- Mindlance (Columbia, SC)
- Job Title: Managed Care Coordinator Job Location: Columbia, SC Top 3/5 Skills: . RN / Registered Nurse License . Chronic condition care . Case Management Job ... manager for resolution. Identifies and reports potential fraud and abuse situations. Managed Care Coordinator Job Requirements . Associate Degree - Nursing, OR,… more
- nTech Solutions, Inc. (Baltimore, MD)
- …two (2) Utilization Management Coordinators who can support the Utilization Management clinical teams by assisting with non- clinical administrative tasks and ... responsibilities related to pre-service, utilization review, care coordination and quality of care . The...Management Coordinators will receive cases from the Manager of Clinical Support on a daily basis, review the information… more
- Northeast Georgia Health System, Inc (Demorest, GA)
- …SummaryResponsible for accounts receivable collections and billing for Long Term Care facility. Provides statistics to NGHS Accounting staff. Responsible for ... Educational Requirements: Preferred Experience: Two (2) years experience in health care accounts receivables.Other: Job Specific and Unique Knowledge, Skills and… more
- A-Line Staffing Solutions (Woodland Hills, CA)
- …Managed Care , MCO, Benefit Verification, Clinical Care , Clinical Service, Clinical Coordinator , Mail Order Medications, Insurance Verification, ... Full time Grievance and Appeals Coordinator openings in Los Angeles CA 91367 area...research savvy Working knowledge of State and/or Federal health care programs preferred (Medicaid, Medicare). Pay: $20-22/hour Schedule: 40-Hours/Week… more
- Option Care Health (Santa Fe Springs, CA)
- …patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining ... no limit to the growth of your career. Option Care Health, Inc. is the largest independent home and...assistance program).Supports the ongoing activities needed to ensure clean claims on hold and denial management (follow-up on paperwork… more
- Option Care Health (Portland, OR)
- …patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining ... no limit to the growth of your career. Option Care Health, Inc. is the largest independent home and...assistance program).Supports the ongoing activities needed to ensure clean claims on hold and denial management (follow-up on paperwork… more
- Optum (Dallas, TX)
- …in a physician's office, clinical or hospital setting Knowledge of managed care , referral processes, claims and ICD-9 and CPT coding At UnitedHealth Group, ... clinical or hospital setting Cardiac, medical-surgical and/or critical care experience Experience related to patient education and/or motivational interviewing… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …trainer works closely with the NGPG Sports Medicine Providers to enhance the all around care given to the patients and clients of NGPG Sports Medicine as well as ... the Georgia Athletic Trainer Licensure Act. The certified athletic trainer performs clinical duties in accordance with population specific guidelines and adheres to… more
- LTCG (MN)
- …from the assessment using company formats, when appropriate. * Manages the clinical quality review for the completed assessments. * Act with independent judgement ... following client and company policies and procedures. * Complete telephonic and virtual interviews as need arises. * Always provides prompt, courteous and excellent customer service to internal and external customers. * Demonstrate effective communication… more
- LA Care Health Plan (Los Angeles, CA)
- Enhanced Care Management Coordinator II Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... required to achieve that purpose. Job Summary The Enhanced Care Management (ECM) Coordinator II provides a...and program operations for grievance and appeal requests. Provides non- clinical support to the Enhanced Care Management… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Care Management Coordinator Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... to achieve that purpose. Job Summary The Supervisor of Care Management Coordinator is responsible for direct...0-2 years of experience in a healthcare or managed care setting, case management, authorization processes and/or claims… more
- Healthfirst (NY)
- + Prepare cases for the clinical team by gathering documentation, loading evidence, and making calls to members and providers. + Perform administrative activities ... associated data entry and authorization creation in the True care system. + Correctly and completely preps completed case...+ Correctly and completely preps completed case files for clinical review. + Notifies team lead of identified patterns… more
- Sharp HealthCare (San Diego, CA)
- …level within SCMG TAT guidelines.Coordinates, reviews and processes more complex retrospective claims for medical care and services, including, SNF inpatient ... Will Do** To review more complex requests for medical care and services, if part of the discharge plan,...denial reason. Maintain mandated TAT for denials.Obtains and gathers clinical information from multiple sources including use of Sharp… more
- University of Utah Health (Salt Lake City, UT)
- …Health exists to enhance the health and well-being of people through patient care , research and education. Success in this mission requires a culture of ... are integral to our mission. EO/AA_ Under the oversight of a Licensed Clinical Social Worker (LCSW) this position provides psychological and social support to… more
- Kelsey-Seybold Clinic (Houston, TX)
- …Administrator, administrative supervisor and nurse supervisor, the Patient Care Coordinator performs both varied clerical and clinical roles to support ... legal, organizational and professional standards. Some duties may be delegated to the Patient Care coordinator by the physician or RN **Job Title: Patient … more
- Crossroads Hospice & Palliative Care (Green, OH)
- …what is sacred. Stewarding the end of life journey well requires an unwavering clinical skill set balanced by the art of compassion. We believe compassion should not ... you in any way, then we want to speak with you! Billing Coordinator Responsibilities: + Obtain referrals and pre-authorizations as required for procedures + Check… more
- Providence (Salem, OR)
- …best people, we must empower them._** **Providence Health Plan is calling an Associate Customer Care Coordinator , Medicaid who will:** + Serve as a member of a ... plan and clinic services + Research and respond to claims and authorization inquiries + Utilize knowledge of complex...posting is for multiple openings of an Associate Customer Care Coordinator , Medicaid + Work Schedule: Monday… more
- Bear Mountain Health Care (Springfield, MA)
- …the current/ upcoming UDA's by the Assessment Coordinators is paramount. Meetings Assessment Coordinator should to attend: o Morning clinical meeting o Medicare ... your skills and compassion as an MMQ Nurses/ Assessment Coordinator to come join our team! We have excellent...of professionalism our team exhibits every day in the care of our resident family. This is a full… more
- Bear Mountain Health Care (Lowell, MA)
- …Assessment Coordinator . Formerly known as the MMQ Nurse the Assessment Coordinator works directly with the clinical team to maximize facility reimbursement. ... for reimbursement. If we don't have it, we pay claims back for all payers. . OBRA UDA's to...5 day, and for significant change MDS's . Ensure care plans are present for all diagnoses for each… more
- Gentiva (Jacksonville, FL)
- …a lasting difference in people's lives every day. **Overview** We are looking for a ** Care Coordinator AIM** to join our team. This position will directly report ... leader in hospice, palliative, home health, and personal home care . Our place is by the side of those...and their family (if applicable). + Manage all daily clinical records functions including establishing and implementing clinical… more
