- State of Colorado (Denver, CO)
- …when possible and refer issues to the hospital Patient's Rights Specialist , as indicated. Model solution-focused problem-solving strategies. + supports patient in ... and addresses safety violations in patient care areas. Using therapeutic clinical skills, anticipates and initiates intervention at an appropriate level in… more
- UnityPoint Health (Cedar Rapids, IA)
- …40 Hours Per Week + Job ID: 168048 Overview The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments serves a key role in ... utilization of health care resources, provision of high-quality health care, optimal clinical outcomes and patient and provider satisfaction. The UM Specialist … more
- University of Rochester (Rochester, NY)
- …GENERAL PURPOSE Serves as the patient referral and prior authorization specialist , with oversight of data and compliance to enterprise standards and ... referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non- clinical staff, identifying barriers to appointment… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE ADMINISTRATIVE CONTRACT SPECIALIST CIVIL SERVICE TITLE OR BE PERMANENT IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9 ... level of functioning and self-sufficiency by providing comprehensive, integrated, individualized clinical and supportive services. CAS works with other components of… more
- Henry Ford Health System (Detroit, MI)
- …and compliance risks. + Provides instruction to department staff and clinical employees in correct documentation processes and coding guidelines. + Provides ... instruction based on clinical documentation requirements related to regulatory and reimbursement rules and regulations, reimbursement systems (federal, state, and… more
- Centene Corporation (Jefferson City, MO)
- …to audit errors + Coordinate auditing outcomes and system maintenance with the Sr. + Clinical Systems Specialist to resolve or enhance clinical systems + ... the auditing of corporate, health plan, and specialty company staff related to clinical systems entry and/or processes + Develop and maintain the audit process and… more
- Trinity Health (Livonia, MI)
- …and references in the assignment of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis and procedure codes, MS-DRG, APR DRG, POA, ... documentation, as part of the coding process, to assess the presence of clinical evidence/indicators to support diagnosis code and MS-DRG, APR DRG assignments to… more
- Children's Mercy Kansas City (Kansas City, MO)
- …nursing, payers, patients, and coworkers. + Utilizes knowledge of hospital processes, clinical patient care, state and federal regulations and payer requirements to ... interdisciplinary teams towards improvement of patient flow and patient progression, clinical outcomes and efficiency of inpatient stays. Continually strives to… more
- Trinity Health (Livonia, MI)
- …and references in the assignment of Internal Classification of Diseases, Clinical Modification diagnosis and procedure codes, and Current Procedural Terminology / ... of current, compliant coder query practices when consulting with physicians, Clinical Documentation Specialists (CDS) or other healthcare providers when additional… more
- Trinity Health (Livonia, MI)
- …and references, in the assignment of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis and procedure codes and Current Procedural ... Hospital Association (AHA) Coding Clinic for International Classification of Diseases, Clinical Modification + The American Medical Association _(AMA_ ) for CPT… more