AR Clinical Denials Director

Senior Leader for Clinical Services Operations Add expected salary to your profile for insights At least five years of supervisory/managerial experience working in Clinical services, such as Clinical Authorization, Utilization Management/Review, and Clinical Denials & Appeals. Prior experience Management experience with Clinical Documentation Integrity (CDI)...

Medical Administration (Healthcare & Medical) The individual in this position works under direction of Case Manager/UR RN or Social Worker with a primary role of supporting the daily operations of the UR team through the completion of various administrative duties. The individual's responsibilities include but are not limited to:Index, process, and document...

Roles and Responsibilities: PH Nurses to review treatment authorization request based on state guidelines and medical necessity and take decision to approve/deny. In case of denial send this to independent panel review to support the decision. Nurses will work with Claims adjuster on denial decision based on risk tolerance to ensure the denial doesn't...

Summary:The Clinical Review Nurse position assesses the medical appropriateness of proposed treatments and medications for our injured employees, and partners with the Client Claims Adjuster team to expedite medically necessary treatment for each claim. Maintains a solid understanding of Client's mission, vision, and values. Upholds the standards of the...

With Ingram Micro, the world will realize the promise of technologyTM. Ingram Micro is a Fortune 500 company and the global leader in technology and supply chain services with nearly $50 billion in revenues, over 200,000 customers and 1,700+ vendors, with operations in 64 countries supported by over 33,000 associates across 6 out of the 7 countries...

US RN certification – Mandatory.With five years of experience in utilization management review or 3 years clinical appeals and denials handling for healthcare insurance/ UMRSalary range – 30-50KExperience range - 5+ yearsShifts – flexibleOnsite in Taguig

Clinical Training Specialist | BPO Healthcare | Competitive Salary | Day-1 HMOAccess Healthcare is looking for an experienced Training Specialist for our Clinical accounts. Facilitates virtual and in-person new hire, upskill, recursive, skill enhancement, knowledge update and compliance training sessionsFacilitates and attends train the trainer sessions, as...

Cash Application Specialist | US Healthcare & EOB for Medical Billing exp IQ BackOffice Inc. (formerly HRMall Inc.) Bookkeeping & Small Practice Accounting (Accounting) Full time Add expected salary to your profile for insights Is responsible for the of daily task of posting cash and adjustments through ERA processing or manual posting in the various...

Job Purpose:Ensure that project related quality processes are followed by associates, client specific metrics and internal metrics are achieved, provide coaching to employees, track and trend data for improvementPrimary Duties and Responsibilities:We are currently looking for a keen individual who is responsible for conducting audits for healthcare...

Roles and Responsibilities Performs AR follow-up on assigned accounts taking into account Timely Filing Limits set by the payer.Submits adjustments or write-off requests for approval to resolve outstanding account balances.Submits medical record packets for submission to the payer for claims reprocessing, reconsideration or appeal requests.Receives inbound...

Job Description:1. Performs administrative functions for the Medical Director, Chief of Medical Services, and Chief of clinics.2. Organize and compile the credentials of ROD and Junior Consultants3. Prepare monthly reports of different departments4. Maintaining records and up-to-date documents of medical consultants5. Attend to concerns and complaints of...

Job DescriptionAt Thermo Fisher Scientific, you'll discover meaningful work that makes a positive impact on a global scale. Join our colleagues in bringing our Mission to life - enabling our customers to make the world healthier, cleaner and safer. We provide our teams with the resources needed to achieve individual career goals while taking science a step...

Manages activities of a department including, but not limited to, planning, problem solving, staff development, and communicationResponsible for client/onshore team partnership and reporting on medical record projects, status updates, and feedback on abstraction results Manages and monitors projects to ensure goal attainment within defined parameters...

Manage activities of a department including, but not limited to, planning, problem solving, staff development, and communication related to accounts assigned and project managementManage relationship with clientReview and analysis of periodic reports and metricsExecutes function/area objectives that support continuous improvement and Evaluation of...

Responsibilities· Provides strategic leadership and technical, operational, financial, and managerial leadership for successful implementation of project activities.· Ensures that the program is technically sound, evidence-based, and consistent with funder and stakeholders' priorities.· Provides oversight of program implementation including all...

Primary Duties and Responsibilities: Ensure that training and assessments happen as per statutory requirements. Give feedback and coach trainees on key job capabilities. Update and develop content as per client and business requirements. Ensure that all relevant information is updated on to the MIS trackers regularly. Conduct regular TNA / TNI to ensure that...

The Senior Director, Business Transformation will implement innovative solutions such as AI/ML tech-led solutions to solve complex problems facing today and tomorrow. As the Senior Director, you will be responsible for managing cross-functional teams to deliver projects within aggressive timelines while ensuring quality and compliance with regulatory...

Roles and Responsibilities: PH Registered nurses to review workers compensation claims with serious injury and that need surgery/lengthy treatments, create a return-to-work plan, work with various stakeholders (medical providers, injured worker, employer, attorney) to track the treatment plan and help bring the injured worker back to work. Nurses have...

Provides comprehensive administrative support to field-based staff of complex projects; supports Project Managers and Directors by acting as internal line managers for employees allocated to large, complex, customer-managed projects or across multiple project teams in order to shape and strengthen relationships with the client and to increase employee...

The Team Lead supports clinical performance by leading the team of Quality Analysts, and ensuring the data identified and entered by the team is valid, and that all deadlines are met. These efforts support ongoing quality initiatives, and are an essential part of providing safe and evidence-based care to our patients, as well as meeting the requirements of...