medical and musculoskeletal pathology. The incumbent possesses the clinical evaluation and educational skills expected... pre-authorization and retro-authorization and appeals as needed. Assists with scheduling patient appointments and clinic...
cycle team to ensure proper reimbursement. Identify and address billing errors, denials, and appeals, working closely... and compliance team. Collaboration & Leadership: Work closely with clinical leadership, revenue cycle management, and legal teams...
for communicating necessary clinical information to third party payors and others as necessary to ensure proper certification/approval.... 3. Maintains accurate information in EPIC system, including tracking, monitoring of LOS and denials/appeals...
medical and musculoskeletal pathology. The incumbent possesses the clinical evaluation and educational skills expected... pre-authorization and retro-authorization and appeals as needed. Assists with scheduling patient appointments and clinic...
responsibility of the Utilization Review Specialist is to review medical records and prepare clinical appeals (when appropriate...
authorizations, appeals and updates. Provide efficient, accurate and timely updates to sales reps and instruct on payer coverage... authorization experience in a DME or clinical setting. Experience with Veteran's Administration accounts preferred. Language...
of the strategic and operational goals of PacificSource. Provide clinical expertise for physical, behavioral, and oral health... and appeals, quality programs, and cost of care management. Manage and coordinate externally facing operations of appropriate...
an unparalleled level of service that’s easy and focused on whole health. Through our distinct clinical expertise, digital... authorization determinations. Provides resolution to grievances and appeals issues. Responds to inquiries from physicians, sales...
of the strategic and operational goals of PacificSource. Provide clinical expertise for physical, behavioral, and oral health... and appeals, quality programs, and cost of care management. Manage and coordinate externally facing operations of appropriate...
, and State Tax Commission/Board of Equalization Appeals The typical starting salary range is between $15.00-$18.00 hourly... as required. State Tax Commission/Board of Equalization Appeals: Manages refund process as a result of State Tax Commission and Board...
and computer skills Knowledge of relevant and state utilization review and appeals requirements Rapid cycle change or clinical... required. Prior clinical experience in care and management of hospitalized patients. Experience in acute care utilization, preferred...
of the strategic and operational goals of PacificSource. Provide clinical expertise for physical, behavioral, and oral health... and appeals, quality programs, and cost of care management. Manage and coordinate externally facing operations of appropriate...
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...
clinical support of Medication Access Services team members in a remote setting. Primary responsibilities include... and supporting appeals requests, and conducting utilization management functions. The pharmacist will collaborate with nurses...
of the strategic and operational goals of PacificSource. Provide clinical expertise for physical, behavioral, and oral health... and appeals, quality programs, and cost of care management. Manage and coordinate externally facing operations of appropriate...
system. Performs advanced clinical assessments and provides clinical knowledge of emotional disorders, chronic health... of an individual member’s interdisciplinary health care team. Actively participates in clinical presentations...
of the strategic and operational goals of PacificSource. Provide clinical expertise for physical, behavioral, and oral health... and appeals, quality programs, and cost of care management. Manage and coordinate externally facing operations of appropriate...
of the strategic and operational goals of PacificSource. Provide clinical expertise for physical, behavioral, and oral health... and appeals, quality programs, and cost of care management. Manage and coordinate externally facing operations of appropriate...
, 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...
care. Here, you'll work alongside some of the best clinical talent in the nation leading the way in medical innovation... and pharmacology and acts as a key collaborator with Providers and Clinical areas to ensure the medical record accurately reflects the...