Review
and analyze pre
and post pay complex
health care claims from a medical perspective: Review provider practices
and identify issues of concern, overpayment…
Review
and analyze pre
and post pay complex
health care claims from a medical perspective: Review provider practices
and identify issues of concern, overpayment…
Plans
and implements
nursing care; documents
nursing assessments; identifies
and reports situations requiring further intervention; formulates
and communicates…
Ensures compliance with all applicable Federal, State, and/or County laws
and regulations related to coding
and documentation guidelines for Risk Adjustment.
Employees may interact with upset staff and/or public
and private representatives in interpreting
and enforcing departmental policies
and procedures.
Employer groups reporting
and client ad-hoc reporting related to clinical
and financial
services. The subject matter expertise required will vary based on the…
Maintaining accurate, complete
health care records
and reports. Bachelor degree
or master degree in
nursing. We are looking for a Registered
Nurse to join our…
Identify incomplete
or conflicting documentation in the medical record
and formulate a physician query to obtain missing documentation
and/
or clarification to…
Employees may interact with upset staff and/or public
and private representatives in interpreting
and enforcing departmental policies
and procedures.
General working knowledge of case management practices
and ability to quickly learn
and apply workers compensation/case management products
and
services.
Evaluates the effectiveness of his/her
nursing
service to the individual
and family. This includes admission of patients for
service
and determining and…
High school
or equivalent (Preferred). * Schedule: Part-time
or contract. United States: Reliably commute
or planning to relocate before starting work …