Log In
Sign Up
- Responsible for prior authorizations and reauthorization
- Responsible for tracking authorization status and adding to all necessary systems
- Responsible for confirming medical necessity
- Negotiates single case agreements for out of network insurance cases
- Establish and execute systems for maximizing insurance coverage and reimbursement
- Coordinates with clinics and providers to ensure all necessary documentation is being tracked and logged to allow for reauthorization and continued care
- Works with outside pharmacies for Spravato authorization and coverage
- Collaborates and facilitates needed changes to the plan of care/ level changes
- Continuously checks medical policies for changes to medical criteria needed for services
