Job Search Results for clinical

Pre-Authorization Coordinator

Job DescriptionThe PAVE Coordinator is responsible for initiating Pre-Authorization request to the payer for the claims that require approval. This position require communication with payers,... More patients, physician offices and hospital clinical staff. This position is primarily responsible for pre-certifying procedures ordered by physicians. The PAVE Coordinator will also be responsible monitoring appropriateness and medical necessity and provides necessary information for authorization and continued visits. This individual will confirm pre-certifications that have been obtained or will obtain pre-certifications if needed in addition to conducting quality assurance.Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Serve as primary resource for LH regarding insurance eligibility; prior authorization process and requirements; collects patient demographic information and coverage information. Advises patients of their financial obligation and collects payments in a courteous and professional manner.Contacts insurance companies by phone, fax, or online portal to obtain insurance benefits, eligibility, and authorization information;Updates systems with accurate information obtained; performs quality assurance audits and reports back to leadership opportunities for providing education to patient accessResponsible for communicating to service line partners of situations where rescheduling is necessary, due to lack of authorization or limited benefits and is approved by clinical personnel;Ensures that proper authorization is in place for inpatient, elective, outpatient, surgical, urgent/emergent services and held responsible for timely notification to payers of the patient?s visit to the facility to protect financial standing of the organization. Escalates non-authorized accounts/visits to management;Ensures all benefits (Copays, Deductibles, Co-Insurance, OOP, LTM), authorizations, pre-certifications, and financial obligations of patients, are documented on account, clearly, accurately, precise, and detailed to ensure expeditious processing of patient accounts and denial prevention.;Maintains a close working relationship with clinical partners, and ancillary departments to ensure continual open communication between clinical, ancillary, and Patient Access & Patient Financial Services, Surgical Scheduling departments. Case Management, and Utilization Review to facilitate the sending of clinical information in support of the authorization to the payer, as assigned;Monitors team mailbox, e-mail inbox, faxes, and phone calls responding to all related PAVE account issues, within defined time frames; Adheres to the department accuracy and performance standards.Contact payer to obtain prior authorization. Gather additional clinical and or coding information, as necessary, in order to obtain prior authorization;We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Senior API Developer - INTL India

The API Developer will design, build, and integrate APIs to connect data and orchestrate workflows across key clinical systems, including the electronic health record, clearinghouse, and care... More management platforms, transforming a fragmented prior authorization process into a unified, streamlined solution. Key Responsibilities:? Design and develop RESTful APIs to enable referral and prior authorization workflows across the electronic health record, clearinghouse, and care management systems ? Support real time and batch data exchange to surface authorization requirements, clinical documentation needs, and status updates within provider workflows ? Connect backend services that orchestrate eligibility checks, clinical data retrieval, and authorization submission processes ? Troubleshoot and resolve integration failures, data mapping issues, performance bottlenecks, and production defectsWe are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Coding Educator

Insight global is seeking a Coding Educator for a healthcare system in Virginia. The educator will provide consulting services to physicians, residents, allied health professionals and billing staff... More to support patient care documentation, coding and billing practices according to federal, state and local regulatory compliance standards. Creates and delivers presentations to clinical faculty and billing staff.Develops training programs and delivers training and education sessions for physicians, allied health professionals, residents, and coding and billing staff to support compliance with third party documentation and billing regulatory standards, including but not limited to classroom training, web-based training and one-on-one provider observation and training sessions.Participates on clinical department Billing Quality Councils as a member of the respective councils and acts as the primary resource providing technical and regulatory expertise to the Councils.Presents findings and recommendations from internal and external audits to clinical departments and recommends solutions for implementing appropriate changes.Conducts internal reviews and provides quality review of external billing quality audits.Works with providers and department billing staff to address and resolve documentation deficiencies.Develops and implements Clinical Documentation Improvement Programs in partnership with the clinical departments.We are a company committed to creating inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity employer that believes everyone matters. Qualified candidates will receive consideration for employment opportunities without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, disability, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to Human Resources Request Form. The EEOC "Know Your Rights" Poster is available here. To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ .Less

Remote Healthcare Solution Architect

The Solution Architect will lead the design and delivery of a cloud-based clinical platform on Google Cloud Platform (GCP), with a strong focus on healthcare interoperability and clinical data... More enablement. This role is responsible for architecting and governing data-in and data-out integrations that support secure, standards-based exchange of clinical data across internal platforms and external partners. The architect will design and support large-scale data pipelines that exchange EMR/EHR data and vendor-sourced clinical data between Aetna and partner vendors to address care gaps and support reporting use cases, including vendor-led sponsor reporting. Working closely with engineering, data platform, product, and external vendor teams, this role ensures integrations are scalable, reusable, compliant, and aligned with interoperability guidelines while enabling reliable clinical data access across the enterprise.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Epic Principal Trainer

