At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career. Come join us and be part of a purpose driven company who is invested in your future! Job Summary Under Supervision, This Position Is

Reviews clinical authorization denials and determines appropriate actions per payor to overturn the denial. Functions as a hospital liaison with external third party payors to review authorization denials. Job Duties Monitors and completes claims on team appeals, reconsiderations, and claim investigations. Works with the precertification department and other physician off

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Maintains positive and productive relations with payor representatives, providers, professional services, medical staff services, and the revenue cycle to successfully expedite the enrollment/re enrollment process. Helps resolve issues to ensure that revenue is not negatively impacted. Job Duties Maintains an expanded knowledge and thorough understanding of the IntelliApp

Job Description Under general supervision, provides utilization review and denials management for an assigned patient case load. This role utilizes nationally recognized care guidelines/criteria to assess the patient's need for outpatient or inpatient care as well as the appropriate level of care. The role requires interfacing with the case managers, medical team, other h

This classification learns to perform eligibility determination work of average difficulty. An employee in this class is customer facing and learns to interview customers and determine eligibility for SNAP and TANF programs. This classification performs responsibilities at the learning level under direct supervision. This class differs from the Eligibility Counselor 2 in

This position completes daily insurance verification/authorization for proposed services and patient notification for estimated payments due. The position works with clinicians audiologists and speech language pathologists, and schedules patients in the Practice Management database. The person hired will demonstrate the highest degree of accuracy and readability for all w

Patient Account Representative Del Amo Behavioral Health System, a subsidiary of UHS ,offers a safe and compassionate environment for individuals looking for hope and healing from emotional, psychiatric and addiction issues. Del Amo Behavioral Health offers a wide range of options, including inpatient, outpatient and specialty programs that includes children, adolescents,

Purpose This is a full time position to serve as a member of the Office of Risk and Compliance at Dell Medical School generally focusing on the University of Texas at Austin's clinical practice, UT Health Austin. This position is responsible for policy management at UT Health Austin. The Policy Administrator reports to the Office of Risk and Compliance. The position works

The Human Resources File Clerk is responsible for uploading digital files and data. They organize records and archive paperwork so it can be found when needed most by other departments or personnel who might require its services. They also make copies of documents and distribute them accordingly. The position reports to the Director, Human Resources and provides support t

Coordinates administrative duties associated with daily physician practice operations and acts as a resource to the front line scheduling colleagues. Provides education and support to clerical staff. Functions as the primary practice resource for insurance information, clerical standard work, EMR scheduling, referrals, and other appointment functions. Job Duties Oversees

Production/Indirect Contract and PO monthly audits of Defense/Commercial/Fabrication Supply Chain which are tied to U. S. Government (USG) contracts. This requires checking for both accuracy and content KPI's distributed to Defense/Commercial/Fabrication SCM Leadership, Defense Senior Leadership, Government Compliance Leadership, and others, as needed Facilitate individua

Primary Office Location One North Shore Center. Pittsburgh, Pennsylvania. 15212. Join our team. Make a difference for us and for your future. Position Title Employee Benefits Account Executive Business Unit INSA Reports to Director of Employee Benefits Position Overview This position manages a complex book of employee benefits business and acts as the primary service cont

Receive, screen, and process all referral information to the appropriate team member. Perform insurance verification or obtain authorization from any organization making referral that is at risk and requires prior authorization. Consult with the Director of Patient Care Services as necessary to ensure that all services are authorized and reimbursable prior to providing th

Summary Under immediate supervision, performs eligibility related paraprofessional work of routine difficulty; and performs related work as required. Distinguishing Features An employee in this class assists Eligibility Counselors in case management activities and learns the rules and regulations necessary to determine eligibility for monetary benefits and social services