providers, and other third parties to initiate and resolve appeals, as needed Acts as a liaison between patients, foundations... I Trauma center engaged in thousands of clinical trials and studies. The Froedtert & MCW health network, which includes...
and resolve denials and underpayments with insurance carriers Submit third party payor appeals and reconsideration requests... and Physical Activities Office environment within a clinical setting. Enters data into computer programs via computer, mouse...
payment of treatment stays and timely appeals of denied cases. Works closely with the Directors of Clinical, Intake...
payment of treatment stays and timely appeals of denied cases. Works closely with the Directors of Clinical, Intake...
. Requirements As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise and reviews... insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation of the...
Inpatient Care Management team and Clinical Coverage Review team (prior authorization), Appeals and Grievances, Optum Behavioral.... Growing together. The Community Plan of Idaho Chief Medical Officer (CMO) has accountability for driving clinical excellence...
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...
As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise and reviews insurance... appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation of the medical...
. Requirements As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise and reviews... insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation of the...
Inpatient Care Management team and Clinical Coverage Review team (prior authorization), Appeals and Grievances, Optum Behavioral.... Growing together. The Community Plan of Idaho Chief Medical Officer (CMO) has accountability for driving clinical excellence...
with providers and clinical staff to clarify documentation and coding issues. Monitor denials and rejections, identify trends... (CCS), or equivalent certification required. Experience: 2+ years of medical coding experience, preferably in a clinical...
with care management teams to optimize outcomes. Collaborates effectively with clinical teams, network providers, appeals...You could be the one who changes everything for our 28 million members as a clinical professional on our Medical...
, ME. Requirements: As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical... expertise and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide...
-authorization, concurrent reviews and appeals/denials management throughout the duration of a consumer’s stay. Assists the treatment... is designed to facilitate and ensure the achievement of quality, clinical and cost-effective outcomes and to perform a holistic...
integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis..., collaborating with members and those involved with members' care including clinical nurses and treating physicians. The Regional...
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...
Demonstrates thorough knowledge base of clinical practice through written documentation and contributions at team meetings..., knows eligibility criteria, types of services and clinical information necessary for referral, key diagnostic...
. Requirements: As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise and reviews... insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation of the...
of Leesburg, FL. Requirements: As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical... expertise and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide...
for clinical feasibility prior to final approval. · Participate and assist NCH Physician Group in responding to appeals, denials...; Offer Graduate Medical Education and fellowships; Have endowed chairs; Conduct research and participate in national clinical trials...