Advanced knowledge of medical insurance and the ability to communicate information to customers. Microsoft Office experience and computer savvy. Able to navigate through different carrier websites without detailed training.
Position Requirements Include: Active Full Medical License in KS or CO with willingness to license in additional states as needed. Board Certification or Eligibility in General Psychiatry. Experience or Board Certification in Psychosomatic Medicine or Emergency Medicine Psychiatry is ideal.
3-5 years of Medical Surgery, Heart, Lung or Critical Care Nursing experience required. Prior clinical experience preferably in an acute care, skilled or rehabilitation clinical setting. Previous experience in utilization management required.
Position Requirements Include: Experience with medical decision support tools and government sponsored managed care programs. 2+ years of clinical nursing experience in an acute care setting and 1+ years of case management experience in a managed care setting. Current state's RN license.
Must meet the following requirements for consideration: Able to extract information from medical records, operative notes, hospital admissions, consults, progress notes. Can assist with identifying quality issues with registration and scheduling activities.
7-10 years of experience working on Ambulatory, Clinical, Financial or Revenue Cycle Applications. 5-7 years’ experience working in the healthcare/medical environment. Experience working with project life cycle and project management methodologies.
Knowledge of Good Clinical Data Management Practices, CDASH/CDISC, SDTM, Medical Terminology, GCP, ICH Guidelines, and 21 CFR Part11 Knowledge of SAS. Knowledge of paper, EDC, and hybrid-base data collection and processing.
Collaborating with other health care givers in reviewing actual and proposed medical care and services. Managing network participation, care with specialty networks, care with DME providers, and transfers to alternative levels of care. Applicants must meet the following qualifications:
Qualifications Include: MA or MS in statistics subject, preferably with a strong medical statistics component. 8 years of postgraduate experience in the application of statistics to clinical trials for employees with an MA/MS in statistics subject.
Demonstrates and applies expert level knowledge of medical coding practices and concepts. Maintains or exceeds 95% accuracy. Required Skills: Must be familiar with extensive regulatory coding and associated reimbursement knowledge.