quality to help facilitate the precise representation of a patient's clinical status via assigned codeset. Provides guidance..., oversight, and management in Coding Quality in collaboration with revenue cycle and clinical quality teams. Assists...
Financial Services (billing, insurance appeals, collections) procedures and policies Good written and verbal communication... to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance...
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...
for contacting external case managers and managed care organizations for pre-authorization, concurrent reviews and appeals/denials... of quality, clinical and cost-effective outcomes and to perform a holistic and comprehensive admission and concurrent review...
, clinical research, medical education, a foundation, an accountable care organization, community services... communications. This position requires developing and maintaining positive relationships with donors, Foundation staff, clinical...
documentation. Obtains appropriate clinical documentation and ensures that the clinical information used in measuring and reporting.... Collects data for analysis and report generation. Minimum Qualifications Work Experience Three years of recent clinical...
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...
the clinical integrity of the program, including timely peer reviews, appeals and consultations. The responsibilities... Medical Director position is responsible for providing oversight to and direction of the Clinical Management Program...
, 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...
, 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...
’s. Job Description Communicates with patients, 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...
with Physicians and clinical staff to obtain prior authorizations for treatments, procedures and medications. Ensures accurate... by: Works closely with Patient Accounts to properly follow up on insurance company appeals and denials. Education/Training...
that treatment regimen is appropriate. Process referrals and submit clinical supporting documentation to insurance carriers... as required. Look through denials and submit appeals if requested by physician to get them approved from insurance companies. Document...
. Prices out government reimbursement payments for new or expanded clinical programs. Maintains current knowledge... action plans for areas where formal appeals to third party and governmental payers are warranted. Refines and/or creates...
electronically and via mail. Follow up on outstanding insurance claims, appeals, and denials. Maintain up-to-date knowledge... of dental insurance policies and industry changes. Collaborate with the front desk and clinical teams to ensure accurate...
of reports, appeals and inquiries, related to clinical edits, dlp and clinical editing activities. Education: Associate... of claims is high Role Summary This position is primarily responsible for the coordination of activities within the clinical...
quality managed care administrative and clinical services to medical groups hospitals health plans and employers... with other business functions. Working knowledge of DHPR and CMS rules for Claim. Submission, Claim Payment, Eligibility, Appeals...
and Appeals Reviewers, Program Managers and the Clinical Manager. The Disability Assistant makes complex decisions regarding...Overview: POSITION SUMMARY: Under the general supervision of the Clinical Manager or designee, this position...
to management, potentially requiring pharmacy transfer. Submit appeals and pursue additional payments on medical claims denied... to ensure maximum reimbursement for services provided. Ensure proper submission of complete clinical documentation to justify...
quality managed care administrative and clinical services to medical groups hospitals health plans and employers... with other business functions. Working knowledge of DHPR and CMS rules for Claim. Submission, Claim Payment, Eligibility, Appeals...