- Constructive Partnerships Unlimited (Brooklyn, NY)
- …and SCIP-R. 12. Reports all incidents to the Residence Manager, and reports all medical issues/ injuries to the registered nurse and follows protocols for ... individuals and arranges transportation as necessary. Upon instructions of the Nurse , accompanies individuals on medical appointments and/or visits hospital… more
- Molina Healthcare (Orem, UT)
- …will work on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. JOB DESCRIPTION Job SummaryProvides support ... For this position we are seeking a (RN) Registered Nurse who must hold a compact license. This is...for clinical member services review assessment processes. Responsible for verifying that services are… more
- 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 ... payment systems. This position is responsible for auditing inpatient medical records and generating high-quality recoverable claims ...(2 years in clinical documentation) OR IF NOT A NURSE : Degree in RHIM, RHIA, RHIT with medical… more
- St. Luke's University Health Network (Allentown, PA)
- …health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis and procedure ... care for appropriate reimbursement. + Work with the physician advisor in review of patient medical records identified by RAC/MIC/QIO and other governmental… more
- CVS Health (Harrisburg, PA)
- …+ Explains member's rights and responsibilities in accordance with contract. + Processes claim referrals, new claim handoffs, nurse reviews, complaints ... in 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
- Trinity Health (Columbus, OH)
- …information according to department policies and procedures. + Conducts claim review as required for appropriate claims processing **Position Highlights and ... Medical Directors on case-specific issues. + Coordinates with Claims , Member Services, Grievance Coordinator and other operational departments regarding case… more
- Veterans Affairs, Veterans Health Administration (Springfield, IL)
- Summary This position will serve as a Primary Care Physician and Medical Director at our Springfield Community Based Outpatient Clinic (CBOC) location. ... Responsibilities This position will serve as a Primary Care Physician and Medical Director at our Springfield CBOC location. Major duties include, but not limited… more
- Houston Methodist (The Woodlands, 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
- Veterans Affairs, Veterans Health Administration (Oklahoma City, OK)
- …by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Former EDRP Participants are ineligible to apply ... ad hoc) Work closely with HBPC Program Coordinator, HBPC Nurse Manager, and HBPC Program Support Assistants on overall...in collaboration with others Understand, manage, and assist with review and revision of HBPC Policy to ensure compliance… 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