- Community Health Systems (Franklin, TN)
- …Other duties may be assigned. + File medical necessity and level of care appeals using InterQual and CMS guidelines as needed. + Monitor clinical appeal ... guidance and feedback to related departments as needed. + Track and manage clinical denials using current tools (manuals, training programs). + Identify patterns and… more
- Veterans Affairs, Veterans Health Administration (IN)
- …or in the District of Columbia. Grade Determinations: Occupational Therapist ( Clinical Specialist ), GS-13 Education, Experience, and Licensure. Completion of ... and resource and service linkage. Responsibilities The CSP is a clinical program that provides state-of-the-art continuum of services, education and resources… more
- State of Colorado (Grand Junction, CO)
- Board Certified Behavior Analyst (BCBA), ( Clinical Behavioral Specialist II ) - Grand Junction Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4770759) Apply Board Certified Behavior Analyst (BCBA), ( Clinical Behavioral Specialist II ) -… more
- State of Colorado (CO)
- CDOC Addiction Specialist II Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4765768) Apply CDOC Addiction Specialist II Salary ... Number CAA Statewide D&A 01/2025 Department Department of Corrections Division Clinical and Correctional Services Opening Date 12/19/2024 Closing Date 6/30/2025 4:00… more
- Priority Health Care (Marrero, LA)
- JOB SUMMARY: The Revenue Cycle Specialist II must adhere to the Code of Ethical Conduct and foster positive relationships within the company, across departments, ... response from third-party payors, processing payor denials, documentation requests, and appeals , and monitoring day-to-day activities related to appeal follow-up and… more
- State of Colorado (Golden, CO)
- Behavioral Health Specialist , Social Work/Counselor II - Lookout Mountain Campus Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4758553) ... Apply Behavioral Health Specialist , Social Work/Counselor II - Lookout Mountain Campus...of Work Unit: This work unit exists to provide clinical mental health services to committed treatment level youth… more
- State of Colorado (Lakewood, CO)
- Youth Services Specialist II - Rocky Mountain YSC in Lakewood Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4774176) Apply Youth ... Services Specialist II - Rocky Mountain YSC in...Recommends any modifications of the program to supervisory and/or clinical staff. Facilitates and monitors cleanup of pod and… more
- Guthrie (Sayre, PA)
- Position Summary: Fulfills all requirements of Insurance Specialist I, as well as serving as a group leader by participating in staffing and employment issues. ... Serves as a resource specialist within the department. Trains Insurance Billing Specialists I...to complete all types of complex insurance billings and appeals . Reviews and analyzes the insurance processing procedures to… more
- Dignity Health (Bakersfield, CA)
- …position is remote** **within California** **.** **Position Summary:** As a Delegation Management Specialist II , you will play a critical role in managing and ... Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups hospitals health plans and employers with a… more
- LA Care Health Plan (Los Angeles, CA)
- …dates for each file. Inform nurses of a new case received from Grievance and Appeals Specialist .; submit all Grievances and Appeals response letters to ... Authorization Technician II Job Category: Clinical Department: Utilization...to achieve that purpose. Job Summary The Authorization Technician II supports the Utilization Management (UM) Specialist … more
- State of Colorado (Denver, CO)
- …Bonding Mental Health Counselor Social Worker/Counselor II (Denver) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4773660) Apply CDOC ... Perinatal Bonding Mental Health Counselor Social Worker/Counselor II (Denver) Salary $6,122.00 Monthly Location Denver, CO Job Type Full Time Job Number Den SWC … more
- State of Colorado (Denver, CO)
- PHARMACY TECHNICIAN II - Denver Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4773843) Apply PHARMACY TECHNICIAN II - Denver Salary ... Den 14021 Pharm Tech 01/2025 Department Department of Corrections Division Clinical and Correctional Services Opening Date 12/30/2024 Closing Date 1/14/2025 4:00… more
- Novant Health (Winston Salem, NC)
- …up to $5,000 at qualifying locations! Novant Health is seeking an experienced Therapist II for our clinical team on the Inpatient Psychiatric Unit at Forsyth ... such as petitioning for guardianship and navigating the Medicare appeals process. + Willingness to cross train between Inpatient...required. + For the Substance Use Therapist role, Licensed Clinical Addiction Specialist or Licensed Clinical… more
- Hackensack Meridian Health (Hackensack, NJ)
- …departments to reduce clinical denials by: I. Peer-to Peer (P2P) Concurrent appeals ii . Written Concurrent appeals iii. Recovery Audit Contractors & ... **Overview** The Senior Utilization Review Specialist collaborates with the healthcare team in the...and resolution of activities that assure the integrity of clinical records for the patient population and Hackensack UMC.… more
- University of Rochester (Rochester, NY)
- …Position Summary Serves as the patient referral and prior authorization specialist , with oversight of data and compliance to enterprise standards and ... referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non- clinical staff, identifying barriers to appointment… more
- UPMC (Pittsburgh, PA)
- …and HCPCS Level II resources. 4. Submits pertinent demographic and supporting clinical data to payor to request approval for services being rendered. 5. Provides ... **UPMC Mercy is hiring a Full-Time Authorization Specialist to support the Mercy Pain Center!** This...laws and regulations to determine medical necessity for the clinical appropriateness for a broad scope of services and… more
- Trinity Health (Livonia, MI)
- …and references in the assignment of Internal Classification of Diseases, Clinical Modification diagnosis and procedure codes, and Current Procedural Terminology / ... of current, compliant coder query practices when consulting with physicians, Clinical Documentation Specialists (CDS) or other healthcare providers when additional… more
- Whitney Young Health Center (Albany, NY)
- Claims Coding Specialist (Req 100825) Albany, NY (http://maps.google.com/maps?q=526+Central+Ave+Albany+NY+USA+12206) Apply Description GENERAL RESPONSIBILITIES: ... including revenue and rate codes in addition to category II coding for our value base payment arrangements. SPECIFIC...function; reviews the work of other medical coding and clinical staff to ensure compliance with departmental policies and… more
- State of Colorado (Delta, CO)
- …Delta, CO Job Type Part Time Job Number CAA DCC 21138 DCA II 12.2024 Department Department of Corrections Opening Date 12/20/2024 Closing Date 1/16/2025 4:00 ... assessment, diagnosis and treatment of patients in a prison clinical setting. Assures daily completion of dental clinic operations...of the department's action. For more information about the appeals process, the official appeal form, and how to… more