Sentences with phrase «prior authorization process»

This position takes in - coming calls from members, providers, etc providing professional phone assistance to all callers through the criteria based prior authorization process.

Description: This position takes in - coming calls from members, providers, etc providing professional phone assistance to all callers through the criteria based prior authorization process.

Job Description As a certified technician, you will take in - coming calls from members, providers, etc.to provide professional phone assistance to callers through the criteria based prior authorization process.

Take in - coming calls from members, providers, etc providing professional phone assistance to all callers through the criteria based prior authorization process.

Job Description: This position takes in - coming calls from members, providers, etc providing professional phone assistance to all callers through the criteria based prior authorization process.

On February 1, 2017, the Ontario Court of Appeal released its opinion in R v Paryniuk, 2017 ONCA 87 affirming the residual discretion of a reviewing judge on an evidence exclusion motion to vitiate a warrant to protect the integrity of the prior authorization process.

It is important in cases involving police conduct that the purpose of the prior authorization process not be frustrated by positioning it virtually outside the remedial grasp of the Charter.

Once True Health receives the patient's specimen and all required documentation with signatures, we will guide both patient and clinician through the appropriate prior authorization process.

A: The prior authorization process may vary depending on your insurer.

Not exact matches

«[T] his is an under - estimation as all payers require prior authorization and the process is often longer than couple of weeks,» Gal wrote.

True Health has dedicated billing and customer support teams committed to assisting clinicians and patients through the full prior authorization and billing process.

What is Pre - Certification / Authorization: It is the process of obtaining prior authorization from the travel insurance company for major medical services like planned surgery, hospitalization, or other complicated expensivAuthorization: It is the process of obtaining prior authorization from the travel insurance company for major medical services like planned surgery, hospitalization, or other complicated expensivauthorization from the travel insurance company for major medical services like planned surgery, hospitalization, or other complicated expensive procedures.

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Complete and review preliminary estimate with customer Repair Orders: open with BAR (CA) and DRP compliance, including obtaining proper authorizations and update customers throughout repair process Prepare and complete paperwork for final bill prior to vehicle delivery Provide post repair plan communication including all vehicle status updates Total loss administration Performs other related duties as assigned.

Two to five years of related experience and / or training in pharmacy prior authorization and pharmacy technician processes in a managed care setting is required.

Analyze insurance benefits, processing and prior authorizations during scope of medication procurement.

Obtained prior authorizations and processed referrals for diagnostic services and procedures

Monitor utilization of medical services to assure cost - effective use of medical resources through processing prior authorizations

Performs tasks such as tracking and following up on all requests fro prior authorization, contacting insurance companies, coordinating the appeal process, resolving authorization denials, and other assigned duties.

Completes and processes prior authorizations for medications that are not covered by patient's insurance.

• Assist physician in exam rooms • Escort patients to exam rooms, measure vital signs, including weight, blood pressure, pulse, temperature, and document all information • Ensure all related reports, labs and information is filed is available in patients» medical records prior to their appointment • Take telephone messages and provide feedback and answers to patient / physician / pharmacy calls • Triage and process messages from patients and front office staff to physicians and physician assistants • Prior Authorizations Knowledge Medical assistants must have knowledge of: • Healthcare field and medical specialty • Medical terminology • Knowledge of EHRs (if applicable) Requirements • Exceptional customer service and phone etiquette • Ability to maintain effective and organized systems to ensure timely patient flow • The ability to perform phlebotomy and administer injections • High school diploma • Medical assistant certificprior to their appointment • Take telephone messages and provide feedback and answers to patient / physician / pharmacy calls • Triage and process messages from patients and front office staff to physicians and physician assistants • Prior Authorizations Knowledge Medical assistants must have knowledge of: • Healthcare field and medical specialty • Medical terminology • Knowledge of EHRs (if applicable) Requirements • Exceptional customer service and phone etiquette • Ability to maintain effective and organized systems to ensure timely patient flow • The ability to perform phlebotomy and administer injections • High school diploma • Medical assistant certificPrior Authorizations Knowledge Medical assistants must have knowledge of: • Healthcare field and medical specialty • Medical terminology • Knowledge of EHRs (if applicable) Requirements • Exceptional customer service and phone etiquette • Ability to maintain effective and organized systems to ensure timely patient flow • The ability to perform phlebotomy and administer injections • High school diploma • Medical assistant certification

Responsible for assisting the CSC Pharmacist with the day - to - day operational needs, including adjudication of clinical claims, processing prior authorization forms and meeting the requirements of the Clinical Service Center.

* Analyze, evaluate and work to resolve customer inquiries and issues * Interact with customers in a courteous and professional manner * Effectively communicate issues and resolutions to customers and appropriate internal staff * Use judgment and problem - solving skills to solve customer problems * Use multiple screens of information simultaneously to address customer needs * Follow processes according to contact center standards to ensure contact handling accuracy and operational effectiveness * Use technology tools as directed and within established guidelines * Adhere to precise work schedules, taking continuous phone calls for extended periods of time * Answer prior authorization inquiries calls as well as research and resolve formulary and benefit issues * Consistently meet established productivity, schedule adherence, and quality standards * Performs other duties as assigned by management Education / Experience: * High School Diploma or equivalent * Minimum one (1) year current / recent Pharmacy Technician experience in healthcare setting * PTCB Pharmacy Certification required or ability to obtain within six - months of employment

