be an integral part of our vision to make healthcare better for everyone. At Optum, you’ll have the clinical resources, data... appropriateness for payment, assessing provider claims appeals for medical necessity, authorization requirements, contractual...
. Minimum Qualifications: Two years (2) of administrative and clerical experience in medical, clinical, or office settings... or acknowledgement of the department's action. For more information about the appeals process, the official appeal form...
all dental office protocols, policies, and procedures including use of lab and supply formulary Perform quality clinical... and Clinical leaders Assist in the training of new hygienists and dental assistants Provide input to OM for annual performance...
) review, escalating payment variance trends or issues to NIC management, and generating appeals for denied or underpaid claims... coding in DCM is accurate and reflects the denial reasons. Coordinate with the Clinical Resource Center (CRC) for clinical...
) review, escalating payment variance trends or issues to NIC management, and generating appeals for denied or underpaid claims... coding in DCM is accurate and reflects the denial reasons. Coordinate with the Clinical Resource Center (CRC) for clinical...
and as key liaison between patients, families and interdisciplinary healthcare members. Actively participates in clinical... acute and post-acute case mix, LOS, cost per case, excess days, resource utilization, readmission rates, denials and appeals...
of Endo products, payer policy appeals process, and the payer landscape. Leverage all resources (Tableau and other portals...) to develop and execute account support and educate sales colleagues. Ability to synthesize clinical literature and target...
on denied claims. Resubmits or appeals claims as required. Escalates more complex claim issues when necessary. Obtains, reviews... School of Medical Sciences, and the Weill Cornell Physician Organization - are engaged in world-class clinical care...
of Endo products, payer policy appeals process, and the payer landscape. Leverage all resources (Tableau and other portals...) to develop and execute account support and educate sales colleagues. Ability to synthesize clinical literature and target...
from providers/clinical teams Release of Information – process all patient & provider requests for information, including inbound.../outbound and Referrals; Process documentation needs for external audits, appeals & quality requests Faxes – process...
and triaging communication from insurance payors via email, fax and phone inquiries pertaining to clinical requests, approvals... into clinical database. Send information to payers as requested including discharge dates and discharge disposition. Send clinical...
WORK TYPE: Full Time REQUIREMENTS: 2 Years of clinical experience as an Advanced Provider preferred ABOUT NCH NCH...; Have endowed chairs; Conduct research and participate in national clinical trials; and partner with other health market leaders...
(billing, insurance appeals, collections) procedures and policies Good written and verbal communication skills Intermediate... to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance...
appeals and review documentation needed for insurance denials to facilitate expedient resolution and reimbursement... in performance improvement initiatives as assigned. This position will also be involved in collaboration and teamwork with Clinical...
regulatory timeframe of the request and provides clinical rationale for standard and expedited appeals. Utilizes medical... team. We can offer you a meaningful way to make a difference in patients lives, in a non-clinical environment. You can...
Hospital & Medical Center. This individual will provide patient information and referrals to support all clinical specialties... assessment Assist with navigation of insurance approvals, denials and appeals Assess service needs and refers to appropriate...
’s. Job Description Communicates with patients, families, physicians, clinical staff, and insurance companies to obtain information and insurance... verification to ensure quality patient care and payment of hospital accounts. Collaborates with Appeals department to overturn...
care providers. Maintains communication, coordination, and connections with all Clinical Team participants. Ensures... to treatment, appeals, and complaint processes instituted by the Mercy Care RBHA. Communicates with other staff as necessary...
and expertise to ensure the application of best practices. Provides clinical rationale for standard and expedited appeals...) Are you ready to make a meaningful impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field...
Hub services, Copay Support etc. Ensure providers understand payer prior authorization requirements, appeals process..., and clinical criteria as it relates to Rezdiffra. Work effectively with both internal and external stakeholders to achieve target...