- Option Care Health (Honolulu, HI)
- …to hiring, developing, and retaining a diverse workforce. Job Description Summary:The Clinical Transition Specialist is an experienced sales professional who ... patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the… more
- Alameda Health System (San Leandro, CA)
- Care Management Clinical Appeals Specialist + San Leandro, CA + Finance + Patient Financial Svcs - Facil + Full Time - Day + Business Professional & IT + Req ... **SUMMARY:** Coordinates and executes the appeal process for all AHS facilities clinical appeals and third party audits. **DUTIES & ESSENTIAL JOB FUNCTIONS:** NOTE:… more
- Option Care Health (Honolulu, HI)
- …hiring, developing, and retaining a diverse workforce. **Job Description Summary:** The Clinical Transition Specialist is an experienced sales professional who ... patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the… more
- Guthrie (Binghamton, NY)
- …guidelines. 2. Demonstrates knowledge of CDMP guidelines and program, DRG payor issues, documentation opportunities, clinical documentation requirements, and ... Summary: Responsible for improving the overall quality and completeness of clinical documentation Facilitates modifications to clinical documentation through… more
- AdventHealth (Tavares, FL)
- … ensures efficient and cost-effective care through appropriate resources monitoring, and clinical care escalations. The Social Work Specialist is under the ... information and educates interdisciplinary team and patients/caregivers regarding payor requirements/barriers. . Maintains clinical competency and current… more
- Tufts Medicine (Boston, MA)
- …care for an assigned patient population by unit, across the continuum of care. The Case Manager works to achieve daily clinical , quality and cost outcomes by ... continued stay and information needed for discharge. 12. Responds to third party payor requests for concurrent clinical information in timely manner. 13. Ensures… more
- UNC Health Care (Chapel Hill, NC)
- …and well-being of the unique communities we serve. Summary: The RN Quality Assurance Specialist will oversee the clinical documentation of the direct care ... self study and in-service attendance. Maintains awareness of current payor provider agreements in order to complete 485 and...interprets patient data as needed to provide guidance to Case Managers on patient needs relative to his/her age… more
- TEKsystems (Plano, TX)
- …issues on accounts. Including but, not limited to Managed Care, Reimbursement, Clinical , Admissions, Facility Business Office Manager, Coding, Case Management, ... for A/R, and mail follow-up on amounts due from Payor 's, and third-party's on a timely basis in accordance...is not a patient collections position) * Respond to payor 's by phone, or correspondence concerning underpaid, or non-paid… more
- AdventHealth (Orlando, FL)
- …The Population Health Care Manager PT (PHCM) ensures effective utilization and case management oversight activities as defined by inter professional best practices, ... utilization using evidence-based and best practice guidelines to achieve positive clinical outcomes and efficient use of resources. Identifies and collaborates with… more
- Catholic Health Services (Smithtown, NY)
- …why Catholic Health was named Long Island's Top Workplace! Job Details The Clinical Documentation Improvement Specialist is responsible for improving the overall ... service rendered to all patients. Demonstrates knowledge of DRG payor issues, clinical documentation requirements and referral...tools , with knowledge of CDI impact on the case . Proficient in accurately entering queries and MD/MLP responses… more
- Universal Health Services (Groton, CT)
- …care internally or transitions to other internal programs. + Collaborate with clinicians/ case managers to obtain pertinent clinical and discharge information. + ... or written appeals when necessary. + Liaison between insurance and clinical staff, providing information to clinicians/ case managers regarding dispositions… more
- LifePoint Health (Denver, CO)
- …When necessary, call to obtain results; note any missed diagnostic tests or specialist referrals * Review available insurance payor reports to identify gaps ... your next opportunity. We are currently searching for a Remote Patient Care Specialist . The Remote Patient Care Specialist works to enhance patient satisfaction… more
- UCHealth (Loveland, CO)
- Description Patient Access Specialist Sr position with UCHealth Medical Group in primary care and specialty care clinics in Loveland. Full-time positions, several ... and performs related clerical functions. Work collaboratively with the front desk and clinical teams to support patient care in the department's phone room. Work… more
- Tufts Medicine (Lawrence, MA)
- …and financial-clearance duties necessary to facilitate the procurement of clinical services by patients. Collects patient's necessary demographic and financial ... or a role that focuses on support of daily business activities (eg, technical, clinical , non- clinical ) operating in a "hands on" environment. The majority of… more
- Bassett Healthcare (Cooperstown, NY)
- …knowledge and skills necessary to provide care appropriate to each patient. Clinical and Technical Responsibilities: Provides case management services as ... patient to receive IM letter; collaborates with UM Nurse as needed. Assists Clinical Documentation Specialist in engaging physician to respond to queries… more
- AdventHealth (Orlando, FL)
- …performs other duties as required. Maintains a close working relationship with clinical partners to ensure continual open communication between clinical , ... and/or units of medication + Maintain close working relationship with clinical partners and physician offices to resolve issues with obtaining pre-authorizations.… more
- Sutter Health (Sacramento, CA)
- **Organization:** SMCS-Valley Administration **Position Overview:** Reviews confidential clinical information and provides personalized referrals to individuals or ... specialty services from a contracted medical group, hospital, or third-party payor . Facilitates referrals to appropriate Sutter facility, program or affiliated and… more
- University of Colorado (Denver, CO)
- …Health Provider / Instructor Series (Open Rank) in the Non-Tenure Clinical Practice Track** **University of Colorado Denver** **Description** **University of ... / Instructor / Senior Instructor (Open Rank) in the Non-Tenure Clinical Practice Track** **Position Location: Sheridan Health Services (Southwest Denver)** **3525… more
- AdventHealth (Shawnee, KS)
- … information and educates interdisciplinary team and patients/caregivers regarding payor requirements/barriers. + Maintains clinical competency and current ... **Inpatient Social Worker Case Manager FT Days - AdventHealth Shawnee Mission**...efficient and cost-effective care through appropriate resources monitoring and clinical care escalations. The Social Worker is under the… more
- AdventHealth (Hinsdale, IL)
- … information and educates interdisciplinary team and patients/caregivers regarding payor requirements/barriers. . Maintains clinical competency and current ... Manager ensures efficient and cost-effective care through appropriate resources monitoring, and clinical care escalations. The RN Care Manager is under the general… more
