- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the ... and denials for no authorization. The Senior Denials Management Specialist position communicates... management for data gathering on medical resource utilization , and, as appropriate, resolution of inpatient denials… more
- St. Luke's University Health Network (Allentown, PA)
- …communities we serve, regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party ... JOB DUTIES AND RESPONSIBILITIES: + Reviews all Inpatient Retroactive Denials in the Denials Management ...+ Prefer minimum of 2-5 years' experience in case management and/or utilization management . +… more
- Hartford HealthCare (Farmington, CT)
- …**Job:** **Coding and Billing* **Organization:** **Hartford HealthCare Corp.* **Title:** * Denials Specialist 2 / HIM Coding* **Location:** ... now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the… more
- UCHealth (Fort Collins, CO)
- …Background of insurance benefit plans and registration, explanation of benefits, and denials management . + Preferred experience working with payer rejections and ... denials . + Utilization of EPIC software and external third-party payer website experience. We improve lives. In big ways through learning, healing, and… more
- Vanderbilt University Medical Center (Nashville, TN)
- …- American Health Information Management AssociationAmerican Health Information Management Association, Certified Coding Specialist - American Health ... Information Management AssociationAmerican Health Information Management Association, Certified Coding Specialist - Physician - American Health Information … more
- Houston Methodist (Sugar Land, TX)
- …Provides education to physicians, nurses, and other health care providers on utilization management topics. + Initiates improvement of department scores for ... At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position...state, local, and federal programs + Comprehensive knowledge of utilization management , case management , performance… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical ... internal and external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …inpatient, and extended recovery admissions as required based on Emory Healthcare's Utilization Management Plan and the UR Department processes. 4. Ensures ... of Georgia and Federal regulatory requirements as designated in Emory Healthcare's Utilization Management Plan. 3. Maintains all required annual competencies,… more
- Mount Sinai Health System (New York, NY)
- …Excel and Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A. ... **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt...EOW** To maintain front end operations of the Case Management Department by monitoring all incoming correspondence and ensuring… more
- Sanford Health (Bemidji, MN)
- …Conduct level of care medical necessity reviews within patient's medical records. Performs utilization management (UM) activities in accordance with UM plan to ... utilization and potentially, prior authorization. Assists the department in monitoring the utilization of resources, risk management and quality of care for… more