with Transplant/Dialysis coordinator Provide clinical claim file review for claims auditor as needed (5%) Perform appropriate... research for each clinical claim file review request Provide discussion/answer questions for claims auditor as needed Perform...
and distribute to appropriate stakeholders. Own and manage related clinical vendor non-conformances. Review, understand, and audit...Recruiter: Spencer Gregory Hale Principal Clinical QA Specialist About the role: The Principal Clinical QA...
and distribute to appropriate stakeholders. Own and manage related clinical vendor non-conformances. Review, understand, and audit...Recruiter: Spencer Gregory Hale Principal Clinical QA Specialist About the role: The Principal Clinical QA...
Primary Responsibilities The Clinical Specialist will serve as an advisor, trainer, educator and auditor... development of facility policies and procedures. Review resident clinical records. Provide training to the Director of Nursing...
Primary Responsibilities The Clinical Specialist will serve as an advisor, trainer, educator and auditor... development of facility policies and procedures. Review resident clinical records. Provide training to the Director of Nursing...
are within required specifications - Review batch record to ensure equipment challenges and hourly inspections have been conducted and any non... and on track to meet requirements - Review sampling pages to ensure samples have been taken, labeled, and documented appropriately...
with Wellstar Medical Group providers and practices to facilitate denial/appeals process. * Review clinical records to identify... physician coding denials team in the review and appeal of coding denials for all assigned professional service claims related...
and rate review to resolve all CHCA (Auditor) rate outlier concerns throughout the HEDIS® project (Initial, Refresh, Final... Confirmation of all hybrid exclusions entered into HEDIS® software, coordinating clinical review when necessary Complete all HEDIS...
or will be discussed on your first day of employment. Primary Responsibilities: Analyze current Clinical Quality and Claims Quality... to Operational Leaders Create and maintain auditor trending reports and ad-hoc reporting as requested by Quality Leaders Create...
and rate review to resolve all CHCA (Auditor) rate outlier concerns throughout the HEDIS® project (Initial, Refresh, Final... Confirmation of all hybrid exclusions entered into HEDIS® software, coordinating clinical review when necessary Complete all HEDIS...
systems that will enable cGMP manufacturing of pre-clinical to commercial products. Compliance Ensure self, and team... and proper corrective and preventative actions. Review and/or approve basic and technical documentation to include...
-functional meetings. Create, review, and approve product design/process qualification/validation, design/process remediation... of quality-related issues in daily operations. Review and approve supplier-provided First Article Inspection (FAI) documentation...
systems that will enable cGMP manufacturing of pre-clinical to commercial products. Compliance Ensure self, and team... and proper corrective and preventative actions. Review and/or approve basic and technical documentation to include...
Clinician I conducts post service review of claims in prepayment, post payment or audit capacity to ensure appropriate clinical... Claims Clinical Auditor or reviewer Qualifications and Certifications: Associates or Bachelor's Degree in Healthcare...
Company Overview: Acentra Health exists to empower better health outcomes through technology, services, and clinical... authorization, prepayment claims review, and appeals, ensuring efficient and effective utilization management for our contract...
and industry standards and update training accordingly. Formulate, review, and revise compliance policies and SOPs, as directed... Office leadership as well as other key clinical and operational leaders on compliance matters. Ensure that policies...
informed about changes in healthcare regulations and industry standards and update training accordingly. Formulate, review... compliance & ethics reporting. Work with Senior Compliance and Privacy Office leadership as well as other key clinical...
date Clinic RN Nurse Auditor Responsibilities Perform clinical audits and concurrent/retrospective chart reviews for patient...Clinic RN Nurse Auditor Travel Job in Sacramento, CA Advance your nursing career with a high-impact travel nursing...
for payers and patient accounts which includes a complex review and reconciliation of government and non-government payers... denials, preparing appeals as needed, and working with clinical team on clinical denials. ESSENTIAL FUNCTIONS: Exhibits...
Job Category: Revenue Cycle & Coding Job Description: Primary Duties And Responsibilities The Coder reviews clinical... attendance or related in-services. Participates in internal and external quality review meetings. Performs other duties...