PA Reps for staff development and growth opportunities * Plan, assign, and direct work, appraise performance, reward and discipline employees, address complaints and resolve problems within the team * Assist in the hiring process * Assist in the preparation of performance reviews * Deliver performance reviews in conjunction with the Prior Auth Manager * Meet monthly with each staff member to go over performance status * Assist with training as needed * Lead weekly Team meetings with staff to keep them informed of changes to policy and procedures and corporate communications * Meet with the Prior Authorization Management team weekly to report on clinical call center performance and personnel issues Required Qualifications: * High School Diploma or equivalent * Current and unrestricted Pharmacy Technician license * 2 years» experience supervising Pharmacy Technicians in a Call Center environment * Prior Authorization experience * Knowledge of the Pharmacy Benefit Management and / or Health Insurance * Knowledge of Call Center industry through work experience and as obtained through related courses * Proficient in Microsoft Word and Excel Preferred Qualifications: * Bachelors» Degree * PBM experience * National Pharmacy Technician Certification Required Competencies: * Must have strong leadership and problem solving skills * Strong written and verbal communication skills * Strong interpersonal skills * Ability to effectively present information and respond to questions from groups of associates, managers and clients * Ability to comprehend ACD statistical reporting and apply it to the operation of the department * Ability to interpret a variety of instructions furnished in written, oral, diagram or schedule form * Ability to maintain a high level of consistency while working with team members * Ability to recognize the needs of the staff, heighten morale, and decrease stress and burnout * Ability to understand what style of conflict resolution is best suited for a particular situation * Ability to determine the needs of each individual team member and assist them in achieving set goals * Demonstrate a clear understanding of company and client confidentiality * Excellent organizational skills * Exemplary coaching / motivational skills at both an individual and team level * Adaptable and able to move with change while maintaining a positive attitude and strong role model for the Team.

Calculate cost estimates for treatment Explore patient assistance programs, copay cards, and financials to get patient qualified for assistance Create treatment plans for Chemotherapy, Radiation, and Scans Meet with patients to review financial responsibilities prior to treatment and collect payments for treatment Assist patients with inquiries regarding charges, payments, balances, and credits for services rendered Make sure all treatments have authorization and claims are processing correctly Audit logs to make sure payments are accurate Assist the patient with all billing inquires Correct billing and insurance errors Create weekly and monthly financial reports for office.

We do require technicians to make outbound calls to providers and members to collect additional information needed to process prior authorizations if necessary.

This position focuses on prior authorization review and processing in computer systems, follow - ups, calling prescriber offices, computer skills, data entry, and working on the phone.

The Pharmacy Technician receives and inputs prescriptions, prices, prepares, adjudicates, fills and processes the check - out and / or shipment of prescriptions, processes any insurance claims, prior authorization and patient assistance program paperwork, and helps with inventory management.

• Solid knowledge of prescription drug reimbursement, including insurance plan types, PBM and major medical benefits, prior authorizations and appeals processing.

Some duties will include preparing our patients for exams, processing refill requests, notification of lab results, completing and submitting prior authorizations and generally working as a team as we practice the medical home model, which integrates patient care.

This position focuses on prior authorization review and processing in computer systems, follow - ups, calling prescriber offices, computer skills, da...

Some MA positions are highly administrative, where you mainly answer phones, process referrals and prior authorizations.

2 + years retail, mail order, long - term care hospital experience as a Pharmacy Technician - includes experience in dealing with: - Insurance benefits authorization - Prior Authorization approvals - Adjudications issues - Coverage verification - Reimbursement issues - Claim processing - Data entry of prescriptions - Dispensing prescriptions, 2 + years customer service experience in an organization providing superior customer service handling: - Outbound calls to customers, doctor offices, third party administrators, coordinating insurance billing, verifying coverage, resolving insurance coverage issues, and obtaining prior authorizatiauthorization - Prior Authorization approvals - Adjudications issues - Coverage verification - Reimbursement issues - Claim processing - Data entry of prescriptions - Dispensing prescriptions, 2 + years customer service experience in an organization providing superior customer service handling: - Outbound calls to customers, doctor offices, third party administrators, coordinating insurance billing, verifying coverage, resolving insurance coverage issues, and obtaining prior authorization approPrior Authorization approvals - Adjudications issues - Coverage verification - Reimbursement issues - Claim processing - Data entry of prescriptions - Dispensing prescriptions, 2 + years customer service experience in an organization providing superior customer service handling: - Outbound calls to customers, doctor offices, third party administrators, coordinating insurance billing, verifying coverage, resolving insurance coverage issues, and obtaining prior authorizatiAuthorization approvals - Adjudications issues - Coverage verification - Reimbursement issues - Claim processing - Data entry of prescriptions - Dispensing prescriptions, 2 + years customer service experience in an organization providing superior customer service handling: - Outbound calls to customers, doctor offices, third party administrators, coordinating insurance billing, verifying coverage, resolving insurance coverage issues, and obtaining prior authorization approprior authorizationauthorization approvals.

• Provide courteous customer service to the public, both in - person and on the telephone • Register new patients in the pharmacy computer system • Update insurance and demographic information for existing patients as needed • Process prescription and immunization claims through insurance • Request prior authorizations for medications not covered by patient insurance plans • Fill prescriptions in a timely manner and collect patient co-pays at the register • Work both independently and with other team members to meet customer needs • Follow all HIPAA confidentiality guidelines.

Coordinate the scheduling, referral management, registration, prior authorization and insurance verification processes for patients.

Prior should imply that consent has been sought sufficiently in advance of any authorization or commencement of activities and that respect is shown for time requirements of indigenous consultation / consensus processes.