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…
Earned Doctorate in
nursing, allied
health
or related field from an accredited institution. Knowledge
and experience of the roles
and responsibilities of a Dean…
Knowledge
and experience of the roles
and responsibilities of a Dean of a school/college of
nursing, allied
health
or related field.
Nurse I Level III - An ADN
or Diploma in
Nursing
and approximately 2-3 years of
nursing practice/experience;
OR an ADN
or Diploma in
Nursing
and a Bachelor's…
Identify incomplete
or conflicting documentation in the medical record
and formulate a physician query to obtain missing documentation
and/
or clarification to…
Ensures compliance with all applicable Federal, State, and/or County laws
and regulations related to coding
and documentation guidelines for Risk Adjustment.
Proven knowledge of medical
and surgical procedures
and other healthcare practices
and trends. Maintains knowledge regarding legislative and/or healthcare…
Identifies potential
and actual problems involving resources and/or safety.
Nurse I Level III - An ADN
or Diploma in
Nursing
and approximately 2-3 years of…
Employees may interact with upset staff and/or public
and private representatives in interpreting
and enforcing departmental policies
and procedures.
High school
or equivalent (Preferred). * Schedule: Part-time
or contract. United States: Reliably commute
or planning to relocate before starting work …
Makes referrals for Peer reviews
and IME’s by obtaining
and delivering medical records
and diagnostic films, notifying injured worker/disabled individual and…