follow up and working insurance denials, appeals claims as defined by payer and departmental rules. Resolves insurance... to all inquiries from insurance companies. UVA Health clinical departments and patients. Performs analysis of patient accounts...
, including analysis of clinical documentation, assisting in appeals, root cause analysis and tracking as needed. 6. Educates... reviews; including but not limited to, appending modifiers and checking clinical documentation. Works closely with Revenue...
for the care of our residents, which is reflected in our positive clinical outcomes, resident and family member testimonials... reimbursement. You will be responsible for the coordination and completion of clinical assessments, supporting documentation, care...
clinical expertise, and reviews insurance appeals, and prospective and retrospective claims. The physician reviewer...
, 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 claims denial...
of professional, inpatient or outpatient, facility benefits or services, and appeals. Documents decisions using indicated protocol... sets or clinical guidelines. Provides support and review of medical claims and utilization practices. 80% May provide...
formulary restrictions. Assist with the completion of prior authorizations or appeals necessary to ensure medication access... and identify concerns or side effects patients may be experiencing. Consult with pharmacists or providers regarding all clinical...
Medical Director, HIV and Special Needs Program – Hybrid 2 days a week in NYC office (inclluding half a day clinical... involves strategic program development, clinical support, and collaboration with divisions such as Utilization Management...
dangerous person, and sex offender registry cases, as well as in appeals and post-conviction and post-judgment proceedings...; Preparing for and representing clients in pretrial proceedings, hearings, trials, and interlocutory appeals, as well as in the...
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...
Requisition ID 39856 Department Clinical Resource Management Location Escondido, California Union CNA... admitted to acute level of care. Conducts daily concurrent clinical reviews for utilization/quality management activities...
. Responsible for all aspects of disputes and appeals. May assist in special projects as assigned my management. ESSENTIAL DUTIES... to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance...
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...
(billing, insurance appeals, collections) procedures and policies Intermediate skill in Microsoft Office (Word, Excel... their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps...
to optimize productivity and meet department standards. Communicates with customers including clinical and non-clinical staff... and appeals background. Strong Excel skills. Epic experience preferred. Experience working with health plan provider...
quality clinical and radiographic evaluations to diagnose and treat diseases of the oral cavity Promote oral health... to Operations, HR and Clinical leaders Assist in the training of new hygienists and dental assistants Provide input...
designed to provide advanced didactic education and focused clinical experiences so that graduates have the skills..., and transplant hepatology to acquire further expertise in these clinical areas. This position is based primarily in Washington, DC...
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...
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...
, and other clinical professionals who consult on various processes and programs. The Behavioral Medical Director is part of a leadership... and will also advise leadership on health care system improvement opportunities. They are responsible for maintaining the clinical...