- Northeast Georgia Health System, Inc (Gainesville, GA)
- …restricted duty for injured workers. Collaborates with employees, supervisors, care providers, claims processors, brokers, nurse case managers, and attorneys to ... Role:Job SummaryPrimarily responsible for the investigation and management of workers' compensation claims . Conducts a 1 to 3-point contact on the managed claims… more
- Providence (CA)
- …AK and or TX **Providence is seeking an Epic Applications Analyst - AP Claims , who will:** + Demonstrate full use and application of standard principles, theories, ... relevant stakeholders. + Participate in projects and assist project leaders, taking lead on smaller projects as needed. + Synthesizes data, information, and… more
- University of Michigan (Ann Arbor, MI)
- CLINICAL NURSE SPECIALIST (CNS)- University Hospital- Medical Short Stay & 6C Medicine Pulmonary Apply Now **Summary** The Clinical Nurse Specialist will be ... offers a competitive salary with excellent benefits! **Hourly range for Clinical Nurse Specialist $46.27-$69.89 / hour** The benefit package includes: + Excellent… more
- Universal Health Services (Richmond, VA)
- …https://uhs.com/ The Atlantic Region CBO is seeking a dynamic and talented Senior Nurse Auditor. The primary responsibility of the Senior Nurse Auditor is ... to third party payers to obtain reimbursement for denied claims . + Make decisions to downgrade inpatient claims...observation hours. + Assist in training with newly hired nurse auditors. + Provide support to team members with… more
- State of Nevada (NV)
- HEALTH CARE COORDINATOR 2 - NURSE APPROXIMATE ANNUAL SALARY - $60,635.52 to $90,180.72 PAY GRADE: 36 For more information on benefit and retirement programs, please ... to identify abuse and potential fraud and to ensure claims were paid properly by the fiscal agent. Explain...at this level may intermittently serve as the project lead of a case management team, function as coordinator… more
- Oshkosh Corporation (Ogden, UT)
- …JetAire(R), JetPower(R), AmpTekO, Jetway(R), and more.** As an Occupational Health Nurse , you will promote, protect, and help restore worker's physical and ... maintaining a safe and healthy work environment. You will manage all workers compensation claims to provide for timely resolution of each claim, return the worker to… more
- State of Nevada (NV)
- HEALTH CARE COORDINATOR 2 - NURSE APPROXIMATE ANNUAL SALARY - $60,635.52 to $90,180.72 PAY GRADE: 36 For more information on benefit and retirement programs, please ... to identify abuse and potential fraud and to ensure claims were paid properly by the fiscal agent. Explain...at this level may intermittently serve as the project lead of a case management team, function as coordinator… more
- Alight (New York, NY)
- …Psychiatry and Neurology (ABPN). + Minimum 5 years' experience in reviewing disability claims related to psychiatric conditions. + Maintains Applicable ... oversight and direction to Clinical Case Managers managing behavioral health short-term disability and work accommodation claims . This role includes business… more
- State of Minnesota (St. Paul, MN)
- **Working Title: Lead Restricted Recipient Senior Investigator** **Job Class: Human Services Program Consultant** **Agency: Human Services Dept** + **Job ID** : ... to:_ _._ _Running quarterly meetings for the URRP._ _._ _Support, develop, and lead URRP efforts._ _._ _Provide guidance, direction, and management to the URRP from… more
- SSM Health (WI)
- …Epic Health Systems + Or + Charge Router - Epic Health Systems + Or + Claims Graduate Program Certification - Epic Health Systems + Or + Clarita Data Model - ... MyChart Certification - Epic Health Systems + Or + Nurse Triage Certification - Epic Health Systems + Or...Epic Health Systems + Or + Resolute Hospital Billing Claims Administration Certification - Epic Health Systems + Or… more
- Alight (New York, NY)
- …[or Internal Medicine/Family Practice] + Minimum 5 years' experience in reviewing disability claims across both medical and psychiatric conditions. + Maintains ... analytics and metrics. **Responsibilities** + Serving as the Occupational Health Physician Lead for the Americas supporting the disability and leave management… more
- HCA Healthcare (Nashville, TN)
- …you want to join an organization that invests in you as a Clinical Appeals Team Lead ? At Parallon, you come first. HCA Healthcare has committed up to $300 million in ... Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans...We are looking for a dedicated Clinical Appeals Team Lead like you to be a part of our… more
- Trinity Health (Farmington Hills, MI)
- …resolves payment delays and/or variances resulting from rejected and/or denied claims and/or overpayments and underpayments with direction from the Supervisor ... potential liabilities are paid in a timely and accurate fashion. Resolves claims , conducts formal account reviews, identifies lost charge recovery, analyzes and… more
- Trinity Health (Farmington Hills, MI)
- …resolves payment delays and/or variances resulting from rejected and/or denied claims and/or overpayments and underpayments. Processes payments as appropriate in ... potential liabilities are paid in a timely and accurate fashion. Resolves claims , conducts formal account reviews, identifies lost charge recovery, and analyzes and… more
- State of Colorado (Denver, CO)
- …litigation of qui tam cases against national providers, including filing Medicaid False Claims actions against providers. + Lead litigation teams comprised of ... position offers an exciting opportunity to serve as a lead litigator and mentor, focusing on investigating and litigating...on investigating and litigating civil violations of Medicaid False Claims Acts at the state and federal levels, and… more
- City of New York (New York, NY)
- …The Division of Liens and Recovery Casualty Program places liens and assert claims against the personal injury lawsuit settlements of past or present recipients of ... Complex Medical Case Reviewer, who will: - Conduct medical reviews and analyses claims to calculate injury related Medicaid liens pursuant to SSL-104b on cases… more
- University of Virginia (Charlottesville, VA)
- …therapists, and physician and advanced practice leadership * The ability to professionally lead other members of the care team in a dynamic environment * ... review activities as requested. * Prepares and attends to all reports, claims , and correspondence necessary or appropriate to the performance of professional… more
- University of Virginia (Charlottesville, VA)
- …therapists, and physician and advanced practice leadership * The ability to professionally lead other members of the care team in a dynamic environment * ... review activities as requested. * Prepares and attends to all reports, claims , and correspondence necessary or appropriate to the performance of professional… more
- Sutter Health (Santa Rosa, CA)
- …regulations and guidelines. Has frequent contact with the Administrative Team, Nurse Executives and Directors, Risk Management & Ethics staff, Ancillary Services, ... requested, via reports, meetings and presentations. * Works with staff in Patient Access, claims and billing departments to resolve complex claims and follows to… more
- AdventHealth (Orlando, FL)
- …or their designee will systematically investigate all clinical incidents/accidents/events that could lead to patient harm and/or financial loss and ensures all risk ... The CRM identifies potential compensatory events and works collaboratively with claims management coordinators to mitigate litigation. The CRM is responsible for… more
