- Ochsner Health (New Orleans, LA)
- …make a difference at Ochsner Health and discover your future today!** The Appeals Specialist is responsible for managing and resolving insurance claim denials ... decisions. The position requires strong analytical skills and collaboration with clinical and revenue cycle teams to optimize financial outcomes. **Education**… more
- State of Colorado (Denver, CO)
- Certified Therapeutic Recreation Specialist (CTRS) - Clinical Therapist II Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5167891) Apply ... Certified Therapeutic Recreation Specialist (CTRS) - Clinical Therapist II Salary...if your application is eliminated. You will find the appeals process, the official appeal form, and how to… more
- University of Southern California (Arcadia, CA)
- …Documentation Improvement Practitioner (CDIP) certification status preferred. + Certified Clinical Documentation Specialist (CCDS) credential preferred. Pay ... for both formal and informal education for physicians, nursing, and other clinical staff. + Meets established productivity targets for record review and appropriate… more
- HCA Healthcare (Ocala, FL)
- **Description** **Introduction** Do you have the career opportunities as a Clinical Denial Coding Review Specialist you want with your current employer? We have ... are a committed, caring group of colleagues. Do you want to work as a Clinical Denial Coding Review Specialist where your passion for creating positive patient… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Remote PRN Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital ... collaborates with healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence to hospital… more
- Omaha Children's Hospital (Omaha, NE)
- …and obtains appropriate physician documentation while patients are in-house for clinical conditions and procedures to support the appropriate severity of illness, ... and complexity of care of the patient. Exhibits sufficient knowledge of clinical documentation requirements. APR-DRG assignment and clinical conditions and… more
- CaroMont Health (Gastonia, NC)
- …and reporting. Perform data collection and analysis, trend identification for assigned clinical outcomes, and present this data at the appropriate meetings as ... promoting and monitoring safe, high-quality, cost-effective healthcare with the best clinical outcomes possible. Provide physician and nurse education to achieve… more
- Actalent (Chattanooga, TN)
- Job Description We are seeking a detail-oriented and customer-focused Pharmacy Support Specialist to join our team. In this role, you will: + Respond to calls and ... members, and member representatives regarding pharmacy prior authorizations, exceptions, and appeals . + Enter authorizations and test claims into the pharmacy… more
- Actalent (Chattanooga, TN)
- …and/or members/members representatives for pharmacy prior authorizations, exceptions, and appeals Enter authorizations and test claims into the pharmacy benefit ... system to ensure appropriate claim adjudication Perform system edits, data entry, and complete tracking logs Assist with departmental audits and quality improvement activities Skills Pharmacy, Cpht, Call center, PTCB Top Skills Details Pharmacy,Cpht,Call… more
- State of Colorado (CO)
- CDOC Addiction Specialist II Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5123709) Apply CDOC Addiction Specialist II Salary $5,665.00 ... Number CAA Statewide D&A 11/2025 Department Department of Corrections Division Clinical and Correctional Services Opening Date 11/03/2025 Closing Date 1/31/2026 4:00… more