Department of Homeland Security, the Baltimore or Hyattsville Immigration Courts, the Board of Immigration Appeals, or in the..., which can be satisfied by substantive law school clinical or externship experience or relevant paid work during law school...
is a clinician, educator, investigator, consultant, and leader. She/he makes clinical judgments based upon a synthesis of current..., and Clinical Trial Coordination. * Care Coordination Interview, collect comprehensive data, and educate patient and caregiver...
social work intervention as part of the discharge planning process. Responsibilities Clinical Interventions/Discharge... of continued stay rationale, length of stays, and appeals process. Initiates activities to develop positive business relationships...
Financial Services (billing, insurance appeals, collections) procedures and policies Intermediate skill in Microsoft Office... our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare...
as appropriate with Denial and Appeals management, Case Manager, Patient Accounts and other necessary parties for denials, appeals... from a variety of clinical and financial sources Prepare reports and information for Utilization Review meetings. Perform...
situations. Actively Participates in Clinical Performance Improvement Activities related to Case Management Services Assists... barriers, cost per case, readmission rates, denial and appeals. Uses data to drive decisions and plan/implement performance...
obtain authorizations, initiate appeals for denied authorizations, respond to clinic questions regarding payer medical policy... within physician practice and knowledge of third payer rules, and medical record charting/documentation experience required. Clinical...
feedback for process opportunities. Responsibilities: Writes clinical appeals to payors to recover denials. Coordinates... with payors to conduct RN reviews and facilitates MD to MD peer reviews as necessary. Applies payor specific clinical criteria...
feedback for process opportunities. Responsibilities: Writes clinical appeals to payors to recover denials. Coordinates... with payors to conduct RN reviews and facilitates MD to MD peer reviews as necessary. Applies payor specific clinical criteria...
feedback for process opportunities. Responsibilities: Writes clinical appeals to payors to recover denials. Coordinates... with payors to conduct RN reviews and facilitates MD to MD peer reviews as necessary. Applies payor specific clinical criteria...
within Clinical Pharmacy Services (CPS). CPS is responsible for administering client-specific programs to provide clinical expertise... client appeals. Participate in CPS staff meetings, quality improvement initiatives and in-service programs as requested...
is responsible for activities that support Optum Clinical Services with regulatory and delegation contractual requirements... as outlined in the Clinical Services Delegation Oversight framework. Location: Remote/Telecommute Hours: Monday-Friday, 8am...
specialties listed below with active California licenses to address the medical necessity of treatment requests and, in appeals... you apprised of required turn-around time and carefully coordinates all administrative tasks so your time is spent on clinical...
specialties listed below with active California licenses to address the medical necessity of treatment requests and, in appeals...-around time and carefully coordinates all administrative tasks so your time is spent on clinical decision-making Dane Street...
care. Manages patients across the healthcare continuum to achieve optimal clinical, financial, operational... medical necessity and coordinate with the interdisciplinary team to assure correct status for payment. Assist with clinical...
hospital setting (inpatient vs. outpatient) based on medical necessity. Actively seeks additional clinical documentation... of retrospective reimbursement issues, including appeals, third-party payer certification, and denied cases. Monitors effectiveness...
in an intensive 12-month training program designed to provide advanced didactic education and focused clinical experiences so... disease, motility disorders, nutrition, and transplant hepatology to acquire further expertise in these clinical areas. The...
, state, DEA, fire, and alarm). Work alongside assigned Clinical Coordinator to assist with grievances, appeals... staffing standards for clinics based on patient care needs, workflow, and other clinical needs. Identify, de-escalate...
management (UM) and care management (CM) activities demonstrating clinical judgement and independent analysis, collaborating... with members and those involved with members' care including clinical nurses and treating physicians. Responsibilities...
Financial Services (billing, insurance appeals, collections) procedures and policies Intermediate skill in Microsoft Office... our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare...