, staff, physicians, and other departments. Assists with the denials process with focus on clinical reviews, peer-to peer..., resources, services, clinical standards, and outcomes is preferred. Is proactive, with the team, to achieve desired clinical...
in a timely manner of pending authorizations or denials when verifying insurance. Sends a copy of the daily final procedure... to schedule cases outside of approved schedule BLOCK TIMES. Indicates on the schedule and communicates with clinical staff when...
. Essential Responsibilities: Independently review, available clinical, medical, and nursing information to determine if there... is a need for admission to a post-acute level of care. The consistent use of the clinical support system (approved guidelines...
Collaboration with clinical staff regarding challenging patient needs Basic understanding of complete revenue cycle Knowledge... with clinical departments, providers, referral sources, insurance companies, and authorization staff. Accurately obtains insurance...
organizations, external reviewers, and other payers. Assures that good customer service practices are utilized. Maintains denials... or Bachelor Degree in Nursing or Social Work preferred. Experience:Two (2) years direct clinical experience in a psychiatric...
organizations, external reviewers, and other payers. Assures that good customer service practices are utilized. Maintains denials... or Bachelor Degree in Nursing or Social Work preferred. Experience:Two (2) years direct clinical experience in a psychiatric...
and accountable for ensuring high-value patient care that is coordinated, efficient, and aligned with institutional clinical... parameters in the clinical pathway or treatment plan. 3. Utilizes information obtained from various resources...
, and aligned with institutional clinical and financial objectives. In collaboration with the healthcare team, the Case Manager... and monitors compliance with documenting variances from established parameters in the clinical pathway or treatment plan. 3...
or denial for facility entry; Works with proper clinical leadership on complex cases for pre-assessment approval or denials... up for admission coordinator duties including handling phone and e-mail inquiries, entering information into salesforce...
Senior Scheduler Job Code: 29133 Position Summary In addition to all Outpatient Services Coordinator... with surgical and procedural information related to preparation and instructions as appropriate Mitigates procedural denials...
Researches and communicates appropriate treatment of charges to clinical managers, CDM Specialist (coordinator), other customers... payors. Responsibilities: Assist various departments in ensuring all denials are captured & appealed in a timely manner...
, Vice Dean, Associate Dean for Student Affairs, Associate Dean for Research, Associate Dean for Clinical Affairs, Associate... Dean for Extramural Clinical Practices, Associate Dean for Faculty Affairs, Assistant Dean for Dental Education...
days Other duties as assigned. POSITION SPECIFIC RESPONSIBILITIES: Utilization Management Balances clinical... patient and balancing cost and quality to assure optimal clinical and financial outcomes Completes admission reviews...
Business Unit Lake Forest Hospital Job REQID 161540 Job Function Nursing Coordinator Shift Day Job (1st) Type of Employment...-class care. Here, you'll work alongside some of the best clinical talent in the nation leading the way in medical innovation...
Facility: VIRTUAL-GA Job Summary: The Utilization Management Nurse (UM) Coordinator is responsible for conducting... medical necessity reviews 24 hours per day, 7 days per week. Utilizing mcg Indicia, clinical reviews are performed...
KeyPro/First Health web based review procedures. Refers problem cases/denials to the Clinical Service Coordinator...&R, First Health or other specific criteria related to diagnosis, clinical condition, cost and/or payor. Follows unit...
Financial Assessor and Operations Coordinator. Timely follow-up and collection of third party payer receivables. Denials... for bill, outbound compliant claim submission, clinical documentation requirements and any other communication required (verbal...
Sciences (UAMS) has a unique combination of education, research, and clinical programs that encourages and supports teamwork... University's Title IX Coordinator and to the U.S. Department of Education Office for Civil Rights. Persons must have proof...
Job Summary The Clinical Operations Manager oversees the revenue cycle team at the Department of Medicine... and implementing workflows for new or modified clinical services, identifying billing opportunities, analyzing trends, and resolving...
and denials management activities as defined by the RN Discharge Coordinator and RN Utilization Reviewer. They assume a pivotal... role with the patient care team to achieve optimal clinical and resource outcomes. Key Responsibilities Applies...