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Hoag
Overview
The Quality Management Nurse prepares, reviews, and presents findings on quality management events and grievances submitted to various medical directors and committees according to established policies. This role involves tracking grievances until final determination, documenting all activities, and participating in quality management projects, including HEDIS record collection and process improvement activities.
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Compensation
$49 - $76 / HOUR
Posted
1 month ago
Mount Sinai Health System
This role involves testing, coding, modeling, and reporting on Hospital Billing and Professional Billing contracts for the Health System to ensure accuracy of terms and reimbursement structures. The individual will also facilitate the flow of contract data into the revenue cycle system.
$19 - $29 / HOUR
2 months ago
Healthcare Outcomes Performance Co. (HOPCo)
The coordinator is responsible for verifying and updating patient registration information, obtaining necessary benefit verifications and authorizations for all ambulatory visits, procedures, and radiology services prior to patient arrival. Key tasks include processing a high volume of daily referrals, updating insurance eligibility, completing chart prepping, and responding to internal staff inquiries regarding referral status.
$16 - $18 / HOUR
3 months ago
McLaren Health Care
The Risk Adjustment Coder supports McLaren Health Plan lines of business by reviewing medical records to identify, collect, assess, monitor, and document claims and encounter information related to risk adjustment for Medicare and Commercial/ACA populations. This role requires strong skills in identifying chronic conditions and coding according to industry guidelines to ensure accurate and compliant documentation.
Salary not listed
Indiana Regional Medical Center
The specialist will be responsible for verifying patient insurance eligibility, benefits, and authorization requirements before or during services, and obtaining necessary initial and continued insurance authorizations for inpatient stays. This role also involves communicating coverage details and financial obligations to patients and staff, and ensuring medical documentation aligns with payer guidelines.
5 months ago