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Alignment Health
Overview
Review prior authorization requests for medical necessity using CMS and MCG guidelines to ensure high-quality, cost-effective care. Collaborate with providers and medical directors to process referrals and manage appeals and grievances.
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Compensation
$77,905 - $116,858 / YEAR
Posted
23 days ago
International Community Health Services
The Medical Referral Specialist is responsible for providing various office and administrative support services, which includes greeting and coordinating patient referrals and assisting with insurance screening and referral processing.
$22 - $33 / HOUR
25 days ago
Youth Advocate Programs, Inc.
The Intake Specialist manages the referral process by collecting and verifying documentation while entering participant data into the system. They also conduct assessments, facilitate program classes, and provide support to families within their homes and communities.
$43,000 - $46,000 / YEAR
1 month ago
Dartmouth-Hitchcock Health
Coordinates the admission process by educating prospective patients and managing insurance authorizations. Manages daily admission flow and facilitates the intake documentation process in compliance with regulatory standards.
Salary not listed
Regal Medical Group
The Prior Authorization Nurse manages specialty referral requests by applying clinical guidelines to ensure appropriate care and cost-effectiveness. They act as a liaison between providers, health plans, and patients while maintaining accurate documentation and regulatory compliance.
$38 - $50 / HOUR
St. Luke's University Health Network
The specialist receives and reviews behavioral health intake referrals, making unit placement recommendations to the appropriate inpatient behavioral health unit. They facilitate admission decisions by interacting with crisis intervention teams and unit staff, while also verifying insurance authorizations and commitment documentation compliance.
AltaMed
The Onsite Discharge Coordinator supports the Hospitalist program by managing the timely processing of outpatient and inpatient referrals and authorizations. They are responsible for troubleshooting complex issues and ensuring compliance with state and federal guidelines.
$27 - $34 / HOUR
2 months ago
Sutter Health
Processes referral requests for patients to achieve timely and accurate determinations. Assists providers and patients with referral status questions and participates in improvements to the referral process.
$26 - $35 / HOUR
The Clinical Assistant supports patient care throughout the clinical visit, handling check-in, rooming, scribing during the visit, check-out, and follow-up coordination under the supervision of the practice manager. Key duties include conducting pre-visit planning, prepping patients by obtaining vitals, performing provider documentation in the EMR, and assisting with scheduling and patient communications.
This specialist receives and reviews behavioral health intake referrals, making unit placement recommendations and facilitating admission decisions in coordination with crisis intervention teams and inpatient units. Responsibilities also include verifying insurance authorizations, ensuring commitment documentation compliance, and arranging necessary patient transportation.
The specialist receives and reviews behavioral health intake referrals, makes unit placement recommendations, and coordinates with crisis teams and unit staff to facilitate admission decisions. This role also involves verifying insurance authorizations, ensuring commitment documentation compliance, and arranging necessary patient transportation.
Baptist
This role coordinates and facilitates business functions for physician services, primarily by processing patient referrals accurately and efficiently, generating reports, and communicating confirmations with relevant parties. Responsibilities also include scheduling appointments, maintaining customer relationships, and submitting required medical records.
Integrated Home Care Services, Inc.
This role is responsible for processing patient referrals from the Home Health Department by staffing cases with the appropriate discipline and agency under the direction of the Staffing Specialist Team Lead. The specialist will also serve as a resource for the Home Health Department and stay current on program, policy, and procedure changes.
3 months ago
NeoMed Center Inc
The Medical Clerk provides direct patient services in the registration area using automated information systems, courteously greeting patients and verifying requested services based on assignment area. Responsibilities include calling registered patients to validate appointments, collecting and recording deductibles and service payments, and verifying patient medical plan eligibility.
$13 - $14 / HOUR
University of Tennessee
The Medical Administrative Specialist 1 processes patient referrals, schedules new patients, and checks patients in and out. Additionally, they handle paperwork related to hearing aids and prepare daily collections reports.
$19 / HOUR
4 months ago
Lifepoint Health
The Certified Medical Assistant performs routine clinical and administrative duties to support the nephrology office. Responsibilities include patient assessments, documentation, assisting with medical procedures, and coordinating patient care.
5 months ago
Pancare of Florida Inc
The Certified Medical Assistant will provide direct patient care, prepare patients for exams, take vital signs, and assist with medical treatments. They will also document care in the Electronic Medical Record and maintain a clean and efficient clinic environment.
SB Clinical Practice Management
The Referral Coordinator will act as a liaison between referring providers, specialists, patients, and support staff to ensure timely and accurate processing of referrals. This role promotes continuity of care and enhances the overall patient experience.
$25 - $32 / HOUR
The Referral Coordinator will serve as a liaison between referring providers, specialists, patients, and support staff to ensure timely and accurate processing of referrals. This role promotes continuity of care and enhances the overall patient experience.
The Referral Coordinator will serve as a liaison between referring providers, specialists, patients, and support staff, ensuring timely and accurate processing of referrals. This role promotes continuity of care and enhances the overall patient experience.
