The Eligibility & Benefits Specialist verifies patient insurance coverage and eligibility to ensure accurate admission and revenue integrity. They manage patient referrals, coordinate with insurance payors, and document benefit details to prevent claim denials and administrative delays.
The Eligibility & Benefits Specialist verifies patient insurance coverage, eligibility, and financial responsibilities prior to admission to ensure revenue integrity. They manage patient referrals, coordinate with insurance providers, and document benefit details within the central access team.
The Utilization Management Manager oversees front-end prior authorizations and in-house concurrent review authorizations to ensure timely patient access to care. This role acts as a liaison between clinical teams, payors, and administration to manage medical necessity assessments and navigate the appeals process.
Lead the litigation department and manage pre-litigation matters, lawsuits, investigations, outside counsel, discovery, and liability claims. Advise company leaders on litigation risk, settlements, reserves, compliance, and dispute-resolution strategies, and represent the company in mediations, arbitrations, and court proceedings.
The analyst is responsible for designing, developing, and supporting application solutions while managing small-scale projects. They will also document system requirements, perform testing, and collaborate with senior team members to ensure project success.
