- HonorHealth (AZ)
- …it does. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization of health care services ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
- Sharp HealthCare (San Diego, CA)
- …coverage through MCA for SRS/SCMG and MPV (or Portal) for potential Medicare or Medi-Cal.Use Coordination of Benefits (COB) standards to prioritize billing order ... of insurance plans. Medicare patients - Medicare Secondary Payer (MSP)...medical records and facilitate transfers from/to outside facilities.Create patient chart for physician and organize charts for the HIM… more
- Bassett Healthcare (Cooperstown, NY)
- …functions, and or provides orientation as requested by supervisors for new employees. Patient Flow/ Chart Review Performs chart review in preparation for ... arrival prior to patient appointment as measured by supervisory observation. Based on chart review , ensures all necessary equipment and supplies are available… more
- Fresenius Medical Center (Kennesaw, GA)
- …Coordinator, expectations established and controls set. + Nurse Manager, assuring proper chart documentation is established. + Physician, review of policies ... teams to assure proper direction is obtained. + Assuring compliance with Medicare /Medicaid requirements and regulations by: + Maintaining current knowledge on … more
- Penn Medicine (Philadelphia, PA)
- …PENN Chart to truthfully demonstrate current state discovered via chart review , discovery of qualities needing further provider clarification, abstraction ... Physician or designee requesting appropriate documentation + Ongoing concurrent chart review , identification of complications and co-morbidities, collaboration… more
- Mount Sinai Health System (New York, NY)
- …registered; Completes the central log assuring all fields are complete 5. Completes Medicare Payor Questionnaire for all Medicare patients 6. Collects visit fees ... Patient Registration log 8. Makes appropriate copies of complete chart and stores in dedicated locations 9. Disburses ... 16. Gives attending physician walk out charts for review twice daily **About Us** **Strength through Unity and… more
- St. Luke's University Health Network (Hamburg, PA)
- …education of network policy on Patient Identification including Mark for Merge, Chart Corrections, and Patient Look-Up. + Responsible for the patient registration ... related to registration. Can require contacting provider office, reviewing patient medical chart for diagnosis and medical necessity information. + Required to cross… more
- Walgreens (Deerfield, IL)
- **Job Description:** **Job Summary:** Responsible for managing the finances for the Medicare Part D Pharmacy contracts with PBMs and insurance companies. **Business ... earnings, annual budget, and annual 3YP process for the Medicare reimbursement area: one of the primary sources of...efficient and allows for more in depth analysis and review resulting in improved recommendations and solutions for the… more
- Trinity Health (Columbus, OH)
- …**Shift:** **Description:** **Why MediGold?** MediGold (https://medigold.com/) is a not-for-profit Medicare Advantage insurance plan serving seniors and other ... the operating systems and routes cases to appropriate clinical personnel for review . + Obtain confidential medical records from providers offices utilizing secure… more
- Trinity Health (Syracuse, NY)
- …standard, based on service line and charge type; including but not limited to: chart review , charge extraction, E&M level assignment and charge entry. Documents ... lines, advanced proficiencies in surgical or specialty coding practice. Reviews chart , including nursing notes, physician orders, progress notes, and surgical or… more
- Fresenius Medical Center (Queen Creek, AZ)
- …(supply inventory for order, Kt/V collection, bringing meds to clinic visit for review ) + Prepare initial patient chart for admission. Complies and maintains ... the designated clinical application in an accurate and timely manner. + Review treatment sheets for completeness, ensure nursing signatures are documented, and… more
- Fresenius Medical Center (Decatur, IL)
- …(supply inventory for order, Kt/V collection, bringing meds to clinic visit for review ) + Prepare initial patient chart for admission. Complies and maintains ... the designated clinical application in an accurate and timely manner. + Review treatment sheets for completeness, ensure nursing signatures are documented, and… more
- Trinity Health (Syracuse, NY)
- …based on service line and charge type; including but not limited to: chart review , charge extraction, E&M level assignment and charge entry.Documents lessons ... service lines, advanced proficiencies in surgical or specialty coding practice.Reviews chart , including nursing notes, physician orders, progress notes, and surgical… more
- CenterWell (San Antonio, TX)
- …medical care and quality for patients and monitors care using available data and chart reviews. + Assists in the coordination of patient services, including but not ... Leadership. + Meets with RMD about quality of care, review of outcome data, policy, procedure and records issues....required to be screened for TB **Preferred Qualifications:** + Medicare Provider Number + Minimum of two to five… more
- CenterWell (Fort Lauderdale, FL)
- …medical care and quality for patients and monitors care using available data and chart reviews. . Assists in the coordination of patient services, including but not ... Leadership. . Meets with RMD about quality of care, review of outcome data, policy, procedure and records issues....Medicine preferred . Active and unrestricted DEA license . Medicare Provider Number . Medicaid Provider Number . Minimum… more
- CareOregon (Portland, OR)
- …care costs and increase provider/care team satisfaction. Housecall Providers has saved Medicare millions of dollars, while providing better care to our patients, ... diseases. This trend will continue as roughly 10,000 baby boomers a day enter the Medicare system. If you receive an offer of employment for this position, it is… more
- University of Michigan (Ann Arbor, MI)
- …Clinical background or experience in medical coding, hospital billing, or utilization review preferred + Medical chart auditing experience preferred **Work ... Facility Patient Assessment Instrument (IRF-PAI) in accordance with Centers for Medicare and Medicaid Services. This individual utilizes specialty knowledge of IRF… more
- Option Care Health (Bozeman, MT)
- …is maintained by providing direct patient care 20-40% of the time. In a Medicare Certified Home Health agency, this position may also serve as the alternate ... + Acts as Administrator and/or Director of Nursing of the Home Health Agency for Medicare certified home health agencies in the absence of a director or Manager of… more
- Northwell Health (Staten Island, NY)
- …ambulance discharges. Notifies private ambulances of diversion status. + * Performs final chart review , incorporates loose sheets and ensures entire chart ... phone or Pocket Talker when necessary. + * Completes Medicare Secondary Payor questionnaire. + * Completes, reviews, updates...census log. Maintains 'Left After Triage Log' and 'Missing Chart Log'. + * Enters orders into the computer… more
- CenterLight Health System (NY)
- …appropriate. + Review and analyze monthly financial reports submitted by Medicare related to diagnostic data. + Present HCC/RAF performance results and findings ... sites around NYC) as well as other entities within the organization. + Review coding and billing process for operational enhancements. Responsible for reviewing and… more