- UnityPoint Health (Cedar Rapids, IA)
- …S + Shift: 0900-1700 + Job ID: 174223 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
- Texas Health Resources (Arlington, TX)
- …PCP and attempts to schedule follow up appointments with either a PCP, specialist , clinic, visiting physician or other transitional care visit prior to discharge. ... discharge disposition, barriers to discharge, avoidable days, and potential denials . Coordinates/facilitates patient care progression throughout the continuum with… more
- Mohawk Valley Health System (Utica, NY)
- …+ Provide guidance and advisory services to physicians, case managers and clinical documentation specialist regarding correct level of care and reimbursement. ... potential barriers to patient discharge. The Physician Advisor (PA) conducts clinical review of cases to ensure compliance with regulatory requirements, hospitals… more
- Veterans Affairs, Veterans Health Administration (Fort Meade, SD)
- …is required for all positions above the journey level; however, for clinical documentation improvement specialist assignments, a clinical documentation ... or uncoded episodes of care for inpatients Ensures claim denials related to coding errors are resolved, and/or daily...for accurate billing and data collection Provide education to clinical and coding staff Assess current audit findings and… more
- University of Washington (Seattle, WA)
- …the patient medical record from governance, integrity, documentation timeliness, completion, clinical coding, billing, release, and tracking to management of access, ... Cycle and has a unique role in the organization that supports both clinical and operational activities. **PRIMARY JOB RESPONSIBILITIES** + Serve as an organization… more
- AdventHealth (Hinsdale, IL)
- …ensures efficient and cost-effective care through appropriate resources monitoring and clinical care escalations. The Social Worker is under the general supervision ... and communicates these goals and preferences to the multidisciplinary team. Incorporate clinical , social and financial factors into the transition of care plan.… more
- University of Rochester (Rochester, NY)
- …referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non- clinical staff, identifying barriers to appointment ... functionality required for testing and services ordered by referred to specialist includes, preparing and providing multiple, complex details to insurance or… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …performing utilization management activities. The goal is to achieve clinical , financial, and utilization goals through effective management, communication, and ... when appropriate * Collaborates with department director and professional development specialist to develop standard work and expectations for the utilization review… more
- AdventHealth (Shawnee, KS)
- …ensures efficient and cost-effective care through appropriate resources monitoring and clinical care escalations. The Social Worker is under the general supervision ... and communicates these goals and preferences to the multidisciplinary team. + Incorporate clinical , social and financial factors into the transition of care plan. +… more
- Essentia Health (Duluth, MN)
- **Job Description:** This position is responsible for reviewing clinical documentation and assigning ICD-10-CM diagnosis, CPT/HCPCS procedure codes, and modifiers to ... that support medical necessity for services provided + Works with the coding denials team for education and assists with denial prevention solutions + Ensures… more