- Cognizant (Denver, CO)
- …. Draft and submit the medical necessity determinations to the Health Plan/ Medical Director based on the review of clinical documentation in accordance with ... the Health Plan/Payer. The comprehensive process includes analyzing, reviewing, and processing medical necessity denials for resolution. You will be a valued member… more
- State of Colorado (Pueblo, CO)
- …Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director 's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, ... and communicate to the applicable WM critical issues, legal matters, potential lawsuits/ appeals , and complaints. + Research the appropriate action or person to… more
- State of Colorado (CO)
- …of notice or knowledge of the action: Colorado State Personnel Board/State Personnel Director , Attn: Appeals Processing, 1525 Sherman Street, 4th Floor, Denver, ... enriching professional development opportunities and a wide range of benefits. + Medical and dental options are available for permanent employees and their… more
- State of Colorado (Grand Junction, CO)
- …the facility clinic in a fiscally minded manner. Main contact with the DYS Medical Director for consultation and collaboration on individual cases. Oversees and ... specialty care and recommendations made by providers. Collaborates directly with the DYS Medical Director and/or other providers to determine referrals to other… more
- State of Colorado (Pueblo, CO)
- …the facility clinic in a fiscally minded manner. Main contact with the DYS Medical Director for consultation and collaboration on individual cases. Oversees and ... specialty care and recommendations made by providers. Collaborates directly with the DYS Medical Director and/or other providers to determine referrals to other… more
- State of Colorado (Pueblo, CO)
- …Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director 's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, ... safe, secure, and therapeutic setting for patients with both psychiatric and medical issues. The services provided include evaluation and treatment for patients who… more
- State of Colorado (Pueblo, CO)
- …Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director 's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, ... safe, secure, and therapeutic setting for patients with both psychiatric and medical issues. The services provided include evaluation and treatment for patients who… more
- State of Colorado (Denver, CO)
- …Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director 's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, ... over six treatment milieus serving civil and forensic individuals. Medical services, occupational therapy, neuropsychological-rehabilitation services, and trauma-informed care… more
- State of Colorado (Denver, CO)
- …Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director 's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, ... over six treatment milieus serving civil and forensic individuals. Medical services, occupational therapy, neuropsychological-rehabilitation services, and trauma-informed care… more
- State of Colorado (Rio Grande County, CO)
- …Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director 's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, ... cash, and donation accounts + Overseeing/completing regular billings for Medicare , Medicaid, Hospice, the Department of Veterans Affairs, Managed Care/Insurance… more