; LNA or other clinical license preferred. POSITION PHYSICAL REQUIREMENTS Anything listed here requires a pre... and deliverables. Areas of responsibility include claim denials, ABNs, authorization issues and subsequent medical necessity...
Job Objective: A brief overview of the position. Establishes and monitors clinical documentation and coding... o Required: Three (3) years of coding and clinical documentation review experience with one (1) year of experience collaborating...
in quality health and medical services. Trinity Health Livonia has received numerous awards recognizing excellence in clinical...-authorization needs. Working all denials in a timely manner to maximize reimbursement. Responsible for tracking patient charges...
documentation required for the patient's clinical care as well as the financial clearance. Ensures accurate patient admission.../registration. Works closely with both the financial team and the clinical team to ensure the optimum patient experience, accurate...
and tracks payer responses / requests of completed clinical reviews, including; approvals, appeals and denials and communicates..., and denials / appeals tracking. This position serves as a liaison between the Case Management department, payers, post-acute...
management follow up. Attends clinical in-services or required operational/clinical training sessions. * Act as a resource... and accurately follows Health Plan and/or Medicare Guidelines when issuing denials. Ensures that all denials for medical necessity...
-site locations as necessary. Gathers necessary clinical information and processes referrals, pre-certification, pre... and denials. Responds in a timely manner to last minute/emergency referrals or additional codes performed during a procedure...
-site locations as necessary. Gathers necessary clinical information and processes referrals, pre-certification, pre... and denials. Responds in a timely manner to last minute/emergency referrals or additional codes performed during a procedure...
team to achieve optimal quality, clinical and resource outcomes. Works to provide a comprehensive range of services... or clinical care associated with and in accordance with standards of excellence established by Riverside Health system...
a leadership role with the interdisciplinary team to achieve optimal quality, clinical and resource outcomes. Works to provide... a comprehensive range of services or clinical care associated with and in accordance with standards of excellence established...
denials and/or benefit exclusions when needed. 8. Provides specialty medication inventory management including maintaining..., Clinical Pharmacist Specialists and pharmacists to facilitate the process of obtaining prior authorization from third party...
with the peer-to-peer coordination, and denials / appeals tracking. This position serves as a liaison between the Case... department staff regarding clinical insurance review completion and/or issues. Forwards the necessary patient clinical...
of improvement identified through utilization review, clinical records audit, claim denials, member satisfaction surveys...
with the peer-to-peer coordination, and denials / appeals tracking. This position serves as a liaison between the Case... department staff regarding clinical insurance review completion and/or issues. Forwards the necessary patient clinical...
, staff, physicians, and other departments. Assists with the denials process with focus on clinical reviews, peer-to peer..., resources, services, clinical standards, and outcomes is preferred. Is proactive, with the team, to achieve desired clinical...
in a timely manner of pending authorizations or denials when verifying insurance. Sends a copy of the daily final procedure... to schedule cases outside of approved schedule BLOCK TIMES. Indicates on the schedule and communicates with clinical staff when...
Collaboration with clinical staff regarding challenging patient needs Basic understanding of complete revenue cycle Knowledge... with clinical departments, providers, referral sources, insurance companies, and authorization staff. Accurately obtains insurance...
organizations, external reviewers, and other payers. Assures that good customer service practices are utilized. Maintains denials... or Bachelor Degree in Nursing or Social Work preferred. Experience:Two (2) years direct clinical experience in a psychiatric...
organizations, external reviewers, and other payers. Assures that good customer service practices are utilized. Maintains denials... or Bachelor Degree in Nursing or Social Work preferred. Experience:Two (2) years direct clinical experience in a psychiatric...
Sciences (UAMS) has a unique combination of education, research, and clinical programs that encourages and supports teamwork... Coordinator and to the U.S. Department of Education Office for Civil Rights. Persons must have proof of legal authority to work...