Facility: VIRTUAL-GA Job Summary: The Utilization Management Nurse (UM) Coordinator is responsible for conducting... medical necessity reviews 24 hours per day, 7 days per week. Utilizing mcg Indicia, clinical reviews are performed...
Emergency Department Care Coordinator, in collaboration with the clinical team to include the medical provider, delivers... throughput, length of stay, readmissions, potentially avoidable utilization (PAUs) and denials. The Care Coordinator serves...
coordinator regarding patient needs.Answer department phone for all General, Memorial, and W&C divisions and route calls... appropriately.Payroll for Clinical Quality Management, Case Management, and Palliative Care departments.Purchase supplies and order...
. Will assist with the duties of the Denials Coordinator when assistance is needed to provide cross coverage. Other duties...Job Description: Communicates discharge recommendations of the clinical team to patient, care givers...
with documentation to ensure complete information is provided to the Denials Coordinator and Corporate Business Office team for claim...Job Description: OVERVIEW At Redeemer Health, we offer nurses the opportunity to choose their preferred clinical...
complete information is provided to the Denials Coordinator and Corporate Business Office team for claim and appeal processing...OVERVIEW: At Redeemer Health, we offer nurses the opportunity to choose their preferred clinical setting, be it...
Management Specialist at Hackensack Meridian Health includes: 1. In collaboration with the Care Coordinator, reviews daily... into EPIC systems for denials/ lower level of cares. 11. Contacts insurance company for benefit coverage and obtains...
payors. Notifies the UR Nurse and Denials Coordinator of potential denials. Supports the denials coordinator to manage... and clinical best practice to concurrently screen admission review and review with payors in collaboration with Case Management...
Business Unit Palos Hospital Job REQID 152472 Job Function Nursing Coordinator Shift Night Job (3rd) Type of Employment Full.... Here, you'll work alongside some of the best clinical talent in the nation leading the way in medical innovation and breakthrough...
and other UH corporate staff. This includes but not limited to Revenue Cycle, Clinical Supervisors, Clinical Managers, Centers... to: ◦ Inventory/ Shrinkage ◦ Billing/ AR/ Denials ◦ Physician usage ◦ Expenses/AP/ Purchasing/ * Salary and budget management...
Job Description: Summary: Under the supervision of a Clinical Social Work Manager, or the designated Social Worker... for hospitalization. Works closely with treating physician to address insurance denials and participates in denial process...
any resource limitations that could impact the plan Educates providers and clinical staff on the resources available for a safe... complex case reviews, and care conferences Coordinate with home care coordinator and social worker any discharge planning...
replacement, emergency/trauma care, comprehensive cancer care, wound care and clinical trials and research. Take advantage... and to assist in prevention of denials. Advises Provider and patient if authorization is denied. The Specialist works with patients...
. Consistently follow-up and update authorization/certification information on an ongoing basis. Track denials and appeals, document... them on a consistent basis, and then refer to the denial management coordinator as indicated. Functions as the central...
successful candidate The Assistant Site Director has overall responsibility to plan organize and direct the clinical and operational... including co pay collection insurance verification authorization and referral management and front-end denials * In conjunction...
/31/2025 Type of Position: Clinical Staff - Medical Services Job Type: Regular Work Shift: Sponsorship... (UAMS) has a unique combination of education, research, and clinical programs that encourages and supports teamwork...
and commercial payors. Responsibilities: Assist various departments in ensuring all denials are captured & appealed in a timely... manner. Coordinating appeal discussions with clinical & third party payors. Develop, Implement and coordinate billing...
some of the best clinical talent in the nation leading the way in medical innovation and breakthrough research with Northwestern... resolution of all claim edits, reporting of candidates for bill, outbound compliant claim submission, clinical documentation...
Utilization Review Nurse will also be responsible for issuing pre-authorization approvals/denials, notifying providers/enrollees... of denials verbally and in writing. They will also coordinate pending cases for a review determination with Health Solutions...
with Physicians and clinical staff to obtain prior authorizations for treatments, procedures and medications. Ensures accurate... Coordinator for clarification. Audits for correct billing/documentation by: May audit billing for correct documentation...