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OrthoCarolina
Overview
The UR Pre-Certification Specialist is responsible for receiving all OrthoCarolina claim denials for services not authorized. This role requires familiarity with EMR and investigating documentation for all departments.
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Compensation
Salary not listed
Posted
4 days ago
St. Luke's Hospital - MO
Manage the enrollment process for new providers and handle re-credentialing for established medical group and hospital-based providers. Coordinate enrollment forms, update the CAQH database, and maintain communication with health plans.
27 days ago
Luminis Health
This role facilitates the exchange of clinical information and authorization between the hospital and third-party payors, directly supporting the utilization review process. Responsibilities include reviewing daily work lists, communicating clinical updates to payors for authorization, and ensuring Case Managers are informed of determinations and potential denials.
$19 - $29 / HOUR
1 month ago
This role facilitates the exchange of clinical information and authorization between the hospital and third-party payors to support the utilization review process. Responsibilities include reviewing daily work lists, communicating clinical updates to payors for authorization, and ensuring Case Managers are informed of determinations.
