- Premera Blue Cross (Mountlake Terrace, WA)
- …serve through our Healthsource blog: https://healthsource.premera.com/ . The ** Care Coordinator ** - ** Clinical Appeals ** performs prospective review ... Care Services and Claims to ensure appropriate cost-effective care by applying their clinical knowledge and critical thinking skills to assess the medical… more
- BroadPath Healthcare Solutions (Tucson, AZ)
- …seeking a highly motivated and results-driven **UM RN Appeals Coordinator .** This role collaborates with clinical review staff, medical directors/physician ... reviewers, network physicians, and network facilities to ensure consistent clinical evaluation and processing of medical necessity appeals . Accurate… more
- Jobleads-US (Chicago, IL)
- …for appropriate tests or procedures and facilitates the process with managed care and the clinical team. Documents all information and authorization ... these plans; Works closely with the staff on managed care and referral related issues; communicates findings to patients....findings to patients. Coordinates the pre-certification process with the clinical staff as it relates to procedures in the… more
- Catholic Health Services (Melville, NY)
- …Long Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Coordinator will perform activities to help facilitate utilization ... payors. + Serves as a liaison between patient account services, physicians, care coordinators, Utilization and Appeals Managers, physician advisors and facility… more
- CVS Health (Harrisburg, PA)
- …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... issues and may require coordination of responses from multiple business units. Appeals are typically more complex and may require outreach and deviation from… more
- Nuvance Health (Danbury, CT)
- …5-9pm- Rotate Weekends/Evenings* *Summary:* Provides high quality administrative support to Clinical Denial Prevention & Appeals Specialist RNs, Physician ... to inquiries and facilitates communications with the System Business Office related to appeals , denial and clinical reviews 9. Reviews new denials and appeal… more
- CommonSpirit Health (Englewood, CO)
- …We are seeking a highly skilled individual to develop and submit clinical appeals , expertly crafting physician-aligned letters based on federal and ... regulations, including CMS rules and the Two-Midnight Rule, while leveraging clinical criteria and prioritizing medical necessity to defend inpatient status. This… more
- Select Medical (Dallas, TX)
- …joint venture with Select Medical & Baylor Scott & White Health Dallas, TX ** Clinical Intake Coordinator / Clinical Liaison (RN strongly preferred)** ... Disabled/Veterans_ Apply for this job (https://jobs-selectmedicalcorp.icims.com/jobs/342545/ clinical -intake- coordinator neurotransitional-center-%28-rn-strongly-preferred-%29/job?mode=apply&apply=yes&in\_iframe=1&hashed=1374627814) Share… more
- Touro University (Hawthorne, NY)
- Overview A professional and productive clinical educational coordinator (CEC) plays a significant role in the day-to-day administration of a successful medical ... also a central point of contact for faculty and administrators from affiliated clinical sites where students are assigned to clerkship and elective rotations. This… more
- Providence (Beaverton, OR)
- …retain the best people, we must empower them.** **Providence Health Plan is calling a Clinical Program Coordinator RN, Medicare / Medicaid who will:** + Provide ... Health Plan Partners and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here,… more
- Cedars-Sinai (Beverly Hills, CA)
- …fuels innovation. **A Little More About What You Will be Doing** The RN Care Coordinator is responsible for the case management of patient while hospitalized ... settings. In collaboration with the Inpatient Specialty Program (ISP) hospitalists, the RN Care Coordinator will assist patients from the time they are admitted… more
- State of Colorado (Denver, CO)
- Complaint Intake Coordinator Work Lead, Acute Care HFEMS - FAA00086 (Health Professional IV) Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5126436) Apply Complaint Intake Coordinator Work Lead, Acute Care HFEMS - FAA00086 (Health… more
- State of Colorado (Denver, CO)
- Chronic Disease Sustainability and Policy Coordinator - Term Limited Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5108358) Apply Chronic ... Disease Sustainability and Policy Coordinator - Term Limited Salary $72,000.00 - $77,688.00 Annually...of disease, supporting health-related social needs, and growing health care access across Colorado through all of our programs… more
- Guthrie (Binghamton, NY)
- …for those that qualify Monday through Friday 8:00am-4:30pm Position Summary: The LPN Care Coordinator will assist the providers with medication refills, patient ... of coverage of ordered medications. + Coordinate and complete appeals for denials as needed + Monitor and Review... while they are not in the office LPN Clinical Care + Dressing changes, injections, rooming… more
- Guthrie (Corning, NY)
- Position Summary: The LPN Care Coordinator will assist the providers with medication refills, patient messages, in basket monitoring, overdue results, referrals, ... of coverage of ordered medications. * *Coordinate and complete appeals for denials as needed * *Monitor and Review... while they are not in the office LPN Clinical Care * *Dressing changes, injections, rooming… more
- Clark County, NV (Las Vegas, NV)
- …Court is seeking qualified candidates to apply for the Specialty Courts Coordinator position. This position provides clinical case management duties associated ... SPECIALTY COURTS COORDINATOR Print (https://www.governmentjobs.com/careers/clarkcounty/jobs/newprint/5110323) Apply SPECIALTY COURTS COORDINATOR Salary $32.77… more
- HCA Healthcare (Manchester, NH)
- …for benefits may vary by location._ Come join our team as a Medical Staff Services Coordinator . We care for our community! Just last year, HCA Healthcare and our ... to caring for patients with purpose and integrity. We care like family! Jump-start your career as a Medical...family! Jump-start your career as a Medical Staff Services Coordinator today with Catholic Medical Center. **Benefits** Catholic Medical… more
- Insight Global (Nottingham, MD)
- Job Description Day to Day: Insight Global is looking for a Denial Coordinator to support a large hospital system in the Maryland/DC area. This person will be ... overseeing and managing the insurance denial and appeals process to minimize financial risk and improve reimbursement outcomes. Primary Responsibilities: *… more
- Corewell Health (Royal Oak, MI)
- …criteria, when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff, physicians, and payers to obtain authorization ... About the Department Coordinates the care for groups of patients as it relates...Level II pediatric trauma designations. The advanced capabilities and clinical expertise within this center have earned it Magnet… more
- Sacramento County (Sacramento, CA)
- Treatment Center Program Coordinator *Revised Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/1180508) Apply Treatment Center Program ... Coordinator *Revised Salary $114,401.52 - $139,060.80 Annually Location Sacramento,...supervisory and administrative duties, including administration of direct acute care programs, related contracts, and County-operated mental health programs… more
