- HCA Healthcare (Nashville, TN)
- …treatment is reimbursed by contacting managed care organizations and completing initial utilization review . Documents in Midas as required. Involves mobile ... on face to face or telemedicine assessment completed and physician consult. + Provides a thorough clinical review...patients in regard to managed care organizations + Conducts utilization review for managed care cases in… more
- Houston Methodist (TN)
- …caring for adults in an acute care hospital setting + Coding and utilization review experience preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN ... At Houston Methodist, the Clinical Documentation Specialist is responsible for improving the overall quality...of the clinical information used for measuring and reporting physician and hospital outcomes and educating all members of… more
- Datavant (Nashville, TN)
- …tools. The specialist serves as a key liaison between coding, billing, utilization review , case management, and payer relations to reduce denials and improve ... experiences to realize our bold vision for healthcare. The Specialist is responsible for identifying, analyzing, and resolving claim...with revenue integrity functions in a hospital or large physician group setting. + Familiarity with DRG and APC… more
- Covenant Health Inc. (Harriman, TN)
- …the patient that will meet identified needs. + Facilitates timely documentation review with the Clinical Documentation Improvement (CDI) specialist , as necessary ... physician to identify the necessary resources and ensures the appropriate utilization of same. + Communicates effectively with physician offices, home health… more
- Covenant Health Inc. (Harriman, TN)
- …for the patient that will meet identified needs. + Facilitates timely documentation review with the Clinical Documentation Improvement (CDI) specialist + As ... physician to identify the necessary resources and ensures the appropriate utilization of same. + Communicates effectively with physician offices, home health… more
- Covenant Health Inc. (Lenoir City, TN)
- …the patient that will meet identified needs. + Facilitates timely documentation review with the Clinical Documentation Improvement (CDI) specialist , as necessary ... physician to identify the necessary resources and ensures the appropriate utilization of same. + Communicates effectively with physician offices, home health… more
- Covenant Health Inc. (Knoxville, TN)
- …the patient that will meet identified needs. + Facilitates timely documentation review with the Clinical Documentation Improvement (CDI) specialist as necessary ... physician to identify the necessary resources and ensures the appropriate utilization of same. + Communicates effectively with physician offices, home health… more
- ChenMed (Memphis, TN)
- …COE and HCT leaders to support improved medical costs and specialty care utilization . This individual will work closely with and consider feedback from those leaders ... quarterly meeting National Specialty Directors and Network Director to review pattern, trends, and opportunities within the CPL. +...CPL. + Responsible for meeting with high volume community specialist at least monthly to give them feedback on… more
- Covenant Health Inc. (Knoxville, TN)
- …and employees. Recruiter: Madeline Fornadel || ###@covhlth.com Responsibilities + Complete review of evaluation packets, OASIS/HIS and 485/Plan of Cares (POC). ... status for homecare and eligibility guidelines for hospice. + Ensures service utilization correlates with assessment data. + Processes the OASIS/HIS and 485/POC, and… more