- 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
- State of Colorado (Pueblo, CO)
- NURSE III - Clinical Specialist - Pueblo Regional Center Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5186234) Apply NURSE III - ... Clinical Specialist - Pueblo Regional Center Salary...Clinical Specialist - Pueblo Regional Center Salary $3,863.20 - $4,635.20...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
- Baylor Scott & White Health (Dallas, TX)
- …The Appeal Support Specialist also serves as an appeal writer for non- clinical appeals that meet specific criteria. **ESSENTIAL FUNCTIONS OF THE ROLE** ... details of previous submissions and resubmits the appeal to the payer. Performs non- clinical appeals on low dollar, outpatient, pre-auth denials. Reviews the… 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