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Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope. May also engage in grievance and appeals reviews.
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Overview Working in a fast-paced, high volume, dynamic environment, the Clinical Authorization Specialist will bring clinical expertise to the prior authorization and appeals processes and serve as a liaison and patient advocate between Dana Farber Cancer Institute and various health plans.
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The Medical Director provides medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts.
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Supervises and assists staff liaisons to the Planning Board (PB), Zoning Board of Appeals (ZBA), Urban Design Commission (UDC), and/or Historic Preservation Commission (HPC), as necessary. Reviews plans, prepares staff reports, and presents information for cases going before the PB, ZBA, and/or HPC.
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The Coordinator will work closely with our fundraising staff to write donor-centric solicitations and appeals, inspiring cases for support, and tailored proposals for major donors; oversee an impact driven stewardship and acknowledgement calendar; contribute to ARL e-newsletters and magazine; and produce our Annual Report.
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The Surgery Assistant needs to be able to appropriately handle critical and emergent cases with the team including the anesthetist, surgeon and other on-call team members. The primary responsibility of the On-call Surgery Assistant is to provide overnight out of hours support for emergent cases through the surgery department practicing the highest quality surgical support for the patients and team members.
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Maintains current knowledge of hospital utilization review processes and participates in the resolution of retrospective reimbursement issues, including appeals, third-party payer certification, and denied cases.
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Hands on experience in data models and defining star and snowflake schemas on various banking use cases. In-depth working knowledge on Datawearhouse for various Investment banking use cases will be quick consideration.
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Our solutions span use cases across the product life cycle, from product development to mass production and aftermarket operations, and they address an array of industries, including automotive, aerospace, healthcare, consumer products, heavy industry, machine design and research and development.
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Reports cases of possible abuse and/or neglect to DPPC and DCF as a mandated reporter and works appropriately with DCF, MRC, DDS, DMH, and DPPC on abuse cases. Tracks progress of active cases, documents services provided, and keeps an updated organized client databaseAnalyzes and interprets data, laws, and policies and performs advanced or specialized work involving diverse or complex factors or situations based on a thorough knowledge of the specialty area.
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Serve as the site supervisor for the peer recovery coach in the IMA Meet regularly with the recovery coach to review patient cases, address logistical or patient care related challenges in the practice Communicate with the Recovery Coach Program Manager, the primary manager for this recovery coach role about any issues or challenges that arise and partner to do the annual performance evaluation 5.
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Handle a wide variety of cases including trauma, burns, general surgery, orthopedics, neurology, vascular, thoracic, electrophysiology, endoscopy, interventional radiology, and pediatrics. Handle a wide variety of cases including trauma, burns, general surgery, orthopedics, neurology, vascular, thoracic, electrophysiology, endoscopy, interventional radiology, and pediatrics.
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Practice a wide variety of cases, including ortho, OB/Gyn, ENT, general surgery, vascular and plastics, and take back-up call only. If you're looking for outdoor recreation, head to the Charles River for your favorite water activities, hike, bike and enjoy the natural wildlife at one of many trails and nature reserves in the area as well.
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Billing & Certified Coding Specialist II Facility: Beth Israel Lahey Health - Non Executive, 11 / 30
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Assists the Billing Supervisor with the resolution of complex claims issues, denials and appeals. Reviews provider documentation in order to determine appropriate coding and initiate corrected claims and appeals.
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If this specific job opportunity and the chance to work at a nationally renowned R&D innovation company appeals to you, apply now www. Performs wafer fabrication, packaging and assembly operations, such as photolithography, electroplating and chemical analysis, metal deposition, oxidation, reactive-ion etching, deep reactive ion etching, plasma-enhanced chemical vapor deposition, wet etching, pick and place, laser drilling, encapsulation and other processes as required, following detailed procedures, under the close supervision of senior technical personnel.
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grievance appeals cases jobs in Somerville, MA
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