
201 - 500 employés
💼 Conseil
📦 Logistique
🏥 Santé
Consulting • Logistics • Healthcare
Assembly Health est dédiée à l'amélioration de la performance financière pour les prestataires de soins de santé grâce à une gestion innovante du cycle de revenus et à des solutions de back-office. Leur équipe d'experts et leur technologie optimisent les processus, permettant aux organisations de santé de se concentrer sur la prestation de soins de qualité aux patients. Avec une approche globale qui inclut l'analyse, le conseil en conformité et les services de personnel, Assembly Health sert une large gamme de spécialités médicales et de communautés de soins de longue durée à travers les États-Unis.
🔥 il y a 15 heures
🇺🇸 États-Unis – Télétravail
💵 $22 - $25 / heure
⏰ Temps Plein
🟢 Junior
🟡 Intermédiaire
🚫👨🎓 Aucun diplôme requis
👻 Score fantôme 1%
🗣️🇺🇸🇬🇧 Anglais requis
Améliorez vos chances d'obtenir un entretien en vérifiant votre score de CV avant de postuler.

201 - 500 employés
💼 Conseil
📦 Logistique
🏥 Santé
Consulting • Logistics • Healthcare
Assembly Health est dédiée à l'amélioration de la performance financière pour les prestataires de soins de santé grâce à une gestion innovante du cycle de revenus et à des solutions de back-office. Leur équipe d'experts et leur technologie optimisent les processus, permettant aux organisations de santé de se concentrer sur la prestation de soins de qualité aux patients. Avec une approche globale qui inclut l'analyse, le conseil en conformité et les services de personnel, Assembly Health sert une large gamme de spécialités médicales et de communautés de soins de longue durée à travers les États-Unis.
• Obtain and manage prior authorizations for Spravato and TMS services from commercial and government insurance plans • Ensure timely submission of clinical documentation, including medical necessity letters, progress notes, rating scales, and treatment plans • Review payer-specific medical policies to determine criteria for Spravato and TMS coverage • Coordinate with providers, clinical staff, and billing teams to ensure complete and accurate submissions • Track and follow up on authorization requests, denials, appeals, and renewals • Maintain detailed records of payer communication, submission timelines, and authorizations received • Support new customers during their start-up phase by navigating authorization processes and clinical documentation • Stay current on insurance requirements, payer policies, and clinical documentation standards • Take on additional projects and tasks as assigned
• Minimum 2 years of experience in medical prior authorization, utilization review, or billing, preferably in behavioral health or neuromodulation • Strong working knowledge of medical necessity criteria for Spravato and TMS services, including familiarity with CMS, commercial payer, and MassHealth guidelines • Experience with a wide range of insurance carriers, including Massachusetts and Rhode Island-specific carriers • Comfortable working with EHR systems, payer portals, and medical documentation • Proven ability to manage multiple priorities and tight deadlines • Detailed and organized written and verbal communication skills • Ability to work independently and collaboratively with clinical and administrative staff • Preferred experience with in-network and out-of-network authorization workflows • Preferred prior work with REMS-certified treatment programs
• Medical insurance • Dental insurance • Vision insurance • 401(k) • Paid time off • Opportunity to participate in company bonus programs • Comprehensive benefits package
Postuler Maintenant🔥 il y a 19 heures
Care Specialist conducting health assessments and care coordination calls for Equality Health’s tech-enabled healthcare system. Supporting diverse patients with healthcare access, referrals, and community resources.
🗣️🇺🇸🇬🇧 Anglais requis
🔥 il y a 19 heures
Care Specialist conducting health assessments and coordinating patient support remotely for Equality Health’s value-based healthcare system. Connecting members with providers, appointments, and community resources.
🗣️🇺🇸🇬🇧 Anglais requis
🔥 il y a 19 heures
Home-based Check Airman conducting FAA training, simulator, and flight evaluations for HeliService USA helicopter operations. Ensuring pilot proficiency, standardization, and regulatory compliance.
🗣️🇺🇸🇬🇧 Anglais requis
🔥 il y a 19 heures
201 - 500
🏥 Santé
🤝 À but non lucratif
🌍 Impact social
Utilization Review Specialist evaluating behavioral health and developmental disability treatment plans for Network180. Identifying discharge barriers and coordinating transitions to appropriate care settings.
🗣️🇺🇸🇬🇧 Anglais requis
🕒 il y a 1 jour
Release of Information Specialist processing medical record requests and HIPAA-related releases for Verisma. Managing records accurately through Verisma software and customer service channels.
🗣️🇺🇸🇬🇧 Anglais requis