- St. Luke's University Health Network (Allentown, PA)
- …appropriate to the age of the patient treated. + Performs admission review on all inpatients. Attends daily patient rounds and shares professional knowledge, ... placement) prior to discharge to meet patient's needs with recognition and documentation of patient choice of service providers. Demonstrates effective use of these… more
- Guthrie (Troy, PA)
- …others. + If applicable, conduct and document in EPIC the initial Phase I review to include medical record review and patient interview to effectively ... goals with update of goals as needed. Collaborate with Cardiac Rehab nurse . Provide information to patient/family regarding status, program planning and discharge… more
- St. Luke's University Health Network (Bethlehem, PA)
- …and responds to all inquiries for admission to ARC + Completes thorough review of documentation and information and assesses a patient's appropriateness for ... Admission's Clinical Reviewer is responsible for the comprehensive medical review and screening of all referrals made to the...a post-acute rehabilitation setting preferred. Clinical experience as a nurse or therapist in an inpatient setting for a… more
- UPMC (Altoona, PA)
- …clinical or supervisory personnel when needed, including thorough and accurate documentation of telephone encounter for messaging. + Obtain chief complaints in ... session timeshares (single specialty phone room or front desk environment). + Review and verify the patient's insurance information. + Routinely attend department… more
- Penn Medicine (Philadelphia, PA)
- …optimal reimbursement for the hospital for services provided. Responsibilities: + Review chemo schedule in advance and determines patients insurance requirements for ... of obtaining insurance authorizations Internet, envoy. Follow up with all review companies on all pending authorizations and referrals. Checks-in/arrives patient… more
- Penn Medicine (Philadelphia, PA)
- …to guidelines to satisfy 3rd party payer requirementsEducates team in appropriate documentation to reflect Intensity of service (IS) / Severity of Illness (SI) ... care settings and timely patient flow; elevates issues appropriatelyEnters all review activity in Canopy concurrentlyAccounts for all patient days accurately in… more
- UPMC (Pittsburgh, PA)
- …and ensure goal of 72 hours patient access are met. **Responsibilities:** + Review , verify and enter the patient's demographic information to ensure data integrity. ... phone calls to other areas and/or clinical providers (billing, nurse , operations lead, etc.). + Treat all patients with...Work the overflow call list and Audiocare report. + Review and verify the patient's insurance information. + Coordinate… more
- Highmark Health (Pittsburgh, PA)
- …operational areas regarding issues related to supported technology. Manage utilization review , translation of foreign claims, coordination of benefits (COB), and ... team (IDT) including, but not limited to, appropriateness of care, documentation requirements, severity of illness and intensity of services criteria, insurance… more
- UPMC (Pittsburgh, PA)
- …such as responding to call lights and transporting patients. + Documentation & Compliance: Document patient information accurately and complete clerical tasks. ... Receive and act on feedback, identify learning needs, and participate in self- review . Suggest and support departmental changes and improvements. Strictly adheres to… more
- BAYADA Home Health Care (Norristown, PA)
- …+ Demonstrate mastery of clinical and regulatory home care eligibility criteria. + Review all medical documentation and work with physicians to make clinical ... for a TCM:** + Holds a current license in good standing as a clinician ( Nurse , therapist or social worker) in the state of practice OR have experience with case… more