up needed on a patient exam.</li><li>
Identifies faxes from prior authorization fax server sent in by referring providers and renames with standard nomenclature</li><li>
Updates patient demographics as needed</li><li>
Adds and verifies patient current insurance information and verifies any changes indicated as part of the insurance look-up process on our internal system. Updates this information when needed.</li><li>
Keeps all on-line web portals accounts active to ensure access is maintained in order to obtain prior-authorization verification.</li><li>
Maintains a working knowledge of supplemental programs (Recondo and Payer websites)</li><li>
Demonstrates appropriate verbal and written communication skills to relay accurate information in a clear, concise manner to peers, staff, management, patients, guests, and medical staff.</li><li>
Initiates appropriate questions and provides timely feedback to lead and management on any issues, policies, and procedures, etc.</li><li>
Organizes and maintains records to provide accurate reporting, easy access to information and historical data.</li><li>
Coordinates patient care between technologists and clerical staff to facilitate a smooth workflow</li></ul><ul><li>
Acts as a liaison between staff, management, and physicians</li><li>
This position may be required to work in a hospital, urgent care or clinical setting.</li><li>
Responsible to be aware of assigned work rotations and monthly assignments</li><li>
Identifies and reports any updates to exam codes and CPT codes to Team Lead that may be encountered when working accounts.</li><li>
Identifies and reports any Payer updates or changes that may be encountered when working accounts to Team Lead.</li><li>
Identifies and reports any changes or updates to Payer web portals used in prior authorization process that may be encountered when working accounts to Team Lead</li><li>
Provides a Bi-weekly or monthly report out of identified issues or concerns regarding payers, system workflow or referring office items.</li><li>
Maintains the prior authorization resource portal by updating referring office contact information.</li><li>
Maintains the prior authorization issue log in smartsheet for tracking payer, billing, referring office or other issues to be reviewed and followed-up on by the Team Leader.</li><li>
Performs other duties as assigned.</li></ul><p><br>
</p><p><b>General Duties/Responsibilities:</b></p><ul><li>
Ability to maintain strict confidentiality within the Inland Imaging companies and Inland&rsquo;s customers.</li><li>
Follows all Health and Safety policies and guidelines of Inland Imaging, Navani or its partners depending on work location.</li><li>
Follows all company policies including those regarding harassment, non-retaliation, discrimination, respectful workplace, and related policies.</li><li>
Follows all policies regarding HIPAA, non-disclosure of confidential information and company security.</li><li>
Honest, pleasant manner and good personal hygiene.</li><li>
Free of alcohol and drug abuse.</li><li>
Valid state driver&rsquo;s license and proof of insurance.</li><li>
Excellent communication and interpersonal skills.</li><li>
Detail oriented; ability to multi-task; organized and able to work in a fast-paced environment.</li><li>
Demonstrates self-directed learning and participation in continuing education through professional journals, approved seminars, etc.</li><li>
Ability to consider individual needs in communication with and assessment and treatment of patients of all ages.</li></ul><ul><li>
Adheres to departmental standards and personnel policies by demonstrating professional demeanor in conduct and appearance.</li><li>
Follows company departmental standards and personnel policies by using good teamwork and communication skills to help identify concerns and solutions, assisting where needed to ensure a smooth functioning department.</li><li>
Performs other duties as required by displaying team spirit and self-growth, accepting and performing other projects and responsibilities, and requesting other projects and responsibilities.</li><li>
Attendance is required for this position.</li><li>
Rotates to other shifts and locations as needed.</li></ul><p></p><p><b>
Supervisory Responsibilities:</b></p><ul><li>
There is no supervisory responsibility in this position</li></ul><p></p><p><b>
Advocacy:</b></p><p>
Treats all patients with dignity and respect Provides excellent customer service Conforms to Joint Commission and HIPAA regulations Complies with PHI (Protected Health Information) Demonstrates the Inland Imaging Core Values</p><ul><li>
Show We Care, Do The Right Thing, Maximize Individual Potential, Challenge Convention</li></ul><p></p><p><b>
Qualifications:
</b></p><ul><li><i>Education: </i>High School Diploma/GED required</li><li><i>
Experience: </i>One year of previous scheduling, insurance or medical office experience required<ul><li>
Proficient and accurate with electronic health systems including applications of billing, pre-authorizations, demographics and coding preferred</li><li>
Anatomy and medical terminology preferred</li><li>
Medical office experience preferred</li><li>
Knowledge of coverage and requirements for private insurances, commercial insurance and government payers. Demonstrated experience using software applications for Electronic Medical Records preferred</li><li>
Understanding of procedures to be read by radiologist preferred</li></ul></li><li><i>
Computer Skills</i>: Experience with the following computer applications is highly desired: Microsoft office products and a strong understanding of internet related access, Workday, Qgenda</li><li><i>
Background Check</i>:<ul><li>
Must be able to pass a background check required by RCW 43.43.830-840 to work with children under the age of 16, developmentally disabled persons or vulnerable adults</li><li>
In order to comply with provisions set forth in Sections 1128 and 1156 of the Social Security Act, all new employees of Navani Health Solutions will be checked against the LIST OF EXCLUDED INDIVIDUALS provided by the Department of Health &amp; Human Services, Office of the Inspector General (OIG). Employees must not be included on this list.</li></ul></li><li><i>
Drug Test</i>: Eligible employees must be able to pass a post-offer, pre-employment drug test including marijuana.</li></ul><p></p><h2 class="jobSectionHeader"><b>
Nuvodia/Inland is an EEO employer...</b></h2></div>

