Primarily answering prior authorization with inbound calls (up to 50 to 70 calls per day) from providers/members as well as research and resolve formulary and benefit issues using the appropriate reference material Process authorizations through various computer systems and use of job aid/policies/procedures ensuring the accuracy of all data and updating as necessary Have

Conduct in home assessments including an evaluation of past medical history, review of systems, medication reconciliation, vital signs, and comprehensive physical exam Perform evidence based practice screenings including point of care testing (as appropriate) Identify diagnoses to be used in care management and active medical management in the furtherance of treatment For

Enter prescriptions and verify appropriate and accurate information Contact patients, pharmacists and doctor's offices to resolve claims issues Process prescriptions (from intake to order completion) Resolve customer issues; ensuring accurate information is provided You'll be rewarded and recognized for your performance in an environment that will challenge you and give y

improving the quality, cost and experience of health care. Here, we focus on delivering the best patient care, rather than volume. Through innovation and superior care management, we support patients and your well being as a team member. Join a team at the forefront of value based care and discover the meaning behind Caring. Connecting. Growing together. Positions in this

Regularly perform intakes, diagnostic evaluations, prepare and monitor treatment planning while engaging in appropriate client therapy practices and following guidance provided by one's supervisor Form effective therapeutic alliances, supporting each client's unique needs and goals, with the result in positively impacting client outcomes and retention Demonstrate advanced

improving the quality, cost and experience of health care. Here, we focus on delivering the best patient care, rather than volume. Through innovation and superior care management, we support patients and your well being as a team member. Join a team at the forefront of value based care and discover the meaning behind Caring. Connecting. Growing together. This position wil

$5,000 Sign on Bonus for External Candidates Careers with MedExpress. At MedExpress, we believe in delivering quality, convenient, affordable health care and exceeding our patients' expectations. Our neighborhood medical centers are open every day from 8 8 with a full medical team and no appointments necessary to help patients get in, get healthy, and get back to what's r

Locate, outreach and engage members within the community that clinicians and care navigators have not been able to reach; create a positive experience and relationship with the member Assesses functional and social needs of members and collaborates to develop and implement solutions with the frequency established in the model of care Work collaboratively the multidiscipli

Opportunities with Optum in the Tri State region (formerly CareMount Medical, ProHEALTH New York, Crystal Run Healthcare and Riverside Medical Group). Come make a difference in the lives of people who turn to us for care at one of our hundreds of locations across New York, New Jersey and Connecticut. Work with state of the art technology and brilliant co workers who share

Serve as a resource or Subject Matter Expert (SME) for other team members or internal customers Handle escalated calls, resolving more complex customer issues in a one and done manner Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explan

Locate, outreach and engage members within the community that clinicians and care navigators have not been able to reach; create a positive experience and relationship with the member Assesses functional and social needs of members and collaborates to develop and implement solutions with the frequency established in the model of care Work collaboratively the multidiscipli

Greets and welcomes patient in person Collects demographic and insurance information Checks in or interviews patient to complete appropriate paperwork Directs patient to their appointment or procedure May assist in scheduling add on appointments Verifies eligibility and benefits information for payers and interprets results Obtains signatures from patients as needed Colle

Obtain accurate and updated patient information, such as name, address, insurance information Perform insurance verification on the date of service Obtain patient signatures for required documents File and maintain medical records Confirms and schedule appointments Answering incoming and outgoing telephone calls promptly and courteously, Perform referral documentation pro

Treating and managing patients according to standard, usual, and customary methods, and techniques. Provides understanding of diagnosis, treatment, therapy, and management of patients according to current standards of care utilizing best practice recommendations. Counsels and educates patients and families. Maintains accurate, complete, concise, and timely documentation i

You already love the Northwest. Why not love your career here, too? The Everett Clinic and The Polyclinic, part of Optum, are physician led, close knitted teams that have deep roots in the Puget Sound area. We are passionate about patients. We are leading the state of Washington toward better healthcare practices, and we are looking for amazing clinicians like you to join