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Executive Medical Director Revenue Cycle
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$123 - $184 an hour
Full-time
- Acts as a liaison between contracted Managed Care/Commercial payers related to managed care denials, Care Management and the Hospital’s Medical Staff to facilitate the accurate and complete documentation for coding and abstracting of clinical data, capture of severity, acuity and risk of mortality, in addition to DRG assignment.
- Serves as a member of the Utilization Management (UM) Committee by ensuring committee is actively reviewing and acting upon trends identified through data.
- Provides trend data of denials to assist in improving payer or care delivery behavior.
- Reviews concurrent payer denials and intervenes with attending and/or consulting physicians and managed care medical directors, as needed, for reconsideration and denial avoidance.
- Responsible for managing the efficiency of inpatient care delivered in the organization and collaborates with all levels of managed care team, utilization review management, hospital executive team including the Chief Medical Officers, and leadership of medical and nursing staff.
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