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Job Description:
* Responsible for the review and evaluation of clinical information and documentation.
* Reviews documentation and interprets data obtained from clinical records or systems to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for member and/or provider issues.
* Independently coordinates the clinical resolution ...
JOB SUMMARY
The Revenue Cycle Clinician for the Appellate Solution is responsible for:
a) Recovering revenue associated with disputed/denied clinical claims or those eligible for clinical review
b) Preparing and documenting appeal based on industry accepted criteria.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Include the following. Others may be assigned.
* Performs retrospective (post –d...
Job Description
JOB SUMMARY
The Revenue Cycle Clinician for the Appellate Solution is responsible for:
a) Recovering revenue associated with disputed/denied clinical claims or those eligible for clinical review
b) Preparing and documenting appeal based on industry accepted criteria.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Include the following. Others may be assigned.
* Performs retrospectiv...
Everlywell is a digital health company pioneering the next generation of biomarker intelligence—combining AI-powered technology with human insight to deliver personalized, actionable health answers. We transform complex biomarker data into life-changing insights—seamlessly integrating advanced diagnostics, virtual care, and patient engagement to reshape how and where health happens.
Over the p...
Overview
Are you looking for a place where you can make a genuine difference in our patient’s lives?
With over 20 locations and growing, Bridge Home Health & Hospice’s culture of love for our patients and employees is the top priority. Our commitment to our Core Values allows us to be the provider and employer of choice. We embrace a diverse workforce and understand that our employees are key...
CLINICAL QUALITY NURSE SPECIALIST- WORK AT HOME- ACCREDO
Excited to grow your career?
We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position, you see is right for you, we encourage you to apply!
Our people make all the difference in our success.
Full time...
New
JOB SUMMARY
The Medical Director for Education, Quality, Compliance and Advocacy has primary responsibility for reviewing, developing, and implementing industry leading training focused on the physician and nurse practitioner role within Pennant. He/She leads out on the direct 1:1 training and education of agency medical directors and nurse practitioners. He/she serves as a resource to the qual...
Details
* Remote - PFS Denial Nurse Auditor
* PFS Billing-Follow Up-Denials
* Full Time Status
* Day Shift
* Pay: $60,382.40 - $96,616.00 / year
Summary
* Candidates residing in the following states will be considered for remote employment: Alabama, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Minnesota, Missouri, Mississippi, Nebr...
Employment Type:
Full time
Shift:
12 Hour Day Shift
Description:
Job Title: Virtual Registered Nurse
Employment Type: Full time
Shift: Day; 7am – 7pm
This position rotates weekends and holidays.
Location: Please note that this is a Virtual RN position but the employee will physically work on-site at the central HUB located at Holy Cross Health in Silver Spring, Maryland. This is...
OUR MISSION
We exist to create a more connected, compassionate, and confident experience for people with cancer and those who care for them. We make it easier to get answers, access high-quality care quickly, and feel supported throughout treatment and beyond.
Today, Thyme Care is a market-leading value-based oncology care enabler, partnering with national and regional health plans, provider...
Job Introduction
Maximus is currently hiring for Sr. Regional Nurse Managers to support the New York Independent Assessor Program (NYIA). The NYIA Program serves the State of New York by conducting UAS assessments to determine eligibility for community-based long-term services. The Sr. Regional Nurse Manager will have the opportunity to lead and support a team of Nurse Managers who are on the...
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Essential Functions: * Under general guidance form Senior Quality Practice Advisors and management, educate...
Responsibilities
* Job Responsibilities: The Nurse Practitioner (APRN) Nocturnist is to provide healthcare to patients with an emphasis on disease prevention, health promotion, health maintenance, and supportive care. The APRN works independently as well as collaboratively to diagnose, prescribe treatment, manage and evaluate patient care. The APRN functions as an educator, healthcare resou...
About RPM
Roman Pennsylvania Medical, P.C. (RPM) is a telehealth practice dedicated to providing high-quality, patient-centric care. RPM is part of the provider network affiliated with Ro, a direct-to-patient healthcare company. Providers help patients seeking care through Ro’s platform for their mental health, women’s health, men’s health, fertility, metabolic health, and skincare needs.
RPM...
Job Introduction
Maximus is currently seeking Quality Assurance Clinical Analysts to support the Independent Practitioner Panel (IPP) Program, which completes assessment reviews and issues practitioner orders for New Yorkers who qualify for long-term in-home care. The QA Clinical Analyst is responsible for reviewing assessments to ensure accuracy and consistency and collaborating with other pr...
Providence Health Plan caregivers are not simply valued – they’re invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
Providence Health Plan is calling a Coding Quality Auditor, HEDIS who will:...
VIRTUAL INTERVIEW DAY: RNs, LVNs, & CNAs – Loan Forgiveness & Sign-on Bonus
July 5th, 2023 from 2pm to 5pm (Los Angeles)
Apply now to Register for the event.
We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer o...
Position: Endocrinology Nurse Practitioner
Thi9 is in anticipation of a future need. The Monogram Endocrinology Nurse Practitioner will be responsible for the delivery of personalized compassionate medical care to patients primarily with diabetes and other endocrine conditions. The Nurse Practitioner will be responsible for caring for patients, maintaining accurate and current patient reco...
Senior Vice President of Compliance and Quality - Hospice
If you are a Chief Compliance Officer, Compliance Officer, Executive Vice President of Quality, or senior QAPI leader with Hospice experience then you need to read on….
Senior Vice President of Compliance and Quality Opportunity Description
Our client is a well-established and growing Hospice Care organization. They are looking...
VIRTUAL Hiring Event: RNs, LVNs, & CNAs – Loan Forgiveness & Sign-on Bonus
June 27th from 12pm to 2pm (Culver City)
Apply now to Register for the event.
Note: No registration required; Walk - Ins Welcome! Click on this link to join the job fair directly: CLICK HERE TO JOIN
We are hospitals and affiliated medical groups, working closely together for the benefit of ever...
