The Surgical Authorization Specialist monitors and processes authorizations for upcoming surgical cases while verifying patient insurance eligibility and benefits. They also document authorization progress in patient charts and assist with cost estimation and workflow improvements.
The analyst will evaluate physician contracts, managed care products, and medical cost trends while ensuring compliance with CMS regulations. They are responsible for designing analytical reports and providing actionable recommendations based on reimbursement methodologies.
The Senior Manager of Network Performance will analyze clinical and financial data to drive performance improvements and cost-effective outcomes. They will also engage with providers and medical directors to ensure alignment with value-based care program goals and quality metrics.
The Coder II abstracts medical data and assigns accurate ICD-10 and CPT codes based on clinical documentation. They also coordinate with physicians and staff to ensure accurate billing and provide education on documentation standards.
