- Mount Sinai Health System (New York, NY)
- **Job Description** ** Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical ... internal and external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing stay.… more
- Trinity Health (Pontiac, MI)
- …RN licensure within the State of Michigan. Certified Professional in Utilization Review /Management preferred. **C** **Special Skill / Aptitudes** Understanding ... care utilization management experience. Knowledge of regulations relative to utilization review . Knowledge of Federal, State and Local regulations sources.… more
- Select Medical (West Orange, NJ)
- …a physical rehabilitation setting preferred + Experience submitting prior authorizations and/or utilization review preferred. + Experience working with Excel and ... **Overview** **Kessler Institute for Rehabilitation** West Orange, NJ **Prior Authorization Specialist / Payor Relations Specialist ( RN , LPN )** **This is… more
- Houston Methodist (Houston, TX)
- …caring for adults in an acute care hospital setting is required; coding and utilization review experience preferred + For Medical School graduate - One year ... **Clinical Documentation Specialist - 100% Remote (Must Live in FL,...chart. **QUALITY/SAFETY ESSENTIAL FUNCTIONS** + Demonstrates knowledge of DRG payor issues, optimization strategies, clinical documentation requirements and referral… more
- AccentCare, Inc. (Austin, TX)
- Overview Why You'll Love Being an Insurance Verification Specialist at AccentCare Do you enjoy providing outstanding patient care? Bring your organizational skills ... of at-home care and join the AccentCare team today in this Insurance Verification Specialist job. When you join AccentCare, you become part of a team that is… more
- Baylor Scott & White Health (Dallas, TX)
- …+ Calculates accurate patient financial responsibility. + Communicates timely with Utilization Review , and collaborates effectively with physician and facility ... **JOB SUMMARY** The Insurance Verification Specialist 1, under general supervision, provides patients, physicians and internal hospital personnel with insurance… more
- Guthrie (Binghamton, NY)
- …acute clinical experience in a hospital setting required. Critical care, utilization review or coding experience required. Requires excellent communication ... 2. Demonstrates knowledge of CDMP guidelines and program, DRG payor issues, documentation opportunities, clinical documentation requirements, and referral policies… more
- Mohawk Valley Health System (Utica, NY)
- … regarding correct level of care and reimbursement. Apply knowledge of utilization review , discharge planning, patient status changes, length of stay, ... and reimbursement models in decision making and reviews. + Provide peer-to-peer payor review in collaboration with attending physicians. + Support Recovery… more
- AdventHealth (Shawnee, KS)
- …to nurses, physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge Planning and care ... (as permitted by the patient) as well as a review of the current and past inpatient and outpatient...days, and facilitates progression of care. + Collaborates with Utilization Management staff for collaboration on patient status changes… more
- AdventHealth (Winter Garden, FL)
- …to nurses, physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge Planning, and care ... (as permitted by the patient) as well as a review of the current and past inpatient and outpatient...days, and facilitates progression of care. + Collaborates with Utilization Management staff for collaboration on patient status changes… more