Prior Authorization Specialist

Elevate Patient Financial Solutions

<div><div><b>Elevate Patient Financial Solutions </b>has an exciting career opportunity available as a <b>Bilingual Scheduling and Authorization Coordinator.</b> This position will be a remote role <b>required to live in the Pacific or Mountain time zones</b>. The Full-Time schedule for this role will be <b>Monday through Friday 8 AM to 5 PM (PST or MST required).</b></div>
<div></div><div><b>Job Summary</b></div>
<div></div><div>The Scheduling and Authorization Coordinator delivers exceptional customer service when communicating with patients over the phone to provide the necessary information for applicable scheduling and imaging. They request information related to the coordination and scheduling of diagnostic imaging and other procedures and treatments for hospitals contracted with ElevatePFS&reg;. The Scheduling and Authorization Coordinator interacts directly with the patients, referring physicians, Hospital Services</div>
<div>, and internal company associates to guarantee smooth coordination of procedures and exams.</div>
<div></div><div><b>Essential Duties and Responsibilities</b></div>
<div></div><div><b>Insurance Authorization/Verification</b></div>
<div></div><ul><li>Thoroughly completes the insurance verification process to ensure the accuracy of insurance information.</li>
<li>Obtains insurance authorizations, referral, and treatment consults as needed for all scheduled patients prior to receiving services.</li>
<li>Obtains benefit coverage from insurance companies and accurately enters information into the appropriate computer system.</li>
<li>Obtains diagnosis information and/or CPT code from the physician/office or the outpatient department, as necessary for completing the insurance authorization process.</li>
<li>Maintains proficiency in the various systems utilized during insurance verification and authorization process including various on-line payor eligibility programs.</li>
<li>Monitors appropriate work lists to ensure timely insurance verification processing.</li>
<li>Maintains documentation necessary for compliance with state, federal, and other regulatory agency requirements.</li>
<li>Maintains proficiency in the various systems utilized during insurance verification and authorization process including various on-line payor eligibility programs.</li>
</ul>
<div></div><div><b>Scheduling</b></div>
<div></div><ul><li>Schedules all types of complex exams with attention to detail.</li>
<li>Ability to manage high outbound and inbound calls to schedule patients for imaging services to ensure the best possible customer service by properly educating the patient on exam preparation and answering questions.</li>
<li>Screens and verifies all HIPPA information to ensure accuracy with scheduling and speaking with patients, patients approved representatives and or physicians.</li>
<li>Schedules and documents notes in hospital and ElevatePFS&reg; operating systems.<br>
</li></ul><div><b>Clerical</b></div>
<div></div><ul><li>Monitors and manages the e-mail inbox or fax machine for assigned practices throughout the day.</li>
<li>Works any requests received via e-mailed or fax.</li>
<li>Checks and responds to voicemails.</li>
<li>Creates, maintains and monitors log of patients and procedures scheduled for assigned physician practices.</li>
<li>Monitors appropriate work lists to ensure timely insurance verification processing.</li>
<li>Utilizes multiple commuter application, scheduling software, network, drives to schedule multiple exams within multiple modalities and entities across the hospitals system.</li>
</ul>
<div></div><div><b>Additional Responsibilities</b></div>
<div></div><ul><li>Effectively communicates operational activities and issues with Supervisor and Manager.</li>
