- Stanford Health Care (Palo Alto, CA)
- …development and reporting of findings. + Prepares written reports of review findings and recommendations and presents to management and maintains monitoring ... substandard documentation and inaccurate procedural billing. + Performs concurrent review of hospital bills to document non-billed, underbilled, and overbilled… more
- HCA Healthcare (Salt Lake City, UT)
- …+ 2 or more years of clinical experience preferred. + Knowledge of Utilization Review , DRG review , and Discharge Planning preferred. For 150 years, ... St. Mark's Hospital (https://mountainstar.com/locations/st-marks-hospital/) has provided a full-spectrum of healthcare services to Salt Lake City and its surrounding communities. As Utah's first hospital, St. Mark's team members uphold a rich tradition of… more
- Fairview Health Services (St. Paul, MN)
- …Documentation Liaisons analyze clinical documentation verifying appropriate diagnosis, procedure, DRG , level of service for both revenue and compliance ... practices through financial and activity reports, as well as documentation review , to identify potential opportunities for revenue capture and recognize areas… more
- The Davey Tree Expert Company (Richfield, OH)
- …integrate GIS data from various sources to enhance project datasets.** + ** Review completed tasks to confirm results meet project-specific standards and company ... integrity of GIS data by performing corrections, conversions, and updates.** + ** Review and refine outputs to meet project-specific and organizational standards.** +… more
- Corewell Health (Grand Rapids, MI)
- Job Summary Conducts thorough analysis encompassing clinical review and assessment of patient records focusing on the documentation of the clinical condition and the ... inpatient and outpatient settings. Uses critical analysis to determine appropriate DRG or coding assignment, appropriate setting, medical necessity, coverage of… more
- The Cigna Group (Bloomfield, CT)
- …recommendations to business partners at various levels of the organization + Review tools and reports available to matrix partners (Network Analytics, Competitive ... business needs (eg, Underwriting Discount Guarantee support, Network Analytics/Med Econ review process) + Assist in the development of uniform data submissions… more
- Sutter Health (Modesto, CA)
- …team, nursing management, quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and contracted ... management within a managed care environment. Comprehensive knowledge of Utilization Review , levels of care, and observation status. Awareness of healthcare… more
- Trinity Health (Davenport, IA)
- …Support Training Preferred: Certification in Case Management, Professional Utilization Review or Managed Care; DRG /CPT knowledge; Interqual Admission/Continued ... Physicians/Medical Office Staff, Students/Interns/Residents/Outside Instructors, Third Party Payors/Insurance Companies, Auditors/ Review Agencies. POSITION SPECIFICATION Education: Bachelor's Degree Field Of… more
- BronxCare Health System (Bronx, NY)
- …completing job tasks. -Assists the Administrative Manager and Director with annual review and revisions of departmental policies, and procedures as required. -When ... Regional and Medical Audit Contractors, and other licensing, accrediting, or review agencies. -Provides regular and special reports, in writing and verbally,… more
- Sutter Health (San Francisco, CA)
- …team, nursing management, quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and contracted ... management within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation status. + Awareness of healthcare… more