Top 172 Clinical data coordinator Jobs in Annapolis Md

Prior Authorization Specialist
MARYLAND PRIMARY CARE PHYSICIANS LLC —Bowie, MD
- $20 - $24 an hour
- Full-time
- Hybrid work
- Computer literacy
- Medical office experience
- HIPAA
11h
Clinical Research Coordinator I/II/III Opportunities – Multiple Locations Nationwide
Headlands Research —Baltimore, MD
- $45,000 - $100,000 a year
- Bachelor's degree
- Psychology
- Communication skills
Quick Apply
Research Coordinator - Clinical Trials Unit
Kennedy Krieger Institute —Baltimore, MD
- $40,043.12 - $66,204.53 a year
- Full-time
- Adults
- Mid-level
- Bachelor's degree
13h
Clinical Research Assistant
Velocity Clinical Research, Inc. —Annapolis, MD
- Vital signs
- English
- High school diploma or GED
- Paid holidays
- Health insurance
Quick Apply
7d
Clinical Research Coordinator
No-Resistance Consulting Group —Greenbelt, MD
- $22.50 - $25.00 an hour
- Full-time
- Urgent Care
- Data entry
- Pediatrics
- Health insurance
- Dental insurance
Quick Apply
14d
Clinical Coordinator
MARYLAND PRIMARY CARE PHYSICIANS LLC —Glen Burnie, MD
- $29 - $36 an hour
- Full-time
- Background check
- Pass drug screening
- Mid-level
Patient Coordinator
Guidehouse Digital, LLC —Baltimore, MD
- $56,000 - $94,000 a year
- Full-time
- Bilingual
- HIPAA
- Administrative experience
- Commuter assistance
- Health savings account
8d
Website Content Coordinator (Integrative Learning and Life Design)
Johns Hopkins University —Baltimore, MD
- $18.50 - $34.75 an hour
- Part-time
- Remote
- Background check
- Marketing
- Mid-level
Clinical Registry Coordinator
University of Maryland Medical System —Baltimore, MD
- Full-time
- Nursing
- Surgery
- RN License
Clinical Research Coordinator (CRC) I
Pharmaron —Baltimore, MD
- Full-time
- 1 year
- Associate's degree
- Entry level
Quick Apply
Digital Accessibility Coordinator (IT@JH University Information Systems)
Johns Hopkins University —Baltimore, MD
- $73,300 - $128,300 a year
- Full-time
- Remote
- Background check
- Experience working with individuals with disabilities
- Research
Clinical Research Coordinator GW- Washington DC
Maryland Oncology —Beltsville, MD
- $51,545 - $88,987 a year
- OSHA
- HIPAA
- Mid-level
Front Office Coordinator, Cardiology
University of Maryland Medical System —Glen Burnie, MD
- Full-time
- HIPAA
- High school diploma or GED
- Clinic
Provider Network Specialist
Maryland Care Management Inc —Linthicum, MD
- Full-time
- Remote
- Research
- Mid-level
- Bachelor's degree
- Disability insurance
- Health insurance
Temporary - Clinical Research Coordinator
Axle —Baltimore, MD
- $60 - $64 an hour
- Temporary
- Customer service
- Writing skills
- BLS Certification
- Paid holidays
- Health insurance
Quick Apply
Program Administration Records Coordinator
ResCare Community Living —Greenbelt, MD
- Full-time
- Office
- High school diploma or GED
- Typing
- Paid holidays
- Paid time off
Research Project Coordinator
University of Maryland, Baltimore —Baltimore, MD
- Weekends as needed
- 18 years or older
- Nursing
- Mid-level
13d
Hospital Service Coordinator
Luminis Health —Annapolis, MD
- $17.40 - $30.98 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Hospital
- AD&D insurance
- Paid holidays
9d
Office Supervisor
Anne Arundel County Health Department —Anne Arundel County, MD
- $49,214 - $63,669 a year
- Online Application
- Hybrid work
- High school
- Word processing
- Mid-level
17h
Patient Access Representative
Luminis Health —Annapolis, MD
- $17.50 - $22.00 an hour
- Part-time
- Microsoft Outlook
- Hospital
- HIPAA
- AD&D insurance
- Paid holidays
6d

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Prior Authorization Specialist