<li>Interfaces courteously and effectively with internal and external customers. Must consistently present a positive departmental and organizational image, as well as commitment to departmental goals, objectives, standards, policies and procedures.</li>
<li>Demonstrates proficiency within assigned area of responsibility and a general understanding of the entire Patient Access process.</li>
<li>Adheres to the hospitals and until level policies and procedures and safeguards set forth by each facility.</li>
<li>Identifies and recommends process improvements for RMA services.</li>
<li>Other duties as assigned.</li>
</ul>
<div></div><div><b>Qualifications and Requirements</b></div>
<div></div><ul><li>High school diploma or GED</li>
<li>Associate degree or 2+ years in patient scheduling, registration, or healthcare billing is preferred</li>
<li>Over one (1) year working in a customer service or client relations type role</li>
<li>Effectively communicate both orally and written, to a variety of individuals utilizing fluent Spanish and English.</li>
<li>Office or hospital environment experience is preferred</li>
<li>High volume call center experience is preferred</li>
<li>Strong Literacy (grammar, spelling, math)</li>
<li>Strong Microsoft Products experience, including word, excel, outlook, windows</li>
<li>Familiarity with HCA/Parallon IT systems is preferred</li>
<li>Strong sales and customer service skills</li>
<li>Excellent interviewing and telephone communication skills</li>
<li>Outstanding interpersonal and people‑oriented skills</li>
<li>Excellent written and verbal communication abilities</li>
<li>Ability to communicate assertively and professionally while maintaining confidence and credibility.</li>
<li>Strong analytical, problem‑solving, and decision‑making skills</li>
<li>High level of organization, attention to detail, and time management</li>
<li>Ability to multitask and prioritize effectively in a fast‑paced environment</li>
<li>Proven ability to work independently with minimal supervision</li>
<li>Strong stress management and adaptability skills</li>
<li>Goal‑driven with a strong action and results orientation</li>
<li>Demonstrates initiative, persistence, and a strong work ethic</li>
<li>Team‑oriented with the ability to collaborate effectively</li>
<li>Flexible and adaptable to changing priorities</li>
<li>High standards of honesty, integrity, and professionalism</li>
<li>Profit‑ and performance‑oriented mindset</li>
<li>Remote and hybrid positions require internet connectivity that meet the Company&rsquo;s upload and download requirements.</li></ul><br>
<div>
</div><div></div><div><br>
<b>Benefits</b></div>
<div></div><div>ElevatePFS believes in making a positive impact not only within our industry but also with our employees &ndash;the organization&rsquo;s greatest asset! We take pride in offering comprehensive benefits in a vast array of plans that contribute to the present and future well-being of our employees and their families.</div>
<ul><li>Medical, Dental &amp; Vision Insurance</li>
<li>401K (100% match for the first 3% &amp; 50% match for the next 2%)</li>
<li>15 days of PTO</li>
<li>7 paid Holidays</li>
<li>2 Floating holidays</li>
<li>1 Elevate Day (floating holiday)</li>
<li>Pet Insurance</li>
<li>Employee referral bonus program</li>
<li>Teamwork: We believe in teamwork and having fun together</li>
<li>Career Growth: Gain great experience to promote to higher roles</li></ul><br>
<div></div><div>The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, location, specialty and training. This pay scale is not a promise of a particular wage.</div><br>
<div></div>
<div></div><div><i>The job description does not constitute an employment agreement between the employer and Employee and is subject to change by the employer as the needs of the employer and requirements of the job change.</i></div>
<div></div><div><b>Elevate, PFS is an Equal Opportunity Employer</b></div></div>

Bilingual Scheduling and Authorization Coordinator (PST or MST location required)

