- Garnet Health (Middletown, NY)
- …CLinical Documnetaion Specialist on our CDI team at/in Garnet Health Medical Center. Responsibilities Under the direction of The Administrator, Coding & Clinical ... day operation of the CDI department and DRG Denials appeals process. The Manager will develop, implement and evaluate...department. The Manager ensures that reviews of the patient's medical data are conducted to assess appropriateness and … more
- Baylor Scott & White Health (Dallas, TX)
- …handling Responsibility for the preparation of summaries and files for denials, appeals , medical opinions, subrogation and litigation.1. Collection of documents ... establish reserve requirements, identify subrogation potential, maintain diaryReview and evaluate medical and loss wages, conduct thorough investigation of the claim… more
- 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
- Cedars-Sinai (Beverly Hills, CA)
- …Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We were also awarded the Advisory Board Company's ... stay. + Reviews with hospitalist the patient's admission and continued stay for medical necessity, appropriateness of care and level of care. Use Milliman and… 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
- The County of Los Angeles (Los Angeles, CA)
- …Supervises County employees providing disaster/emergency services, when required. Regional Disaster Medical and Health Specialist Program (RDMHS) Assists in the ... hospitals are training sites for physicians completing their Graduate Medical Education in nearly every medical specialty...to be a valid reason for an extension of appeals rights period. + I understand the above information.… more
- City of New York (New York, NY)
- …of the Office of Equal Employment Opportunity, at ###@health.nyc.gov or ###. CITY MEDICAL SPECIALIST (PART- - 53040 Qualifications Possession of a valid license ... and wellness of students. - Complete Accommodation Reviews and appeals (Home Instruction, Transportation/ Medical Exception, Diabetes Medication Administration… more
- Sharp HealthCare (San Diego, CA)
- …Collaborate with clinical team to communicate changes in pre-authorization, denial, medical review, appeals , managed care contracts, and referrals to ... of financial planning for their transplant surgery, VAD implant, and future medical needs as well as assuring transplant department billing compliance. The primary… more
- BrightSpring Health Services (Englewood, CO)
- …towards individual and company goals for cash collections, credit balances, medical records, correspondence, appeals /disputes, accounts receivable over 90 days, ... state/federal regulations, company policies, insurance contracts in terms of medical policies, payments, patient financial responsibility, credit balances, and… more
- Centene Corporation (Jefferson City, MO)
- …leading clinical coding compliance nurses and non-clinical team members through medical claim review. Ensure compliance with coding practices through a comprehensive ... review and analysis of medical claims, medical records, claims history, state...and resolves escalated health plan, Claims department, and provider inquires/ appeals or issues + Cross communication with IT, health… more