- 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
- 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
- RWJBarnabas Health (Jersey City, NJ)
- …claim in collaboration of corporate services + As directed by the Director of Clinical Risk Management, completes timely reporting of claims and PCEs to the ... corporate services + As Directed by the Director of Clinical Risk Management, in litigation claims , assists...care , education, and research to address both the clinical and social determinants of health. RWJBarnabas Health aims… more
- Access Dubuque (Dubuque, IA)
- …to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer ADA Accommodation Coordinator **PRIMARY PURPOSE:** To process claims and determine accommodation ... ADA Accommodation Coordinator **Sedgwick** 1 Positions ID: R51429 Posted On 06/26/2024 **Job Overview** Taking care of people is at the heart of everything we… more
- State of Nevada (NV)
- …unit, and may be located in Carson City or Reno NV. The Health Care Coordinator (HCC) Nurse position serves as the clinical expert for the LTSS unit. This ... HEALTH CARE COORDINATOR 3 - NURSE -...to identify abuse and potential fraud and to ensure claims were paid properly by the fiscal agent. Explain… 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
- CareOregon (Portland, OR)
- Job Title Program Coordinator - Advanced Illness Care Department HCP Advanced Illness Exemption Status Non-Exempt Requisition # 24323 Direct Reports n/a Manager ... Title Director - Advanced Illness Care Pay & Benefits Estimated hiring range $ 24.54...This position provides billing support and review of unpaid claims . This position additionally provides administrative support to the… more
- University of Washington (Seattle, WA)
- …further HSC services. Track claims to ensure early return-to-work services, care coordination, and improved clinical outcomes of injured workers, as ... and applying rules and regulations and requires extensive involvement with health care providers, patients, other HSCs, clinical staff, and/or the public… 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
- University of Michigan (Ann Arbor, MI)
- …of data visualization best practices. + Experience analyzing and interpreting process measures, clinical outcomes, and costs of care . + Training or certification ... healthcare and enable Michigan patients to access the right care , at the right cost, at the right time....**Job Opening ID** 249458 **Working Title** MVC Site Engagement Coordinator **Job Title** Clinical Info Analyst Inter… 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
- Sedgwick (Columbus, OH)
- …to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer ADA Accommodation Coordinator **PRIMARY PURPOSE:** To process claims and determine accommodation ... Taking care of people is at the heart of...eligibility review; and to ensure the ongoing processing of claims . **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** * Informs claimants of… more
- Trinity Health (Darby, PA)
- …monitoring of Care Coordination EPIC Work Queues to ensure timely claims resolution + Working knowledge of Commercial, Managed Medicaid and Managed Medicare ... monitoring of Care Coordination EPIC Work Queues to ensure timely claims resolution + Working knowledge of Commercial, Managed Medicaid and Managed Medicare… more
- Houston Methodist (Katy, TX)
- …variety of business functions that operate at the system level to help enable clinical departments to provide high quality patient care . Houston Methodist is an ... is a plus** **Note: Office for this position is located at our Continuing Care Hospital:** **701 S. Fry Rd. Katy, TX 77450** **. (Hybrid)** At Houston Methodist,… more
- Fallon Health (Worcester, MA)
- **Overview** **The Authorization Coordinator works M - F 8 am to 5 pm/ 8:30 am to 5 pm and will require at least 6 months of training 5 days/week in the office and ... a company that cares. We prioritize our members-always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon… more
- CareFirst (Baltimore, MD)
- …Diploma or GED. **Experience Required** : 3 years' experience in health care claims /service areas or office support. **Preferred Qualifications:** Two years' ... **Resp & Qualifications** **PURPOSE** : Supports Care Management clinical teams by assisting with non- clinical administrative tasks and responsibilities… more
- Elara Caring (Rocky Hill, CT)
- …Right Care , at the Right Time, in the Right Place. **Job Description:** **Orders Coordinator ** At Elara Caring, we care where you are and believe the best ... To continue to be an industry pioneer delivering unparalleled care , we need an Orders Coordinator with...executive team, and the leadership of the Order and Claims Management team. + Maintains patient medical records in… more
- SOS International LLC (Reston, VA)
- …the community provider to initiate enrollment as well as assist with billing and claims resolution as applicable. **The Referral Coordinator will work out of the ... is contingent upon contract award _** SOSi is seeking a Referrals Coordinator (RC) to process government customer medical referrals for off-site medical… more