- Kaleida Health (Buffalo, NY)
- ** Director Clinical and DRG Denials ** **Location:** Larkin Bldg @ Exchange Street Location of Job: US:NY:Buffalo Work Type: Full-Time **Shift:** Shift 1 ... Job Description **Summary:** The Director , Clinical & DRG Denials provides clinical leadership and administrative guidance to the Clinical … more
- Community Health Systems (Franklin, TN)
- **Job Summary** The DRG Denials Auditor conducts hospital inpatient DRG denial audits for both RAC and non-RAC accounts, reviewing patient records for ... accuracy in ICD-10-CM/PCS coding, DRG assignments, and supporting clinical documentation. This...denial and appeal status. + Consults with Coordinator and/or Director , Coding Denials and Appeals during any… more
- HCA Healthcare (Nashville, TN)
- …our Medical Director role today!** **Job Summary and Qualifications** The Medical Director serves as a clinical resource and consultant to hospitals by ... providing identification, facilitation, and resolution of denials . The Medical Director will be responsible for timely completion of assigned peer to peers and… more
- Covenant Health Inc. (Knoxville, TN)
- …Working directly with the physicians, Manager of Corporate Coding Services, Director of Registration/Admitting, and medical staff education efforts, serves as the ... user advocate between Health Information Management (HIM), Clinical Effectiveness, and Registration. Other job duties include: improving health record documentation… more
- CommonSpirit Health (Englewood, CO)
- …by Utilization Management or Managed Care: Works with the Care Management Director and staff to facilitate client profiles, clinical service utilization ... We are seeking a highly skilled individual to develop and submit clinical appeals, expertly crafting physician-aligned letters based on federal and state… more
- AdventHealth (Tampa, FL)
- …Research Institute, also located at AdventHealth Tampa, leads the way in clinical and academic research in the areas of neuroscience, cardiovascular medicine, ... and other diseases. **The ro** **le you'll contribute:** Oversees site-based Clinical Documentation Integrity (CDI) program; monitors and maintains the timeliness of… more
- AdventHealth (Orlando, FL)
- …Assist in billing for technical component of services and appeals for denials . Provides guidance to clinical questions from Utilization Management staff ... work life balance **PRINCIPAL DUTIES AND JOB RESPONSIBILITIES** **:** Provides clinical support/validation for Care Management, CDI and Quality teams. Provides… more
- HonorHealth (AZ)
- …Works with Director , Management and staff to facilitate client profiles, clinical service utilization and profitable revenue management. + Serves as a consultant ... care services, a cancer care network, outpatient surgery centers, clinical research, medical education, a foundation, an accountable care...severity, acuity and risk of mortality, in addition to DRG assignment. The PA will act as a liaison… more
- AdventHealth (Orlando, FL)
- …and regulatory agencies. It also serves as subject matter expert, providing clinical expertise and business direction in support of medical management programs, ... the other medical directors. Advise and educate Utilization Management staff regarding clinical issues. Acts as liaison for and with attending physicians to arrive… more
- Carle Health (Urbana, IL)
- …correspondence related to medical record documentation and coding. + Reviews all DRG changes/ denials and prepares letters of correspondence/appeal when needed. + ... manager is responsible for yearly cost center budgeting and advises the HIM Director in the area of coding, coding education, coding software, coding staffing and… more
- Ventura County (Ventura, CA)
- …the Health Information Management (HIM) department related to coding and CDI ( clinical documentation improvement). The ideal candidate will have a Bachelor's Degree ... rate, compliance rate with quality standards and HCAI requirements; + Reviews insurance denials and submit appeals as necessary, provide education to coders based on… more
- Novant Health (Charlotte, NC)
- …and oversight of all aspects of Health Information Management (HIM), coding, clinical documentation, and revenue integrity across the enterprise. This role involves ... overseeing strategic planning, leadership, and operations support for clinical work such as utilization review, coding, clinical documentation improvement,… more
- AdventHealth (Hinsdale, IL)
- …ensures efficient and cost-effective care through appropriate resources monitoring and clinical care escalations. The Social Worker is under the general supervision ... and communicates these goals and preferences to the multidisciplinary team. Incorporate clinical , social and financial factors into the transition of care plan.… more
- AdventHealth (Bolingbrook, IL)
- …ensures efficient and cost-effective care through appropriate resources monitoring and clinical care escalations. The Social Worker is under the general supervision ... and communicates these goals and preferences to the multidisciplinary team. . Incorporate clinical , social and financial factors into the transition of care plan. .… more
- Billings Clinic (Billings, MT)
- …service for pharmacy items and supplies. Queries physicians to clarify clinical documentation. Educates physicians either concurrently or after-the-fact on coding ... an on-site resource for providers and staff. Calculates the MSDRG and APR- DRG . Ensures adherence to all Billings Clinic and regulatory compliance policies and… more
- Community Health Systems (Franklin, TN)
- …to relevant departments. The PCCM Analyst collaborates with financial and clinical teams to improve revenue cycle processes and optimize payer relationships. ... + Analyzes contract reimbursement, identifying variances, trends in underpayments/overpayments, denials , and revenue leakage to support maximization of reimbursement.… more
- AdventHealth (Orlando, FL)
- …and Degrees without out-of-pocket tuition expense) *For eligible positions* + Nursing Clinical Ladder Program *For eligible positions* + Whole Person Well-being and ... Manager ensures efficient and cost-effective care through appropriate resources monitoring, and clinical care escalations. The RN Care Manager is under the general… more