appeal correspondence to Payers, while adhering to business process standards and/or review clinical documentation to meet... on clinical strength of cases and potential for payment. Maintain understanding of department policies and procedures. Work...
as well as clinical denial services. Participate and educate team in performance improvement initiatives. Implement..., disciplinary actions, staff planning, and interviews. Oversee the claim denial appeal process; ensure appeals are appropriately...
Maximus is hiring a Clinical Review Specialist - Registered Nurse to join our Audit and Appeals team! In this role..., you will evaluate submitted appeals and make decisions based on clinical evidence. If you're passionate about making a positive impact...
Anticipated End Date: 2025-01-24 Position Title: Clinical Ops Associate Medical Director...; 8.5-hour shifts between 7am – 7pm CT (later shift hours preferred) The Clinical Operations Associate Medical Director...
clinical and denial teams. Essential Functions: Assist AVP Clinical Serices-Audits/Appeals in managing documentation... services, financial services and more. Clinical Systems Documentation Consultant Franklin, Tennessee Job ID 532914...
Company Overview: Acentra Health exists to empower better health outcomes through technology, services, and clinical... is looking for a Clinical Assessor to join our growing team. Job Summary: Acentra Health is seeking clinical assessors statewide in North...
and Appeals team! In this role, you will evaluate submitted appeals and make decisions based on clinical evidence. If you're...Description & Requirements Maximus is hiring a Clinical Review Specialist - Registered Nurse to join our Audit...
in appeals processes from a clinical perspective. Adherence to and compliance with information systems security...Job Description Clinical Education Specialist (CES) - Paramedic Exempt JOB SUMMARY Under general direction, the...
for assigned clinical outcomes, and present this data at the appropriate meetings as defined or needed. Serve as team member... or facilitator, responsible for promoting and monitoring safe, high-quality, cost-effective healthcare with the best clinical...
corrections or appeals as directed. Supports the clinical data abstraction and management process for clinical quality measures...Job Description: Summary: The Clinical Abstraction Specialist reports to the Manager of Clinical Abstraction...
Company Overview: Acentra Health exists to empower better health outcomes through technology, services, and clinical... is looking for a Clinical Assessor to join our growing team. Job Summary: Acentra Health is seeking clinical assessors statewide in North...
Company Overview: Acentra Health exists to empower better health outcomes through technology, services, and clinical... is looking for a Clinical Assessor to join our growing team. Job Summary: Acentra Health is seeking clinical assessors statewide in North...
Sciences (UAMS) has a unique combination of education, research, and clinical programs that encourages and supports teamwork...: FIN | CORE MCPG Medicare/Medicai Department's Website: Summary of Job Duties: The Senior Clinical Billing Specialist...
to build the Clinical Documentation Integrity (CDI) methodology to incorporate denials/appeals management. The role of the... your help to provide our customers with powerful solutions in the pursuit of quality, integrity, clinical and financial value...
A appeals. Minimum Qualifications: Requires AS in nursing and minimum of 1 year of clinical experience; or any combination...Anticipated End Date: 2025-01-22 Position Title: Clinical Review Nurse I Job Description: Clinical Review Nurse...
and comprehensive aftercare plans with placement. Services include clinical assessment, treatment planning, individual therapy, group... treatment team. Group therapy is offered to all patients and group assignment shall be determined by clinical and individualized...
(UAMS) has a unique combination of education, research, and clinical programs that encourages and supports teamwork...: FIN | CORE CCBO Commercial Department's Website: Summary of Job Duties: The Senior Clinical Billing Specialist...
combination of education, research, and clinical programs that encourages and supports teamwork and diversity. We champion being...'s Website: Summary of Job Duties: The Senior Clinical Billing Specialist is an area expert, works under general direction...
Anticipated End Date: 2025-03-24 Position Title: Clinical Operations Medical Director Job Description: The... Clinical Operations Medical Director is responsible for supporting the medical management staff ensuring timely and consistent...
, ensuring that the admissions process is efficient and that turnaround time requirements are met Handle incoming clinical... as needed Manage appeals oversight for the Quality Improvement Organization (QIO) and health plan, ensuring all procedures are followed...