- 3 years customer service experience required
-
Managed Review Coordinator
1 week ago
TransPerfect Dallas, United StatesWho We Are: · TransPerfect is the world's largest provider of language services and technology solutions for global business. From offices in over 100 cities on six continents, TransPerfect offers a full range of services in 170+ languages to clients worldwide. More than 5,000 gl ...
-
Utilization Review Coordinator
2 weeks ago
Carrus Hospital Frisco, United StatesCarrus Care Frisco mental health clinic serving the pediatric and adolescent population, is seeking a Utilization Review Coordinator (RN)ESSENTIAL FUNCTIONS:1. Responsible for coordinating andmonitoring day-to-day operations of the utilization management program for theoutpatient ...
-
Managed Review Coordinator
1 week ago
TransPerfect Dallas, United StatesWho We Are: · TransPerfect is the world's largest provider of language services and technology solutions for global business. From offices in over 100 cities on six continents, TransPerfect offers a full range of services in 170+ languages to clients worldwide. More than 5,000 gl ...
-
Utilization Review Coordinator
2 weeks ago
Carrus Hospital McKinney, United StatesCarrus Cares McKinney mental health clinic serving the pediatric and adolescent population, is seeking Utilization Review Coordinator (RN or LVN only)ESSENTIAL FUNCTIONS:1. Responsible for coordinating andmonitoring day-to-day operations of the utilization management program for ...
-
Institutional Review Board Coordinator
1 week ago
HCA Plano, United StatesIntroduction · Are you looking for a work environment where diversity and inclusion thrive? Submit your application for our Institutional Review Board (IRB) Coordinator opening with Medical City Plano today and find out what it truly means to be a part of the HCA Healthcare team. ...
-
Institutional Review Board Coordinator
3 weeks ago
HCA Healthcare Plano, United States Full timeDescription · Introduction · Are you looking for a work environment where diversity and inclusion thrive? Submit your application for our Institutional Review Board (IRB) Coordinator opening with Medical City Plano today and find out what it truly means to be a part of the HCA H ...
-
Medical City Healthcare Plano, United StatesInstitutional Review Board Coordinator / IRB · Shift: Full time - Days *Onsite* · Location: Medical City Plano Hospital · Introduction · Are you looking for a work environment where diversity and inclusion thrive? Submit your application for our Institutional Review Board (IRB) ...
-
Director of Ems
4 days ago
Tanner Health System Carrollton, United StatesThe Director provides overall leadership for the EMS department including staff supervision, budgeting, policy development and interpretation, planning, and operations. · **Required Knowledge & Skills** · Education: High School Diploma or GED · Experience: Five years of related e ...
-
Registered Nurse
4 days ago
Tanner Health System Carrollton, United StatesThe Float Pool RN performs nursing duties in accordance with hospital policy procedure, may function as a charge nurse or staff nurse, and supervises other nursing personnel who are responsible for patient care. Capable of making independent decisions in the majority of situation ...
-
Operator, Flex/lt
4 days ago
Southwire Company LLC Carrollton, United StatesA leader in technology and innovation, Southwire Company, LLC is one of North America's largest wire and cable producers. Southwire and its subsidiaries manufacture building wire and cable, utility products, metal-clad cable, portable and electronic cord products, OEM wire produc ...
-
Referral Coordinator
4 days ago
Tanner Health System Carrollton, United StatesCentralized Referral Coordinator duties: Working with the Greenway Referral Module, this position schedules testing, procedures, and referrals for TMG practices. Obtains prior authorizations for procedures, outpatient tests, and referrals. Position works closely with the practice ...
-
Planner, Maintenance
4 days ago
Southwire Company LLC Carrollton, United StatesA leader in technology and innovation, Southwire Company, LLC is one of North America's largest wire and cable producers. Southwire and its subsidiaries manufacture building wire and cable, metal-clad cable, portable and electronic cord products, OEM wire products and engineered ...
-
Fusion Dynamics Farmers, United StatesWe are looking for enthusiastic trainees starting in summer 2024 in Lippstadt for the profession of personnel services clerk (m/f/d) at Farmers. WHAT TO EXPECT: * You conduct job interviews, hire personnel and coordinate their deployment * You review the job and applicant market ...
