Top 2708 Contract medical monitor Jobs in Remote

Prior Authorization Specialist I
Boston Medical Center —Remote
- $25.42 - $30.97 an hour
- Part-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- High school diploma or GED
- Health insurance
- Dental insurance
6d
Remote Medical Assistant
FEFA, LLC —Remote
- $15 - $18 an hour
- No weekends
- Remote
- Background check
- Anatomy knowledge
- Military
Quick Apply
6d
Medical Call Center Representative - REMOTE
American Health Connection Inc —Remote
- From $17 an hour
- Urgently hiring
- Remote
- Bilingual
- Background check
- Computer literacy
- Health insurance
- Dental insurance
Quick Apply
Patient Services Representatives - Remote
American Health Connection Inc —Remote
- From $17 an hour
- Weekends as needed
- Remote
- Bilingual
- Background check
- Primary Care
- Paid training
- Health insurance
Quick Apply
Patient Account Representative - Remote
Med-Metrix —Remote
- Full-time
- Remote
- Customer service
- Basic math
- HIPAA
14d
Licensing Specialist (Contract)
Midi Health —Remote
- $35 an hour
- Contract
- Remote
- Mid-level
- Bachelor's degree
- US work authorization
- Flexible schedule
Medical Claims Investigator
Claritev —Remote
- $50,000 - $55,000 a year
- Full-time
- HIPAA
- Mid-level
- Office
- Paid parental leave
- Employee stock purchase plan
Remote Certified Medical Assistant
FEFA, LLC —Remote
- $15 - $18 an hour
- No weekends
- Remote
- Background check
- Anatomy knowledge
- Pass drug screening
Quick Apply
4d
Clinical Denials Specialist
Firstsource Healthcare —Remote
- Monday to Friday
- Remote
- RN License
- HIPAA
- Research
- Health insurance
- Dental insurance
Enrollment Data Analyst II (contract)
Elevance Health —Remote
- $14.93 - $31.46 an hour
- Contract
- Remote
- Research
- Mid-level
- Office
- Health savings account
- Disability insurance
Customer Service Representative
Intelogix —Remote
- $17.75 an hour
- Weekends as needed
- Remote
- Computer literacy
- Writing skills
- Research
- Paid training
- Health insurance
13d
Utilization Management Nurse (Sun–Thurs or Tues–Saturday)
Curana Health —Remote
- Weekends as needed
- Nursing
- LVN
- Mid-level
Registration Specialist
Northwest Pathology, PLLC —Remote
- $19.13 - $22.00 an hour
- Weekends as needed
- Remote
- Microsoft Outlook
- Word processing
- Writing skills
13d
Clinical Documentation Advocate & Quality Assurance Specialist
Aion Therapy —Remote
- $45 - $65 an hour
- Part-time
- Remote
- LMFT
- Word processing
- Writing skills
Quick Apply
2d
Director - Pharmacy Network Contracting & Public Payer Relations
Hemophilia Alliance —Remote
- $130,000 - $170,000 a year
- Full-time
- Background check
- Up to 50% travel
- 5 years
- Health savings account
- Health insurance
Quick Apply
9d
Associate Medical Director, Neurology
Lenox Executive Search —Remote
- $150 - $170 an hour
- Full-time
- Remote
- Background check
- Medicine
- Neurology
Quick Apply
Sr Analyst, Analytics Ops, M&C [C]
TalentBurst, Inc. —New York, NY
- Contract
- Remote
- Mid-level
- 3 years
- SQL
- Health insurance
- Dental insurance
Quick Apply
VP Sales Management - Retail
Cotiviti —Remote
- $170,000 - $200,000 a year
- Full-time
- 7 years
- Research
- Analysis skills
- Paid holidays
- Disability insurance
Telehealth - Endocrinologist
Inspire Health Alliance —Remote
- $120 - $160 an hour
- Choose your own hours
- Remote
- Medicine
- Skilled nursing facility
- BC/BE
Quick Apply
Lead Psychiatric Nurse Practitioner (PMHNP) – CA | Women’s Mental Health | Clinical Leadership
Mavida Health —Los Angeles, CA
- From $100 an hour
- Part-time
- Remote
- Nursing
- Psychiatry
- Supervising experience
- Opportunities for advancement
Quick Apply
11d

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Prior Authorization Specialist I

Boston Medical Center -
Remote

Apply Now

Job Details

Part-time
$25.42 - $30.97 an hour
6 days ago

Benefits

Health insurance
Dental insurance
Flexible spending account
Paid time off
Vision insurance
403(b)
Opportunities for advancement

Qualifications

Microsoft Excel
Microsoft Outlook
High school diploma or GED

Full Job Description

Prior Authorization Specialist I

49281

Remote, United States

Part time

POSITION SUMMARY:

The Inpatient Verification Specialist role belongs to the Revenue Cycle Patient Access team and is responsible for coordinating all financial clearance activities by navigating all referral, precertification, and/or authorization requirements as outlined in payer-specific guidelines and regulations. The role plays an important dual role by helping to coordinate patient access to care while maximizing BMC hospital reimbursement. This role requires adherence to quality assurance guidelines as well as established productivity standards to support the work unit’s performance expectations. This position reports to the Patient Access Supervisor and requires interaction and collaboration with important stakeholders in the financial clearance process including but not limited to insurance company representatives, patients, physicians, Boston Medical Center (BMC) practice staff, case management and inpatient financial counselors.

