- Insight Global (South Jordan, UT)
- …with ICD-9/10CM, MS-DRG, AP-DRG, and APR-DRG with a broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement ... and APR-DRG payment systems. This position is responsible for auditing inpatient medical records and generating high-quality recoverable claims for the benefit… more
- Dignity Health (Rancho Cordova, CA)
- …Documentation Improvement (QCDI) RN is responsible for performing a comprehensive review of ambulatory medical records to confirm documentation compliance ... review provider documentation, provide education to providers, and review trends of assigned providers or medical ...military training that is equivalent to an accredited Registered Nurse program (determination by Dignity Health Medical … more
- Veterans Affairs, Veterans Health Administration (Richmond, VA)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... Responsibilities The Geriatrics Transitional Care Program Medical Director may practice in all settings, including inpatient, outpatient, and telehealth modalities.… more
- ICW Group (Lisle, IL)
- …and vendors. + Acts as a gatekeeper for referrals between in-house telephonic nurse case managers, claims examiners and vendors. Reviews open referrals and ... goals and objectives. Provides cost containment program support. + Provides support to claims and audit teams as needed for medical management oversight results… more
- CVS Health (Franklin, TN)
- …+ Explains member's rights and responsibilities in accordance with contract. + Processes claim referrals, new claim handoffs, nurse reviews, complaints ... preparation of complaint trend reports. + Assists in compiling claim data for customer audits. + Determines medical...requests for appeals and pre-authorizations not handled by Clinical Claim Management. + Performs review of member… more
- Veterans Affairs, Veterans Health Administration (Orlando, FL)
- …Extended Care. The Assistant Medical Director in collaboration with the HBPC Medical Director, HBPC Program Director and HBPC Nurse Manager are responsible ... VHA Education Loan Repayment Services program office after complete review of the EDRP application. VA offers a comprehensive...nurse practitioners. Serves as a consultant to other medical center staff and trainees. Represents the HBPC on… more
- Houston Methodist (Webster, TX)
- …blood pressure, weight, and height), chief complaint(s), preforms medication(s) review , discusses/reviews medical and social history (as appropriate). ... At Houston Methodist, the Multi-Site Senior Medical Assistant, (Multi-Site Sr. MA) position is responsible...the direct supervision of a Physician, APP and/or Registered Nurse . This position oversees appropriate scope of practice, (ie… more
- Adams County Government (Westminster, CO)
- …This Job The Adams County Health Department Nursing Division is comprised of Nurse Family Partnership, Nurse Support Program, Harm Reduction, Sexual Health, ... The Nursing Division is made up of clinical support staff, medical assistants, harm reduction specialists, operations support, nurses, advanced practice nurses,… more
- Veterans Affairs, Veterans Health Administration (Jamaica Plain, MA)
- …Documents below. Responsibilities We are seeking an enthusiastic internist with a passion for medical education for a full time position as Medical Director at ... access to multiple specialties, radiology, laboratory services and Urgent Care. The Medical Director is responsible for ensuring that excellent, high quality care is… more
- Ozarks Medical Center (West Plains, MO)
- …manages claims and insured/uninsured losses; and facilitates physician peer review (including OPPE/FPPE) in collaboration with Medical Staff leadership. The ... The Risk Manager leads the health system's integrated program for medical malpractice/ claims management, enterprise risk management, patient safety, and… more