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... coordination, documentation, and communication of medical services and/or benefit administration determinations. ... appropriate criteria to make a medical necessity determination. Complete telephonic, faxed, ... Case Management Discuss cases with..
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Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
... coordination, documentation, and communication of medical services and/or benefit administration determinations. ... Behavioral Health Professional 2 completes medical record reviews from medical records sent from Behavioral Health ... appropriate..
Description The Wellness Coach 2 supports health promotion and disease prevention and care management services. The Wellness Coach 2 work assignments are varied and frequently require interpretation and independent determination of ..
... audit/validation processes to ensure that medical record documentation and diagnosis coding ... Auditor 2 validates and interprets medical documentation to ensure capture of ... Health field Previous experience in..
... and patient safety. While this associate receives inbound calls, with limited ... and patient safety. While this associate receives inbound calls, up to ... information such as pharmacy; plan..
Description The Medical Coding Auditor extracts clinical information ... information from a variety of medical records and assigns appropriate procedural ... assigns appropriate procedural terminology and medical codes (e.g. CPT)..
... brand for a primary care medical group practice with centers open ... lifelong well-being by giving our associate fresh perspective, new insights, and ... the Medicare population Proficient with..