between $56,800.00 - $108,900.00/ based on experience The RN Clinical Appeals performs all appeals for clinically related claim denials across Ensemble... Health Partners. Role also may assist with analyzing and reviewing records to prevent future denials, provide clinical...
and feasibility of appeal. Consults with attending physician, physician advisor, and case managers to formulate secondary appeals... and written formal appeals using appropriate medical management tools for medical necessity determination ( MCG/Interqual/ CMS...
's most skilled and highly regarded multidisciplinary team of healthcare professionals. Summary Clinical Denials Coordinator... functions as needed. Clinical Denials Coordinators are also responsible for reviewing denied accounts, establishing trends...
Management, Medical Appeals & Grievances (MHK clinical solutions) as a subject matter expert to ensure the success of our clients...Job Description: The Business Consultant Clinical SME is responsible for supporting the implementation of new clients...
Clinical Transplant Coordinator, Miami Transplant Institute, Kidney Acquisition, Full Time, Days Jackson's Miami... consistently rank among the nation's best in terms of patient outcomes. Job Summary The Clinical Transplant Coordinator...
Clinical Transplant Coordinator, Heart Acquisition, Miami Transplant Institute (MTI), Per Diem, Days Jackson's Miami... among the nation's best in terms of patient outcomes. Job Summary The Clinical Transplant Coordinator is a professional...
Clinical Transplant Coordinator, Pediatrics Acquisitions, MTI, Full Time, Days Jackson's Miami Transplant Institute... among the nation's best in terms of patient outcomes. Position Summary: The Clinical Transplant Coordinator...
's most skilled and highly regarded multidisciplinary team of healthcare professionals. Summary Clinical Denials Coordinator... functions as needed. Clinical Denials Coordinators are also responsible for reviewing denied accounts, establishing trends...
Our Client, a Mutual Insurance Holding company, is looking for a Medical Review Nurse (RN) for their Remote location... and authorize, as appropriate, phone/fax referral/authorization and clinical form requests per established criteria meeting...
, and appropriate level of care. The Utilization Management RN leverages the algorithmic logic of the platform, utilizing key clinical...RN Utilization Management Nurse – Frontline Opportunity Greater Orlando, Florida The RN Utilization Management Nurse...
Job Description: JOB SUMMARY: The Behavioral Health Utilization Review Manager- RN at LifeStream oversees the... resources for behavioral health services. This team of three individuals is dedicated to reviewing clinical documentation...
. Responsible for all insurance authorizations, clinical communication, and denial and appeals. Tracking and reporting of data...Job Description: Summary Responsible for utilization review and discharge planning of all acute clinical areas...
The purpose of this position is to conduct initial, concurrent, retrospective chart review for clinical financial... with physicians. Identify opportunities for expedited appeals and collaborates to resolve payer issues. Ensures/Maintains effective...
. Retrieve clinical related messages and return calls within 48 hours. Manage and resolve UChart messages. Submit lab order... and procedures. Process appeals and peer to peer reviews. Assess barriers to care and refers to support services. Review outside...
requested by provider/pharmacy Notify provider of appeals/denials Arrange appeals/peer review for providers Patient phone... call Patient evaluation- Nursing (clinical) assessment of symptoms or clinical concern Secure message provider...
process and follow-up and managing clinical denials and appeals. Coordinates closely with the hospital's interdisciplinary.... Independent Practice Scope License in state of practice, LCSW, LMFT, LPC or BSN RN, Preferred. Minimum three years' experience...