Clinical Denials and UMR

Job Summary:We are seeking a skilled Registered Nurse to perform advanced level work related to clinical denial and utilization management at Access Healthcare Services.The successful candidate will manage medical denials by conducting comprehensive reviews of clinical documentation, handle audit/compliance responsibilities, and resolve charge problems to...

Job Description:We are looking for a skilled Inpatient Denials and UR Reviewer to join our team at Omega Healthcare Management Services Inc. The ideal candidate will have experience in reviewing denied claims and identifying root causes.The successful candidate will have a strong understanding of medical necessity and billing procedures, as well as...

Clinical Appeals Specialist (Registered Nurse)Our partner in the BPO industry is looking for Clinical Appeals Writers to help navigate the complexities of medical claim denials and ensure fair resolutions for patients and providers.100% Remote – Work from anywhereDay Shift Hours – Enjoy a consistent scheduleWhat You'll Do:Prepare and Submit Clinical...

About the Role:This is an exciting opportunity for a Registered Nurse to join our team at Access Healthcare Services and contribute to the efficient management of patient care.The successful candidate will be responsible for performing advanced level work related to clinical denial and utilization management, including managing medical denials, handling...

Job Summary:At Omega Healthcare Management Services Inc., we are seeking a highly skilled Clinical Appeals Specialist to join our team. As a key member of our appeals team, you will be responsible for reviewing denied insurance claims and determining the validity of denials.The successful candidate will have experience in clinical nursing or case management,...

We are currently seeking a Clinical Analyst to support a growing client base while combining their clinical and/or coding expertise with payment accuracy. The Clinical Analyst is responsible for analyzing, interpreting, and assigning the correct codes for the descriptions available on various medical procedures and diagnoses, as well as other related medical...

Access Healthcare is looking for REGISTERED NURSE to join our growing team.You'll be ensuring the completion of assigned patient cases by doing roll calls, processing concurrent and retro clinical reviews, work processing surgery authorizations, as needed.Responsibilities:Perform advanced level work related to clinical denial and utilization...

Nezda Technologies Inc. is currently hiring for Clinical Nurse Case Manager - USRN.Salary: P 50,000 - P 68,000 (with Perks and benefits).Work Set up: Work From HomeQualifications:Active and Non-Active USRN License.With at least 1 Year Clinical or Hospital Experience.USRN with RN License.Job Description:We are in partnership with multiple companies for this...

Job Description:We are looking for a skilled Registered Nurse to join our team at Access Healthcare Services and assume responsibility for clinical denial and utilization management.The successful candidate will be responsible for managing medical denials, handling audit/compliance responsibilities, and resolving charge problems to ensure accurate...

Role Overview:Access Healthcare Services seeks a highly skilled Registered Nurse to manage clinical denial and utilization management tasks, ensuring the efficient delivery of patient care.The successful candidate will be responsible for managing medical denials, handling audit/compliance responsibilities, and resolving charge problems to ensure accurate...

Position SummaryThe Clinical Task Coordinator (CTC) plays a crucial role in streamlining communication and coordination across various departments in a healthcare setting. They manage clinical tasks through the EHR system, oversee medication prior authorizations, and handle patient phone calls or inquiries, directing them to the appropriate staff. This role...

A Clinical Appeals Nurse Specialist is responsible for understanding and analyzing the denials of insurance claims or coverage for medical treatments or procedures at a healthcare facility and determining whether the denial was warranted or whether to move forward with an appeal. An appeal is defined as formal, specific, account-level communication issued to...

Sourcing Specialist at Access Healthcare ServicesAccess Healthcare is looking for a Registered Nurse to join our growing team.You'll be ensuring the completion of assigned patient cases by doing roll calls, processing concurrent and retro clinical reviews, and processing surgery authorizations as needed.Qualifications:Registered Nurse with Active license.BPO...

Med-Metrix is seeking a highly experienced Director of Clinical Services to lead our revenue cycle operations. As a key member of our team, you will be responsible for managing the daily activities of offshore partners, ensuring they meet our high standards for quality and productivity.In this role, you will work closely with the Vice President to develop...

About the Role:We are seeking a skilled Nurse Case Manager - Medical Necessity to join our team at Omega Healthcare Management Services Inc. The successful candidate will have experience in reviewing denied claims and determining the validity of denials.The ideal candidate will have a strong understanding of medical necessity and billing procedures, as well...

Medical Coder for Outpatient (US Healthcare)• Review medical charts electronically; assign accurate codes for diagnoses and procedures, using ICD, CPT and HCPCS codes based on the documented information in the medical record.• Ensures codes are accurately assigned and sequenced correctly according to medical coding rules and guidelines to prevent any...

Overview:Omega Healthcare Management Services Inc. is seeking a highly skilled Appeals Nurse Specialist - Interqual Expert to join our team. The successful candidate will have experience in reviewing denied claims and determining the validity of denials.The ideal candidate will have a strong understanding of medical necessity and billing procedures, as well...

At Global Group Innovative Services, Inc., we are seeking a skilled Healthcare Expert Trainer to join our team. This role involves training healthcare professionals in various clinical skills and knowledge areas.Key ResponsibilitiesWe are looking for individuals with 2 years of experience in healthcare training, preferably with a background in medical allied...

Job Title: Aesthetic Clinic ManagerRoma Wellness and Beauty Centre is seeking an experienced Aesthetic Clinic Manager to lead our team and drive business growth. The successful candidate will be responsible for developing and implementing sales strategies, managing clinic operations, and supervising staff to deliver exceptional client experiences.Main...

The Aesthetic Clinic Manager is responsible for overseeing the clinic's daily operations, ensuring efficient workflow, and delivering a high standard of client care. This role involves driving sales, managing staff, and implementing strategies to achieve revenue targets and business growth.ResponsibilitiesSales & Business Growth: Develop and implement sales...