ECU Health

Position Summary
<br>Responsible for creating the first impression of the organization's services to patients and families and other external customers. Essential duties may include performing all pre-arrival duties related to the pre-registration and financial clearance process for both outpatient and inpatient services. This position is responsible for collecting proper demographic and financial data to insure hospital bill is paid by a third party payer or the patient, in addition to verifying insurance eligibility, referral coordination, and securing authorization. Acts as primary liaison for patients receiving professional and hospital services at ECU Health.
<br>Responsibilities
<br>Conducts phone interview and completes pre-certification and insurance verification process prior to the patient's scheduled arrival.
<br><br>
Collects complete and accurate demographic, financial, and clinical information to properly enter into the electronic health record to properly a hospital registration.
<br><br>
Obtains diagnosis and procedure information from patient, clinical department or physician offices to perform ABN/Medical Necessity screening, as required.
<br><br>
Reviews registration account for accuracy to ensure the hospital is properly reimbursed
<br><br>
Works closely with physician office staff and utilization review/case management to coordinate certification process (initial authorization and extended stay authorization).
<br><br>
Resolves any insurance verification and financial clearance issue prior to or during hospital service; this involves contacting insurance/third party payers to resolve eligibility and benefits issues and to initiate insurance appeals if necessary.
<br><br>
Pre-registers patient by transcribing data provided by the doctor's office.
<br><br>
Negotiates deposits and payment arrangements with patients and or guarantors and attempt to collect patient copayments or other uninsured balances on accounts.
<br><br>
Explains financial obligations, negotiates deposits and payment arrangements with patients and or guarantors and attempt to collect patient copayments or other uninsured balances on accounts.
<br><br>
Verify insurance benefits using the electronic insurance eligibility application (Passport), internet application or telephone calls to insurance carriers, obtain authorizations and pre-certification for applicable visits.
<br><br>
Cross trained to perform other functions within the division as assigned.
<br><br>
Serves as a coach to new staff as assigned.
<br><br>
Provides feedback to management on issues that impact departmental workflow.
<br><br>
Provide focused training for individuals identified by the Team Lead and/or Supervisor.
<br><br>
Ensure that scheduling and registration reports and work queues are being addressed by Insurance Verifiers.
<br><br>
Assist management with special projects and reports.
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Serve in a lead capacity for departmental goals and initiatives.
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Other duties as assigned.
<br>Minimum Requirements
<br>High School or Equivalent (GED) or higher is required
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<b>Associate Degree:</b> preferred
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<b>Bachelors Degree:</b> preferred
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2 to 4 years of Registration, Scheduling and Insurance Authorization experience within a healthcare setting is required.
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5 years of customer service experience is required.
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Excellent communication (both written and oral), detail orientation, organization, and multitasking skills required
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Proficient computer skills; Experience with Microsoft Office applications (Outlook, Word and Excel)
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Preferred
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Experience with EPIC and medical office workflows
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Insurance Verification Experience
<br>Other Information
<br>Monday - Friday 8am-5pm
<br>ECU Health
<br>About ECU Health Medical Center
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ECU Health Medical Center, one of four academic medical centers in North Carolina, is the 974-bed flagship hospital for ECU Health and serves as the primary teaching hospital for The Brody School of Medicine at East Carolina University. ECU Health Medical Center has achieved Magnet® designation twice and provides acute and intermediate care, rehabilitation and outpatient health services to a 29-county region that is home to more than 1.4 million people.
<br>General Statement
<br>It is the goal of ECU Health and its entities to employ the most qualified individual who best matches the requirements for the vacant position.
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Offers of employment are subject to successful completion of all pre-employment screenings, which may include an occupational health screening, criminal record check, education, reference, and licensure verification.
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We value diversity and are proud to be an equal opportunity employer. Decisions of employment are made based on business needs, job requirements and applicant’s qualifications without regard to race, color, religion, gender, national origin, disability status, protected veteran status, genetic information and testing, family and medical leave, sexual orientation, gender identity or expression or any other status protected by law. We prohibit retaliation against individuals who bring forth any complaint, orally or in writing, to the employer, or against any individuals who assist or participate in the investigation of any complaint.

Patient Access Representative III - PAS Pre Cert and Authorization

Virikson Travel

<p><b>Responsibilities:</b></p><ul><li>Provide exceptional customer support for healthcare clients.</li><li>Handle patient scheduling for US-based doctors, including appointments, follow-ups, and reminders.</li><li>Manage prior authorization requests by coordinating with insurance providers and verifying required documentation.</li><li>Respond promptly to patient inquiries via phone, email, and chat while maintaining high service standards.</li><li>Possess working knowledge of insurance providers and their plans.</li><li>Be familiar with EMR/EHR platforms and medical billing systems.</li><li>Demonstrate strong communication, problem-solving, and customer service skills.</li></ul><p><b>Requirements:</b></p><ul><li>Up to 2 years of professional experience.</li><li>Excellent English communication skills (spoken and written).</li><li>Candidates with an O/A Levels background or IELTS certification will be preferred.</li></ul><ul><li><b>Work Mode:</b> Onsite, 5 days a week</li><li><b>Shift:</b> Night Shift (5:00 PM to 2:00 AM) &amp; (6:00 PM to 3:00 AM)</li></ul><p>Job Type: Full-time</p><p>Pay: Rs120,000.00 - Rs170,000.00 per month</p><p>Work Location: In person</p>

Customer Support Representative

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