Position: Prior Authorization Specialist I

Department: Insurance Verification

Schedule: Part Time (M-F 10:30A-5P)

ESSENTIAL RESPONSIBILITIES / DUTIES:

Monitors accounts routed to precertification and prior authorization work queues and clears work queues by obtaining all payer specific financial clearance requirements in accordance with established management guidelines.
Maintains knowledge of and complies with insurance companies’ requirements for obtaining pre-certifications/prior authorizations/referrals, and completes other activities to facilitate all aspects of financial clearance.
Acts as subject matter experts in navigating both the BMC Community and the payer world to get the right “permissions” (authorizations, pre-certs, referrals, for example) for the care plan to proceed.
The Impatient Verification Specialist is an important part of the larger team and helps clinicians understand what payer requirements are necessary for the widest possible patient access to services.
Supports BMC staff at all levels for hands-on help understanding and navigating financial clearance issues.
Uses appropriate strategies to underscore the most efficient process to obtaining authorizations, including on line databases, electronic correspondence, faxes, and phone calls.
Obtains and clearly documents all pre-certifications/prior authorizations for scheduled services prior to admission within the Epic environment.
Collaborates with patients, providers, and departments to obtain all necessary information and payer permissions prior to patients’ scheduled services.
Communicates with patients, providers, and other departments such as Utilization Review to resolve any issues or problems with obtaining required pre-certifications/prior authorizations.
Escalates emergent and elective accounts that have been denied or will not be financially cleared within 3 days of admission as outlined by department policy
Keeps current on CMS requirements and guidelines.
Coordinates with patients and Patient Financial Counseling to initiate/process Charity Care applications as needed.
Maintains confidentiality of patient’s financial and medical records: adheres to the State and Federal laws regulating collection in healthcare, adheres to enterprise and other regulatory confidentiality policies and advises management of any potential compliance issues immediately.
Participates in educational offerings sponsored by BMC or other development opportunities as assigned/available and complies with all applicable organizational workflows, as well as established policies and procedures.
Performs other duties as assigned by Management.
Demonstrates knowledge & skills necessary to provide level of customer experience as aligned with BMC management expectations.
Demonstrates the ability to recognize situations that require escalation to the Supervisor.
Establishes relationships and effectively collaborates with revenue cycle staff to support continuous improvement aligned with BMC management expectations as outlined.
Takes opportunity to know and learn other roles and processes, and works together to assist with process improvement initiatives as directed.
Consistently meets productivity and quality expectations to align performance with assigned roles and responsibilities.
Must adhere to all of BMC’s RESPECT behavioral standards.

(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required).

JOB REQUIREMENTS

EDUCATION:

High School Diploma or GED required, Associates degree or higher preferred.

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:

Case manager and/or coding certification desirable

EXPERIENCE:

4-5 years medical billing/denials/coding/and/or inpatient admitting experience desirable

KNOWLEDGE AND SKILLS:

General knowledge of healthcare terminology and CPT-ICD10 codes.
Complete understanding of insurance is preferred.
Requires excellent verbal communication skills, and the ability to work in a complex environment with varying points of view.
Must be comfortable with ambiguity, exhibit good decision making and judgment capabilities, attention to detail.
Knowledge of and experience within Epic is preferred.
Demonstrates technical proficiency within assigned Epic work queues and applicable ancillary systems, including but not limited to: ADT/Prelude/Grand Central, HB & PB Resolute.
Demonstrates proficiency in Microsoft Suite applications, specifically Excel, Word, and Outlook.
Displays a thorough knowledge of various sections within the work unit in order to provide assistance and back-up coverage as directed.
Displays a deep understanding of Revenue Cycle processes and applies knowledge to meet and maintain productivity standards as outlined by Management.

Compensation Range:

$25.42- $30.97

This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, and licensure/certifications directly related to position requirements. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), contract increases, Flexible Spending Accounts, 403(b) savings matches, earned time cash out, paid time off, career advancement opportunities, and resources to support employee and family wellbeing.

Equal Opportunity Employer/Disabled/Veterans

According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or “apps” job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.

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Refine Your Search

contract medical monitor jobs in remote

Prior Authorization Specialist I

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