- Locations: Florida, Hawaii, Alabama, Illinois, Massachusetts
- Related Keywords: Clinical, Clinical Supervisor, Denial, Supervisor
- Supervisor , Specialty Case Review
- CVS Caremark (Northbrook, IL)
- ...experience in acute care, ambulatory care or home care clinical setting. Previous experience in nursing or pharmacy education or...and procedures to health plan/employer specifics, and review of denial management processes. - Documentation and validation of client specific...
- Utlization Review Supervisor
- AvMed Health Plans (Fort Lauderdale, FL)
- ...Summary: To support the Management of Utilization Management to achieve clinical and service driven objectives by assisting in coordination of care...department to reflect UM Compliance on UM issues and the denial process. Provide coverage for UM nursing staff and Management as...
- Denial & Client Outreach Supervisor
- University of California - San Francisco (San Francisco, CA)
- Req Number 30562BR Job Title Denial & Client Outreach Supervisor Job Code and Payroll Title 7247 :...The primary role has responsibility for analyzing, reporting and communicating to hospital clinical departments all billing, payment and denial issues received and...
- Supervisor , Specialty Case Review
- CVS Caremark (Northbrook, IL)
- Requisition ID 21595BR Title Supervisor , Specialty Case Review Job Category Management Employment Status Full Time Location/State/City...3-5 years experience in acute care, ambulatory care or home care clinical setting. Previous experience in nursing or pharmacy education or program...
- Supervisor of Specialty Case Review
- CVS Caremark (Northbrook, IL)
- ...experience in acute care, ambulatory care or home care clinical setting. Previous experience in nursing or pharmacy education or...and procedures to health plan/employer specifics, and review of denial management processes. - Documentation and validation of client specific...
- Supervisor , Care Specialist
- Molina Healthcare Inc. (Columbus, OH)
- ...Northern and Southern California. The company's corporate headquarters are in Long Beach, California. The Supervisor Care Specialist will be responsible for the direction of non- clinical staff. Supervise all functions of Correspondence Team letter generation; responsible for but not...
- Utlization Review Supervisor
- AvMed Health Plans (Fort Lauderdale, FL)
- ...Summary: To support the Management of Utilization Management to achieve clinical and service driven objectives by assisting in coordination of care...department to reflect UM Compliance on UM issues and the denial process. Provide coverage for UM nursing staff and Management as...
- Utilization Management Supervisor
- AvMed Health Plans (Miami, FL)
- ...of Utilization Management, Medical Directors', and UM staff in achieving clinical and service driven objectives by assisting in coordination of...department to reflect UM Compliance on UM issues and the denial process. Provide coverage for UM Manager as needed. Coordinate...
- Patient Access Associate - The Grove ( Irvine, CA )
- DaVita (Irvine, CA)
- ...and DeNovos * Participate in regularly scheduled meetings with supervisor / manager to discuss key success metrics regarding...Operations, Insurance Management, and other teams to conduct effective denial review sessions and support monthly leadership reporting. Collects,...
- Nurse Reviewer
- Hawaii Medical Service Association (Honolulu, HI)
- ...and review of the medical records and pre-authorization requests, applies clinical expertise, established review criteria and knowledge of standard practice...and pharmaceutical management is unclear, 2) there is a potential denial of services, or 3) a potential of reducing the...
- Collector - FSU HME/Infusion (Contract)
- Gentiva (Scottsdale, AZ)
- ...America. And Gentiva is leading that revolution with exceptional clinical care, innovative solutions and uncompromising service. Gentiva offers...but is not limited to, making collection calls, communicating denial problems, status coding their Account receivables and requesting...
- Physical Therapy- PT, PTA
- Aegis Therapies (Alexander City, AL)
- ...* Assistance with professional dues and licensure * Ongoing clinical support * Master Clinician program * Student affiliation sites...abreast of ever-changing regulatory issues, we assertively pursue the denial /appeal process, and we can indemnify our customers for therapy...
- Nurse Reviewer
- Hawaii Medical Service Association (Honolulu, HI)
- ...and review of the medical records and pre-authorization requests, applies clinical expertise, established review criteria and knowledge of standard practice...and pharmaceutical management is unclear, 2) there is a potential denial of services, or 3) a potential of reducing the...
- Operations Nurse
- AMERIGROUP Corporation (Tampa, FL)
- ...Review claims and/or appeals received in the Medical Claims Review/Appeals Specialty Units requiring assessment of medical records or clinical coding to ensure appropriate processing of the claim/appeal. Analyzes the claim/appeal submission, AMISYS/Facets, CAT database, and clinical...
