- Southeast Georgia Health System (Brunswick, GA)
- …and are the key to our culture of Service Excellence. As a Resource Management Coordinator , you will conduct medical record reviews of all denied inpatient ... in a timely manner. Demonstrates proficiency in preparation and follow-up of denial appeals. Maintains denial spreadsheet report-keeps it current & accurate… more
- UCLA Health (Los Angeles, CA)
- …for accuracy, confirming the receipt of necessary documentation to support the denial and ensuring compliance with all contractual obligations and state and federal ... laws/regulations. You will extrapolate and summarize essential information for the UM Manager and Medical Director and regularly meet with them for clinical guidance in resolving cases. You will also document appeals in the tracking system and maintain… more
- Hackensack Meridian Health (Hackensack, NJ)
- …healthcare and serve as a leader of positive change. The Case Management Care Coordinator , Utilization Management is a member of the healthcare team and ... of the patient's treatment. Accountable for a designated patient caseload; the Care Coordinator , Utilization Management plans effectively in order to manage… more
- Hackensack Meridian Health (Perth Amboy, NJ)
- …healthcare and serve as a leader of positive change. The Care Management , Care Coordinator , Utilization Management is a member of the healthcare team and ... of the patient's treatment. Accountable for a designated patient caseload; the Care Coordinator , Utilization Management plans effectively in order to manage… more
- Hackensack Meridian Health (Edison, NJ)
- **Overview** The Care Management , Care Coordinator , Utilization Management is a member of the healthcare team and is responsible for coordinating, ... of the patient?s treatment. Accountable for a designated patient caseload; the Care Coordinator , Utilization Management plans effectively in order to manage… more
- Universal Health Services (Doylestown, PA)
- …is a Monday-Friday full-time position offering full-time benefits and competitive pay. The Utilization Management Coordinator is responsible for all ... of medical necessity and timely discharge planning. + Maintains data on utilization management activities and generates required reports, logs, and files… more
- UCLA Health (Los Angeles, CA)
- …Under the direction and supervision of the RN Assistant Director, the Case Management Coordinator is responsible for patient high risk care coordination ... the next level of reviewer in review, and health plan contracts. The Case Management Coordinator will also be responsible for: * Preparation and maintenance of… more
- Universal Health Services (Chicago, IL)
- …continued treatment based on payer's criteria and in accordance with the hospital wide Utilization Management Plan. Serves as liaison to 3rd and 4th party ... physician reviews with payers as required. Maintains all records/data pertaining to the Utilization Management Program. Actively participates in Utilization … more
- Universal Health Services (Chicago, IL)
- …Responsible for all denial and appeal activities for the Utilization Management department, including Expedited Appeals, Standard Appeals, External ... to resolve issues related to appeals. Maintains all records/data pertaining to the Utilization Management Program. Actively participates in Utilization … more
- Baptist Memorial (Memphis, TN)
- …using evidence based criteria. Areas of work include payer notification, authorization management , denial management , escalations, and communication and ... Summary The Authorization Coordinator is responsible for facilitating information documentation and transmission vital to the effectiveness of utilization review… more
- Hackensack Meridian Health (Hackensack, NJ)
- …healthcare and serve as a leader of positive change. The Case Management Care Coordinator , Utilization Management is a member of the healthcare team and ... of the patient's treatment. Accountable for a designated patient caseload; the Care Coordinator , Utilization Management plans effectively in order to manage… more
- Rush University Medical Center (Chicago, IL)
- …managers, community providers, payers and internal/external agencies to provide case management support services related to effective utilization of services ... 1** **Work Schedule:** 8 Hr **Summary:** The Clinical resource coordinator (CRC) applies a collaborative approach in working with...denial appeals, and / or level of care management processes. * In accordance with the case … more
- Hartford HealthCare (Southington, CT)
- …of Connecticut's most comprehensive healthcare network as a Quality Improvement Coordinator . Hartford HealthCare at Home, the largest provider of homecare services ... corrected billing and chart reviews. **Document patient accounting system with all denial activity and actions taken. **Compile monthly denial reports.… more
- Hackensack Meridian Health (Manahawkin, NJ)
- …and post-acute services. **Responsibilities** A day in the life of a Care Coordinator , Utilization Management at Hackensack Meridian Health includes: + ... serve as a leader of positive change. The Care Coordinator , Care Management is a member of...skills + Familiar with hospital resources, community resources, and utilization management **Licenses and Certifications Required:** +… more
- Kepro (Richmond, VA)
- …+ 2+ years of experience in healthcare/managed care, preferably with experience in Utilization Management and/or Quality Management + Ability to review ... health solutions in the public sector. Acentra seeks a UM Reviewer & Appeals Coordinator RN/LCSW (Remote within Virginia) to join our growing team. Job Summary: This… more
- TEKsystems (Houston, TX)
- …of healthcare and/or health insurance + High-level customer service + QA + Utilization management + Appeals & Grievances Education/Experience: Requires a High ... Hiring For Grievance & Appeals Coordinator ! 100% REMOTE - Texas Note: Candidates from...- $20/hr and up Description: + Assist in monitoring utilization of medical services to assure cost effective use… more
- Houston Methodist (Houston, TX)
- …complex patients, receiving coaching from experienced Transplant Coordinators and management , benefiting from their practice. The Pre-Transplant Coordinator ... At Houston Methodist, the Pre-Transplant Coordinator position a registered nurse, responsible for participating in department initiatives, facilitating, and… more
- University of Michigan (Ann Arbor, MI)
- …**Job Detail** **Job Opening ID** 248438 **Working Title** Inpatient Coding and Appeals Coordinator - Remote **Job Title** Utilization Rev Appeals Spec **Work ... Inpatient Coding and Appeals Coordinator - Remote Apply Now **How to Apply**... plays a vital role in the revenue cycle management of Rev Cycle Mid-Service by maintaining the financial… more
- BrightSpring Health Services (Columbus, OH)
- …Payee to Client Trust Fund* Responsible for working with Client Trust Fund Coordinator at the Austin* Business Center to set up RFMS Account* Assure individuals ... to LON based on submitted/approved IDRCs* Reviews Quickbase for utilization issues requiring IPC revisions in the waiver. Ensures...billing is complete for upload into Quickbase. Sends monthly Denial Reports to operations for any billing denied by… more
- Covenant Health (Lubbock, TX)
- …will work collaboratively with the Social Workers (SW), RN Care Managers (RN-CM), Utilization Review RN's (UR-RN) and Payer Denial Specialists by performing ... representatives. Will work collaboratively with the inpatient and outpatient case management teams to provide evaluation and assessment of patient needs. Duties… more