-
Rn Hospice Patient Care Manager
1 week ago
Ethos Richardson, United States**RN Hospice Patient Care Manager** · **Responsibilities**: · The RN Patient Care Manager will implement, coordinate, and supervise all aspects of the delivery of patient/family services, consistent with policies and procedures and State and Federal regulations. · The PCM is resp ...
-
LVN Patient Care Manager Assistant
5 hours ago
DFW Home Health Richardson, United States Full timeWe are hiring for a Patient Care Manager Assistant (LVN) in Dallas. · At DFW Home Health, a part of LHC Group, we embrace a culture of caring, belonging, and trust and enjoy the meaningful connections that come from it: for the whole patient, their families, each other, and the ...
-
Director of Rehabilitation
2 weeks ago
Asbury Care Center Richardson, United StatesThe Director of Rehabilitation (DOR) is responsible for overseeing all aspects of their organization's rehabiltiation services, including the development and implementation of programs, hiring and training of staff. · The DOR is responsible for the day-to-day operations of their ...
-
Telephonic Rn Case Manager
2 weeks ago
Optum Richardson, United StatesOptum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel ...
-
Office Manager
1 week ago
Porter Legal Group, PLLC Richardson, United StatesPorter Legal Group employs professionals who deliver solutions for complex cases. We dedicate the time and diligence necessary for excellent results. At Porter Legal Group a client will never be just another file. The combination of our experienced professionals, legal knowledge ...
-
Horizon Ventures Richardson, United StatesAt the earliest possible date, we are looking for you as a *Team Leader for Signaling and Control Technology (m/f/d)* for DB InfraGO AG for the Berlin-Dresden corridor at the *Berlin location*. · *Your tasks:* · * You ensure the contract-compliant and quality-oriented implementat ...
-
Assistant Project Manager
4 days ago
BakerTriangle Richardson, United States**Job Type**: Full-time · **Schedule**: Monday to Friday · Position Vision: Help the team drive the Prefab vision, by helping identify, create, and improve on project opportunities while providing strong operational support for projects under contract with lead project managers. ...
Physician Review Coordinator - Addison, Texas, United States - Concentra
Description
Overview:
From our Dallas corporate headquarters to our clinics, worksites, and mobile locations, Concentra colleagues remain focused on our driving purpose: to provide superb patient and employer experience by delivering the highest quality healthcare in an efficient, affordable, caring manner.
A healing focus
A selfless heart
A tireless resolve
Position Summary
Working from instructions and pre-established guidelines, under general supervision, assigns medical necessity requests to a qualified reviewer and follows-up to ensure timely determination is delivered based on state/URAC guidelines in accordance with Concentra policies, practices and procedures.
Responsibilities:
The Details
Communicates directly with customer and physician advisor and tracks cases to ensure case is completed and returned to customer within established time requirements.
Receives and reviews physician review requests to ensure that all necessary information is available and contacts customer if additional information is required.
Upon receipt of completed determination, reviews for spelling and grammatical errors, appropriate application of state guidelines, ensures that all questions have been addressed, and releases the final determination to requesting customer.
Works any assigned physician review queue and/or communications queue.
Seeks assistance of more experienced Physician Review Coordinator (PRC) or Supervisor to troubleshoot problem cases.
Responds appropriately to customer or provider complaints. Refers complaint calls to Supervisor, QA Manager, or Director.
Performs other duties as assigned.
Qualifications:
Education/credentials
High School diploma/GED required
1-2 years college preferred
Medical Assistant or Medical Records certification preferred
Job-related experience
Experience with medical terminology, CPT/ICD codes preferred
Job-related skills/competencies
Customer focused
Team oriented
Good telephone etiquette and customer service orientation
Ability to handle confidential information
Knowledge of Microsoft Word and Excel and ability to learn new software applications.
Team oriented
Strong written, oral and interpersonal communication skills
Ability to manage time effectively, set priorities, accommodate multiple demands for time and resources.
Working conditions/physical demands
Office environment
Additional Data:
This job requires access to confidential and sensitive information, requiring ongoing discretion and secure information management.
Concentra is an Equal Opportunity Employer M/F/Veterans/Disabled