Post Close Review Specialist - Franklin, TN

The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services to ensure compliance with utilization management policies. · This role conducts admission and continued stay reviews, supports denials and ...

+The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services to ensure compliance with utilization management policies. · +Performs admission and continued stay reviews using evidence-based criteria, ...

Performs claim documentation review verifies policy coverage assesses policy application validity communicates with healthcare providers policyholders and beneficiaries to ensure accurate and timely handling of the medical review process. · ...

The Utilization Review Specialist ensures that all services provided to patients meet payer requirements for medical necessity and authorization. · Obtain initial authorizations for all new admissions · Submit concurrent reviews and continued-stay requests within required timelin ...

This is an entry-level position that supports the CPPA CORS team by assisting in the review and production of partner site materials about professional behavior with regular guidance. · Performs quality review and edits of documents. · Assists in analyzing document content and de ...

This is an entry-level position that supports the CPPA CORS team by assisting in the review and production of partner site materials about professional behavior, with regular guidance. · ...

We are seeking a Coding Quality Review Specialist for a remote opportunity supporting Health Information Management Service Center (HSC) coding operations. · ...

+Job summary · Inpatient Authorization Review Specialist to help us reach our goals. · +QualificationsOne year of related experience required. · ...

The Clinical Denials Coding Review Specialist is responsible for applying correct coding guidelines and payor requirements as it relates to researching, analyzing, and resolving outstanding clinical denials and insurance claims. · ...

This role involves reviewing and verifying insurance authorizations for inpatient services to ensure compliance and payment accuracy. · ...

This Work from Home position requires that you live and will perform the duties of the position; within 60 miles of an HCA Healthcare Hospital (Our hospitals are located in the following states: FL, GA, ID, KS, KY, MO,NV,NH_NC_SC_TN_TX_UT_VA) · HCA Healthcare has committed up to ...

This role involves reviewing and verifying insurance authorizations for inpatient services to ensure compliance and payment accuracy. · Strong Communication and Customer Service skills. · Experience in Sales and Training. · Familiarity with medical terminology. · ...

Coding Quality Review Specialist performs internal quality assessments of coding accuracy and compliance across inpatient and outpatient records to maintain optimal data integrity. · ...

Heartline Staffing seeks a Coding Quality Review (CQR) Specialist for remote work supporting Health Information Management Service Center (HSC) coding operations. The role requires expert-level knowledge of inpatient and outpatient coding to ensure compliance with national guidel ...

This position requires the review of post discharge accounts that do not have an authorization on file. The specialist will communicate with third party payors to resolve discrepancies prior to billing. · Work prebill accounts imported into the PDU Tool efficiently and effectivel ...

+ Competitive salary with a midpoint of $42.28/hour. · + Full-time, remote work flexibility. · Perform internal quality assessment reviews for Health Information Management Service Center (HSC) coders. · Lead and coordinate all functions of coding quality reviews (routine, pre-bi ...

This Work from Home position requires that you live and will perform the duties of the position; within 60 miles of an HCA Healthcare Hospital. · ...

This Work from Home position requires that you live and will perform the duties of the position; within 60 miles of an HCA Healthcare Hospital. · The Inpatient Authorization Review Specialist will review post discharge, prebill accounts that do not have an authorization on file.. ...

This Work from Home position requires that you live and will perform the duties of the position; within 60 miles of an HCA Healthcare Hospital. Do you want to join an organization that invests in you as a Inpatient Authorization Review Specialist? · ResponsibilitiesWork prebill a ...

HomeFirst Home Healthcare provides quality home health care to thousands of individuals in Tennessee. This is a remote position to support our initiatives in the Nashville area. · ...