- 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 ... care, optimal clinical outcomes and patient and provider satisfaction. The UM Specialist provides the Utilization Management function for patients admitted to BH… more
- University of Rochester (Rochester, NY)
- …company barriers and tracking all assistance provided. Accountable for planning, execution, appeals and efficient follow through on all aspects of the process which ... any discrepancies and/or answer any questions. + Escalates case management when medical assessment is needed. + Prioritizes referral requests using medical … more
- Huron Consulting Group (Chicago, IL)
- …internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and ... and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical...code and MS-DRG, APR DRG assignments to potentially decrease denials . * Works Inpatient claim edits and may code… more
- Whidbey General Hospital (Coupeville, WA)
- …governmental guidelines. + Scans all documentation into the patient's electronic medical record. + Maintains a comprehensive filing system that clearly identifies ... Inputs statistically numbers in online reports. + Prepares insurance appeals and follows up as required. + Processes technical... and follows up as required. + Processes technical denials . + Maintains the Itemized Statement Request Line. +… more
- PSKW LLC dba ConnectiveRx LLC (Pittsburgh, PA)
- …resources, regional level and alternative resources. + Assists in obtaining insurance approvals/ denials and/or appeals for therapy. Assists patients and HCP with ... parts. Join our dynamic team as a Benefits Investigation Specialist and be a crucial part of ensuring access...medications! We seek a compassionate individual to engage with Medical Insurance Payers and Pharmacy Benefit Managers, playing a… more
- The Cigna Group (Arlington, VA)
- …team and/or the employees. Including but not limited to complex claims, authorizations, denials , appeals , incentive issues, etc. + You will provide education and ... others achieve the best outcome? We are looking for a dedicated onsite specialist to provide exemplary customer and client service of our Cigna products, benefits,… more