We are seeking an Epic Principal Trainer to support its enterprise-wide Epic Refuel Project, a multi-phase Epic initiative focused on standardization, workflow alignment, and optimization of Epic?s... More Foundation System prior to an April 2027 go-live.This role will be responsible for designing, delivering, and supporting end-user training across clinical and operational domains, ensuring staff readiness and adoption during system rebuild, testing, and go-live. The Trainer will collaborate closely with the hospital's operational stakeholders, Epic application analysts, project leadership, and clinical champions.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Remote Telehealth Compact and State Specific ? PM? EO

A leading healthcare client is seeking Remote Registered Nurses to support a new program that reviews health risk assessments and supports HEDIS gap closure. In this role, you will conduct inbound... More and outbound calls to assess patients, gather health history, and provide guidance based on physician-approved triage protocols. You will use your clinical judgment to help patients navigate the next steps in their care. This is a remote position offering the opportunity to make a meaningful impact in a healthcare program focused on patient care and well-being. Your key responsibilities include taking inbound and making outbound calls. You?ll complete a brief historical intake and record any symptoms. You will provide guidance using a physician-approved triage protocol, advising patients on whether to follow up with their provider, seek same-day care, or go to the emergency department. You?ll utilize strong clinical judgment to ensure patients take appropriate next steps in their care. You?ll offer concise, supportive patient education during calls and accurately document all phone call details using Athena encounter templates and text macros.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

LIS Analyst

As an LIS Analyst for Insight Global, you will be responsible for the implementation of Data Innovations Instrument Manager to integrate approximately 91 laboratory instruments with Epic Beaker. Day... More to day, the analyst configures instrument definitions within Instrument Manager, establishes connectivity, and installs and validates appropriate DI drivers for each instrument. They evaluate driver compatibility, account for instrument model and firmware differences, and coordinate with vendors when configuration adjustments are required. The analyst builds instrument workflows in DI to ensure accurate result transmission and proper message formatting. In parallel, they configure Epic Beaker Clinical Pathology test records to align with DI output, including test codes, result components, units of measure, and reference ranges. They work closely with lab stakeholders to define and support instrument-driven workflows within Beaker prior to go-live. The role includes comprehensive instrument validation and parallel testing to confirm results match expected values before production cutover. The analyst participates in implementation planning, sequencing instrument deployments to minimize operational impact. They collaborate with instrument vendors and Data Innovations during build and testing phases to resolve driver or configuration constraints. Throughout the implementation, they document instrument builds, mappings, and technical decisions to support a controlled and repeatable rollout.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Digital Content Editor

In this role, the Digital Content Editor will manage daily work through Quickbase, which serves as the central system for assignments and priorities. Day to day will primarily involve editing... More high-level medical content (clinical overviews) for accuracy, clarity, and adherence to AMA style, as well as completing quality assurance tasks once content is ingested into the CMS. The editor will also support ongoing ADA accessibility efforts, including adding and reviewing alt text for images as required. In addition to content work, this role will help with SME communication, such as drafting and sending emails, following up on assignments, and tracking responses. The editor is expected to collaborate closely with the broader team, participate in meetings as needed, use AI tools as part of the workflow, and remain flexible and comfortable working across multiple platforms and tools in a fast-moving, collaborative environment.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Director, Behavioral Health - Transfer Center

In this role, you will provide leadership for a centralized access and patient placement function supporting behavioral health services across multiple facilities. This role is responsible for... More overseeing daily operations of a remote, multidisciplinary team, ensuring timely, clinically appropriate transfer decisions and consistent service performance. The Director partners closely with senior leadership and facility stakeholders to support admission workflows, patient flow, and continuity of care while maintaining compliance with all applicable federal, state, and accreditation standards. Responsibilities include workforce and resource management, staff coaching and performance development, quality monitoring, and continuous improvement of clinical and operational processes. The Director serves as a trusted advisor to internal and external partners, addresses service gaps in real time, and leads the team in a fast-paced, growth-oriented environment focused on patient safety, access, and experienceWe are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Epic OpTime Analyst (OR, Anesthesia, Sedation & Perfusion)

Insight Global is seeking a fully remote Epic OpTime Analyst to configure, support, and optimize perioperative applications in a permanent FTE role. This position focuses on OpTime and Anesthesia... More build, workflow analysis, testing, and ongoing support for OR, anesthesia, and procedural teams.The analyst will partner closely with perioperative leadership, anesthesia providers, nursing, and IT teams to ensure safe, compliant, and efficient surgical workflows. This role is ideal for a developing Epic OpTime professional who wants long-term growth, ownership of perioperative build, and exposure to complex, high-impact clinical environments.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less