Understanding of plan benefit structures, psychiatric/medical terminology, and local communication resources. Experience in a managed care environment, integrated medical and behavioral health care and/or training in chronic pain management. License and Certifications - Required.
Review medical aspects of claims. Position Requirements Include: Worker's compensation or disability management experience. Proven experience in Nurse Case Management. Ability to coordinate the individual's treatment program while maximizing cost containment.
A healthcare company is in need of a Telecommuting Medical Inpatient Coder in Cincinatti. Core Responsibilities Include: Review of medical record documentation. Assignment of codes to describe diagnoses, procedures and the appropriate Medicare Severity.
A healthcare company is filling a position for a Remote Certified Disease Medical Coder III in Dallas. Core Responsibilities of this position include: Analyzing and interpreting documentation from medical records. Completing an accurate coding of diagnoses and procedures.
A healthcare management company is seeking a Remote Medical Case Manager in the Los Angeles County Area. Must be able to: Research and recommend resources and creates flexible, cost-effective options for catastrophically or chronically ill or injured individuals.
Evaluating the pre-service authorization request. Promoting the quality cost-effectiveness of medical care. Forwarding requests to the appropriate physician or medical director with recommendations for other determinations. Qualifications for this position include:
Analyzing and interpreting documentation from medical records. Clearly documenting audit findings and calculating billing error rates. Applicants must meet the following qualifications: Associate’s Degree. RHIA or RHIT, and CCS. 5+ years acute in-patient hospital coding experience.
BS or BA degree in Medical Technology, Microbiology, Life Science or Business major or equivalent experience. 3-5+ years of sales experience in a relevant industry. Proven track record of success. Works independently and in a self directed manner.
Complex Case Management. 1-3 years in case management, disease management, managed care or medical or behavioral health settings. Active, unrestricted State Registered Nursing license in good standing. Must have valid driver's license with good driving record.
Performing telephonic medical records review for commercial and Medicare members. Applicants must meet the following qualifications: Travel for training at office for 8 - 10 weeks and for team meetings. Current unrestricted RN license in New York.