, and follow-ups on insurance denials, appeals, and reconsiderations. You will collaborate with clinical staff to ensure optimal... correspondence related to certifications, appeals, and denials is properly documented and stored. Collaborate with clinical...
resources management. Essential Duties: Leadership & Supervision: Manage and mentor a team of RN Utilization Review... provided by personnel. Clinical Review Oversight: Supervise the clinical review process to ensure reviews are conducted...
related to departmental services. You will build a high-performing team of Clinical Supervisors, Nurses Care Managers... eligible members. Provide direct oversight and guidance to the Clinical Supervisors and other staff, thereby creating a high...
stay, case review for appeals of payment denials, and the review and assessment of the adequacy of clinical information... between Admissions and Finance/Revenue Cycle. Communicates with clinical programs and other internal departments as needed. Updates the...
with students, faculty, staff, and clinical partners to promote positive learning environments. Maintains high-performance..., and staff requests for information and/or guidance. Ensures Deans and Associate Deans establish and maintain clinical sites...
audits and/or appeals. Attends Clinical Team Meetings, All Company Meetings, Education Opportunities, Trainings... AND RESPONSIBILITIES: Reviews, analyzes, and completes internal audits and/or appeals in accordance with client policy, CMS guidelines...
, staff, and clinical partners to promote positive learning environments. Maintains high-performance standards for self... and/or guidance. Establishes and maintains clinical sites; assesses clinical site satisfaction and addresses opportunities...
and continued stay reviews. Serves as liaison with medical staff and other clinical departments. Obtains authorizations... for admission and continued stay, appeals in appropriate reimbursement denials. AUSTIN OAKS HOSPITAL provides acute inpatient...
management (UM) and care management (CM) activities demonstrating clinical judgement and independent analysis, collaborating... with members and those involved with members' care including clinical nurses and treating physicians. Responsibilities...
and continued stay reviews. Serves as liaison with medical staff and other clinical departments. Obtains authorizations... for admission and continued stay, appeals in appropriate reimbursement denials. AUSTIN OAKS HOSPITAL provides acute inpatient...
QC analysts and clinical appeal review teams as needed. Reviews, analyzes, and completes internal audits and/or appeals.... Timely completion of internal audits and/or appeals. Attends Clinical Team Meetings, All Company Meetings, Education...
audits and/or appeals. Attends Clinical Team Meetings, All Company Meetings, Education Opportunities, Trainings... AND RESPONSIBILITIES: Reviews, analyzes, and completes internal audits and/or appeals in accordance with client policy, CMS guidelines...
. Consistently follow-up and update authorization/certification information on an ongoing basis. Track denials and appeals, document... Degree from an accredited, non-online RN program, preferred. Associate or Bachelor of Science in Nursing required. Work...
with unit RN Acute Care Navigator(s) and Social Worker(s) and reports to the Manager of Care Navigation. The Care Navigation... discharge planning updates, clinical updates, and ongoing communication to post-acute providers via established referral...
and appeals. This role entails overseeing a team of utilization review nurses and coordinators, ensuring compliance with clinical...), Registered Nurse (RN) preferred ESSENTIAL FUNCTIONS: Essential functions are those tasks, duties and responsibilities...
and appeals. This role entails overseeing a team of utilization review nurses and coordinators, ensuring compliance with clinical...), Registered Nurse (RN) preferred ESSENTIAL FUNCTIONS: Essential functions are those tasks, duties and responsibilities...
requiring clinical information to LPN RN or Licensed Provider nbsp;Secures appropriate signatures and forwards documents/forms... which includes staff messages appointment notifications etc Provides patients with non clinical instructions for any upcoming...
team focused on strengthening the interface between clinical departments and charge improvement process. Through a holistic..., appropriately coded, supported by clinical documentation, and correctly recorded in the proper department. This not only boosts...
of clinical charge capture and billing processes. This position focuses on auditing medical records and charge capture reports... to verify proper coding, documentation, and compliance with regulatory guidelines. By collaborating with clinical, financial...
unity of our team for the care of our residents, which is reflected in our positive clinical outcomes, resident and family... will be Medicaid and Medicare reimbursement. You will be responsible for the coordination and completion of clinical assessments...