, supporting the entire reimbursement journey through payer prior authorization to appeals/denials requirements and forms Review... of experience in the public or private third-party access arena or pharmaceutical industry in managed care, clinical support...
from an accredited school of nursing and possess active professional licensure. Minimum of 2-4 years of experience in clinical decision... Appeals processing / BFCC Medicare Quality Improvement Organization (QIO) core functions is desirable. Individuals...
, supporting the entire reimbursement journey through payer prior authorization to appeals/denials requirements and forms Review... of experience in the public or private third-party access arena or pharmaceutical industry in managed care, clinical support...
to appeals/denials requirements and forms Review patient-specific information in cases where the site has specifically requested... industry in managed care, clinical support, and/or sales OR Master’s degree AND 6 years of experience in the public...
, supporting the entire reimbursement journey through payer prior authorization to appeals/denials requirements and forms Review... of experience in the public or private third-party access arena or pharmaceutical industry in managed care, clinical support...
(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...
is relatively low, with affordable housing options and a slower pace of life that appeals to families, retirees.... A Supervising Clinician at Centria is somebody who not only believes in the core clinical values we hold as a company...
with the Chief Medical Officer and other clinical leaders to support the delivery of high-quality healthcare services... to our members. This position requires a strong clinical background, a commitment to health equity, and a deep understanding...
clinical consultation and serve as clinical/strategic advisor to enhance clinical operations. May identify cost of care... opportunities. May serve as a resource to staff including Medical Director Associates. May be responsible for an entire clinical...
, Appeals, and Licensure; professional licensing boards; and external entities, e.g. county attorney and law enforcement..., 12 semester hours, or a combination of both in prevention programs, clinical substance abuse, or preventative abuse...
, supporting the entire reimbursement journey through payer prior authorization to appeals/denials requirements and forms Review... of experience in the public or private third-party access arena or pharmaceutical industry in managed care, clinical support...
follow-up and appeals resolution processes, and acting as a functional leader or reference source. This position requires..., clinical and health services research in our communities Lifestyle: Live and work in the Pacific Northwest - offering...
This is remote position in PA. Candidates must be licensed and reside in PA. This position supports the clinical... to support this vision. May serve multiple health plans managed by the Clinical Center of Excellence. Provides clinical...
, supporting the entire reimbursement journey through payer prior authorization to appeals/denials requirements and forms Review... of experience in the public or private third-party access arena or pharmaceutical industry in managed care, clinical support...
, supporting the entire reimbursement journey through payer prior authorization to appeals/denials requirements and forms Review... of experience in the public or private third-party access arena or pharmaceutical industry in managed care, clinical support...
, supporting the entire reimbursement journey through payer prior authorization to appeals/denials requirements and forms Review... of experience in the public or private third-party access arena or pharmaceutical industry in managed care, clinical support...
and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members... required with emphasis in claims, member services, appeals and grievances or prior authorizations. Must obtain Healthcare Anti-Fraud...
from physician order to reimbursement, supporting the entire reimbursement journey through payer prior authorization to appeals... industry in managed care, clinical support, and/or sales OR Master’s degree AND 6 years of experience in the public...
from physician order to reimbursement, supporting the entire reimbursement journey through payer prior authorization to appeals... industry in managed care, clinical support, and/or sales OR Master’s degree AND 6 years of experience in the public...
assignments, reviewing productivity, conducting quality reviews, advising with peer-to-peer appeals, and advising with denial... with Care Coordination Medical Director on patients not meeting criteria and informs Clinical Resource Manager/Director...