MARYLAND PRIMARY CARE PHYSICIANS LLC -
Bowie, MD

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Job Details

Full-time
$20 - $24 an hour
11 hours ago

Qualifications

Computer operation
Computer literacy
Medical office experience
High school diploma or GED
Healthcare referral management
Clinical data entry
Utilization management
Resource utilization in healthcare
Typing
Quality data entry

Full Job Description

Description:

Description

The Prior Authorization Coordinator is responsible for servicing the needs of patients, providers, and the Health Plans representatives, by effectively handling referrals from providers to facilitate the clinical review, issue authorizations and coordination of referrals services utilizing pre-approved screening criteria in compliance with contracted Client's requirements and adopted clinical guidelines. Handles the more complex requests for treatment and authorization requests. Conducts searches on authorization requests to handle complex Provider inquiries.

Job Duties

Obtain prior authorizations for diagnostic imaging, prescription medications, Home Health, and Durable Medical Equipment.
Receives referral requests from providers and Health Plans representatives. Assist in processing medical services request. Completes clerical duties related to the processing of Authorization Requests and Provider Referrals.
Verifies member’s eligibility and benefits with subsequent notification to designated staff of eligibility issues.
Inputs all requests for services received via fax or phone into the system accurately for electronically generated authorization and tracking.
Provides services authorizations to providers per UM Departmental Policy and Procedures and specific contracted Client's process on a timely manner.
Requests submission of appropriate medical records according to established criteria for requested service(s) in accordance with the corresponding Policy and Procedure.
Notifies required parties within the appropriate timeframe for routine and urgent requests for services.
Research member history for duplications and consideration of authorization limits.
Verifies fax numbers and system updates. Communicates with requesting provider for any identified need to clarify a request for an authorization, such as CPT codes, ICD10, requested timeframes and member’s demographics.
Provides effective departmental communication with both internal and external sources.
Forwards Authorizations to appropriate department staff in terms of eligibility and other coverage, pricing, and benefit issues.
Scans, attaches, reviews and effectively works with electronic images as part of the authorization process. Including recording the required information from attachments into the authorization fields.
Collaborates with Supervisor and Insurance companies to resolve complex authorization issues.
Appropriately forwards all referral requests to the next level of clinical review as applicable and after verifying for completeness and appropriateness.
Coordinates approved outpatient surgical procedures in specialist's office and/or outpatient surgical facilities with health plan's authorization department when applicable.
Coordinates approved services with Home Health and Durable Medical Equipment Providers, Nurse Care Managers, Plan discharge Planners and Plan Members as delegated or required by Plan.
Is resource person for PCP to refer to network specialist(s).
Maintains appropriate logs, records, and reports as established.
Documents and communicates areas of concern to supervisor.
Identifies providers who show an educational need to follow national, state and plan requirements.
Adheres to company HIPAA policies and procedures. Identifying, maintaining and protecting sensitive HIPAA information (PHI) and following procedures to ensure the security of such information.
Perform other duties as assigned.

Requirements:

Education

High school diploma or general education degree (GED); Medical coding or authorization education/training preferred.

Experience & Skills Required

Required: computer literacy and advanced data entry capacity (++45 wpm)
Required: 3 - 5 years’ experience in a medical office setting
Experience processing/managing referrals or authorization requests in a Utilization Management department for 2 years, demonstrating production and accuracy well above the minimum required goals, or an equivalent combination of education and experience, which would provide the required knowledge, skills and abilities may also be qualifying.

MMR, TB and Flu

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Refine Your Search

clinical data coordinator jobs in annapolis md

Prior Authorization Specialist

Clinical Research Coordinator I/II/III Opportunities – Multiple Locations Nationwide

Research Coordinator - Clinical Trials Unit

Clinical Research Assistant

Clinical Research Coordinator

Clinical Coordinator

Patient Coordinator

Website Content Coordinator (Integrative Learning and Life Design)

Clinical Registry Coordinator

Clinical Research Coordinator (CRC) I

Digital Accessibility Coordinator (IT@JH University Information Systems)

Clinical Research Coordinator GW- Washington DC

Front Office Coordinator, Cardiology

Provider Network Specialist

Temporary - Clinical Research Coordinator

Program Administration Records Coordinator

Research Project Coordinator

Hospital Service Coordinator

Office Supervisor

Patient Access Representative

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