- R1 RCM (Boise, ID)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Appeals Supervisor ** , you will help support ... excelling in this remote position. **Here's what you will experience working as a Clinical Appeals Supervisor :** + Track and monitor the workflow of the … more
- Centene Corporation (Austin, TX)
- …appeals and grievances from a clinical perspective. Ensure that the clinical Appeals and Grievance department processes all cases in accordance with ... the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified,… more
- St. Luke's University Health Network (Allentown, PA)
- …regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data ... DUTIES AND RESPONSIBILITIES: + Conduct retrospective medical record reviews for clinical validation of diagnosis and procedure code assignment and MS-DRG/APR-DRG… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …high volume, dynamic environment, the Clinical Authorization Specialist will bring clinical expertise to the prior authorization and appeals processes and ... and various health plans. Reporting to the Prior Authorization Supervisor , the Clinical Authorization Specialist is...+ Root causes claim denials, reprocesses, and submits claim appeals . + Creates drug cost estimates for both on-label… more
- Ventura County (Ventura, CA)
- Certified Coding Supervisor - Health Information Management Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4892159) Apply Certified Coding ... Supervisor - Health Information Management Salary $94,952.15 - $132,946.07...Information Management (HIM) department related to coding and CDI ( clinical documentation improvement). The ideal candidate will have a… more
- Select Medical (Dallas, TX)
- …A joint venture with Select Medical & Baylor Scott & White Health Dallas, TX ** Clinical Liaison (RN, OT, PT, or SLP)** **Full-Time, Monday through Friday 8am - 5pm** ... **Competitive base salary with monthly bonuses!** Clinical Liaisons are advocates who educate and guide patients toward the next level of care, while building… more
- Veterans Affairs, Veterans Health Administration (Louisville, KY)
- …informal complaints of employees and referring others, such as formal grievances and appeals to the supervisor or an appropriate management official. Uses a ... Summary The Lead Health Technician (Telehealth Clinical ) provides an array of complex and specialized...direction relating to the telehealth program. Works with the supervisor to develop assignments for team members in order… more
- Northwell Health (New York, NY)
- …write-offs, adjust downs, bad debts and other delinquent accounts. + Coordinates clinical documentation requests to business office to ensure timely appeals . ... + Develops and implements policies and procedures to facilitate billing and maximize case collections. + Reviews and recommends improvements for financial management of each billing area. + Performs related duties as required. All responsibilities noted here… more
- Veterans Affairs, Veterans Health Administration (Grand Rapids, MI)
- Summary The Social Worker ( Clinical Assessor) is assigned to the Caregiver Support Program (CSP) to work independently with multiple VA healthcare services and ... on specific caregiver needs/issues. Conducts Veteran, caregiver, and family clinical interventions to facilitate the identification of caregiver stress, psychiatric… more
- Mount Sinai Health System (New York, NY)
- …Utilization Management - WST, Mount Sinai West **Responsibilities** **A. Clinical /Technical/Service** + Demonstrates the ability to perform clinical ... + Requests or provides Medical Records as required for appeals , On / Off-site Insurance reviews + Implements...of the hospital staff and extended community. + Notifies Supervisor of obstacles / problems affecting the completion of… more
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