- UNC Health Care (Kinston, NC)
- …the Physician Advisors and subject matter experts for all audit and appeals work activities. Assists with documentation review to support the clinical documentation ... and Case management Assistants. 4. Reviews and documents findings on all medical necessity and status denials. 5. Works closely with Patient Financial Services… more
- Mohawk Valley Health System (Utica, NY)
- …and advisory services to physicians, case managers and clinical documentation specialist regarding correct level of care and reimbursement. Apply knowledge of ... planning, patient status changes, length of stay, patient monitoring practices, medical necessity concepts and associated regulations in case management decisions.… more
- State of Colorado (Denver, CO)
- …, Criminal Appeals ,State Services (http://www.coloradoattorneygeneral.gov/departments/state\_services) ... authority for enforcement of consumer protection laws, prosecution of criminal appeals , antitrust laws, and certain natural resource and environmental matters and… more
- State of Colorado (Denver, CO)
- …Plan, plus optional 401K and 457 plans + Medical and dental health plans (https://dhr.colorado.gov/state-employees/state-of-colorado-employee-benefits) + Paid life ... be submitted on the official appeal form, signed by you or your representative. Appeals to the State Personnel Board or the State Personnel Director must be received… more
- HCA Healthcare (Manchester, NH)
- …purpose and integrity. We care like family! Jump-start your career as a Medical Staff Services Coordinator today with Catholic Medical Center. **Benefits** ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...process in accordance with the facility's fair hearing and appeals policy as well as legal and regulatory requirements.… more
- Mount Sinai Health System (New York, NY)
- …is preferred. **Minimum Certification Requirements** + NAMSS Certified Provider Credentialing Specialist (CPCS), Required + NAMSS Certified Professional Medical ... **Job Description** **Director Medical Affairs Operations- Medical Staff Services -Full-Time...Staff Bylaws, Policies, Corrective Actions, FPPE, OPPE, Hearing & Appeals , etc.) is required. + 10+ years progressive experience… more
- Evolent (Helena, MT)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional ... endovascular procedures, implantable cardiac devices, etc) that do not initially meet medical necessity guidelines or require further evaluation by a subject matter… more
- HCA Healthcare (Aventura, FL)
- …and action taken on the account in accordance with policies and procedures. The Specialist will escalate medical review request and/or denial activities to the ... that invests in you as an Inpatient Authorization Review Specialist ? At Parallon you come first. HCA Healthcare has...colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
- State of Colorado (Rio Blanco County, CO)
- …vehicle APPEAL RIGHTS: It is recommended that you contact the Human Resources Specialist listed below to resolve issues related to your possession of minimum ... of the department's action. For more information about the appeals process, the official appeal form, and how to...of this announcement will be reviewed by an HR Specialist against the Minimum Qualifications in this announcement. +… more
- Stanford University (Stanford, CA)
- Development Officer, Medical Center Development **Office of Development, Redwood City, California, United States** Development Post Date Nov 19, 2025 Requisition # ... 107759 ** Medical Center Development** Stanford University is one of the...donors as needed. + Renews giving, designs and manages appeals , increases giving levels, and recaptures lapsed donors. +… more