- SSM Health (MO)
- …or Medical Group revenue cycle areas. The scope of responsibility is all post-billed denials (inclusive of clinical denials ). Engages with key leadership ... improvement. + Oversees communication and follow-up processes related to denials and appeals to ensure such activities are submitted timely, tracked, trended… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …the general supervision of the Director of Patient Financial Services, the Clinical Appeals Specialist performs advanced level work related to clinical ... denials by conducting a comprehensive review of relevant clinical documentation. The Clinical Appeals Specialist will write compelling arguments based on… more
- AdventHealth (Altamonte Springs, FL)
- …and grievances from patients; assists in drafting and submitting clinical denial appeals , as needed + Develops Medical Director relationships with payors to ... as collaborating with other disciplines to assist in the improvement of clinical documentation, patient safety, and quality outcomes. Through primary support of… more
- Mount Sinai Health System (New York, NY)
- …AR trends and billing lags. + Collaborate with department such as coding, IT, clinical service areas and appeals to ensure seamless end-to-end revenue cycle ... **Job Description** **Senior Director , Patient Financial Services (Backend Revenue Cycle) Corporate...Accounts Receivable, increasing cash collections, reducing bad debt decreasing denials and eliminating write offs due to process issues.… more
- Brockton Hospital (Brockton, MA)
- …external review agencies, to coordinate activities involved in medical record review, denials , appeals and reconsideration hearings. Works closely with the ... PURPOSE OF POSITION: The Director of Case Management is responsible for planning,...the development and supervision of staff (RNs, LPN's,SWs and non- clinical support), evaluation and maintenance of case management skills… more
- HCA Healthcare (Manchester, NH)
- …new medical staff members (in partnership with other key stakeholders to include Director of Advanced Clinical and IT&S personnel). Facilitate orientation for ... We care like family! Jump-start your career as a Director Medical Staff Services today with Catholic Medical Center....play a key role in the integration of HCA Clinical Strategies and HCA systems. **Medical Staff Administration** Develop… more
- Centene Corporation (New York, NY)
- …and coordinate the medical affairs functions for the business unit. Oversee the denials and appeals department. May manage other medical directors. Assume VPMA ... and other ad hoc committees. + May oversee all aspects of the Appeals and Denials department including implementing budgetary, policy, and personnel decisions… more
- CVS Health (Hartford, CT)
- …concurrent and prior authorization reviews with peer to peer coverage of denials . * Appeals - The medical director will perform appeals in their "base ... to its membership. Aetna is looking for a medical director to be part of a centralized team that...lead daily rounds. **Required Qualifications:** Minimum 3-5 years of clinical practice experience. Two (2) + years of experience… more
- Mount Sinai Health System (Long Island City, NY)
- …collection, data received from external agencies, Physician 9.Advisors and the Medical Director . 10.Ensures Discharge Appeals functions are carried out within ... **Job Description** The Director will direct and manage departmental activities involved...direct and manage departmental activities involved in utilization review, appeals management and discharge planning to facilitate the case… more
- UPMC (Pittsburgh, PA)
- The Regional Medical Director , CC/DP and Utilization Review, provides clinical and management leadership across multiple hospitals within the region. This role ... and length of stay (LOS) strategic oversight. The Medical Director will report to the Vice President of Care...denials . + Direct UM functions, collaborating with CC/DP, clinical teams, and attending physicians to optimize care delivery… more