- Centene Corporation (Nashville, TN)
- …needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member ... approve medical determinations or provide recommendations based on requested services and concurrent review findings + Assists with providing education to… more
- The Cigna Group (Nashville, TN)
- The Registered Nurse will perform clinical and operational processes related to transition/coordination of care and utilization/case management of Post-Acute ... rehab facilities, home health care, care management, and utilization review . The Registered Nurse is responsible for...license preferred **Minimum Experience Required:** + 2+ years of clinical experience + 2 + years experience in utilization… more
- HCA Healthcare (Nashville, TN)
- …you want to join an organization that invests in you as a Revenue Integrity Clinical Coding Analyst RN? At Parallon, you come first. HCA Healthcare has committed up ... the opportunity to make a difference. We are looking for a dedicated Revenue Integrity Clinical Coding Analyst RN like you to be a part of our team. **Job Summary… more
- Vanderbilt University Medical Center (Nashville, TN)
- …Documents the patient's clinical status and care provided. Performs concurrent review of patient records for documentation to support assignment ... of clinical codes. . KEY RESPONSIBILITIES * Performs assessment of patient records to evaluate documentation for accuracy, legibility and completeness. * Works with… more
- HCA Healthcare (Brentwood, TN)
- … clinical documentation issues and revenue opportunities. Provides charge review results and develops and coordinates educational in-services for facility staff ... our team. **Job Summary and Qualifications** The Billing Integrity Analyst Register Nurse (RN) is responsible for determining the appropriateness of patient charges,… more
- HCA Healthcare (Madison, TN)
- …As a member of our team: + You will be responsible for collecting clinical information relative to a transfer request, and then facilitates the transfer by matching ... the patient's clinical needs to the facility with bed capacity and...plan of care. + You will ensure accurate and concurrent data collection and maintenance in both Meditech and… more
- HCA Healthcare (Madison, TN)
- …As a member of our team: + You will be responsible for collecting clinical information relative to a transfer request, and then facilitates the transfer by matching ... the patient's clinical needs to the facility with bed capacity and...plan of care. + You will ensure accurate and concurrent data collection and maintenance in both Meditech and… more
- Ascension Health (Nashville, TN)
- …continuing education initiatives. + Develop systems and processes for prospective, concurrent and retrospective utilization review for allself-funded and fully ... Management to join our team! In this pivotal role, you'll lead clinical discussions during Payer JOC meetings, oversee denial management activities, and perform… more