Utilization Management Appeals Coordinator

**Responsibilities**: **JOB SUMMARY**: Responsible for all denial and appeal activities for the Utilization Management department, including Expedited Appeals, Standard Appeals, External Independent Reviews, Retrospective Reviews, and State Fair Hearings. Review clinical information for all appeals utilizing nationally recognized criteria to determine...

Hartgrove Behavioral Health System consists of a 160-bed leading psychiatric hospital dedicated to providing quality behavioral health services for a diverse population of all ages. A flagship behavioral health facility within Universal Health Services, Inc. and throughout Illinois, Hartgrove is a state-of-the-art facility offering some of the most advanced...

Responsibilities JOB SUMMARY: Responsible for all denial and appeal activities for the Utilization Management department, including Expedited Appeals, Standard Appeals, External Independent Reviews, Retrospective Reviews, and State Fair Hearings. Review clinical information for all appeals utilizing nationally recognized criteria to determine medical...

Job Description Responsibilities JOB SUMMARY: Responsible for all denial and appeal activities for the Utilization Management department, including Expedited Appeals, Standard Appeals, External Independent Reviews, Retrospective Reviews, and State Fair Hearings. Review clinical information for all appeals utilizing nationally recognized...

**Responsibilities**: **JOB SUMMARY**: Performs timely, daily clinical reviews with all payer types, to secure authorization for initial and continued treatment based on payer’s criteria and in accordance with the hospital wide Utilization Management Plan. Serves as liaison to 3rd and 4th party reviewers, effectively coordinating collection of all...

Responsibilities JOB SUMMARY: Performs timely, daily clinical reviews with all payer types, to secure authorization for initial and continued treatment based on payer's criteria and in accordance with the hospital wide Utilization Management Plan. Serves as liaison to 3rd and 4th party reviewers, effectively coordinating collection of all supporting data to...

Responsibilities JOB SUMMARY: Performs timely, daily clinical reviews with all payer types, to secure authorization for initial and continued treatment based on payer’s criteria and in accordance with the hospital wide Utilization Management Plan. Serves as liaison to 3rd and 4th party reviewers, effectively coordinating collection of all supporting...

ESSENTIAL FUNCTIONS: * Act as liaison between managed care organizations and the facility professional clinical staff. * Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements. * Monitor patient length of stay...

Hartgrove Behavioral Health System consists of a 160-bed leading psychiatric hospital dedicated to providing quality behavioral health services for a diverse population of all ages. A flagship behavioral health facility within Universal Health Services, Inc. and throughout Illinois, Hartgrove is a state-of-the-art facility offering some of the most advanced...

Duties may include but are not limited to: - Providing daily support to two attorneys - Heavy research - Department billing - Tracking appeal deadlines - Appealing property values, which includes gathering and entering property values and tax rates into a database - Preparing paperwork for appeal (i.e., form, cover letter, etc.) - Coordinating hearings...

Duties may include but are not limited to: - Providing daily support to two attorneys - Heavy research - Department billing - Tracking appeal deadlines - Appealing property values, which includes gathering and entering property values and tax rates into a database - Preparing paperwork for appeal (i.e., form, cover letter, etc.) - Coordinating hearings...

Job DescriptionJob DescriptionSalary: 50,000 annuallyPrimary responsibilities include providing daily research and support to two supervisory attorneys, including maintaining and organizing the calendar, appealing property values, and data entry. Candidates should be organized, motivated, a self-starter, able to multitask, work well with others, have a...

Job DescriptionJob DescriptionSalary: 50,000 annuallyPrimary responsibilities include providing daily research and support to two supervisory attorneys, including maintaining and organizing the calendar, appealing property values, and data entry. Candidates should be organized, motivated, a self-starter, able to multitask, work well with others, have a...

GENERAL SUMMARY/BASIC PURPOSE OF JOB: This position provides monitoring of inpatient and outpatient accounts to ensure accuracy of submissions and proper authorizations are obtained in order to secure reimbursement. The success is measured by the ability to reduce bill holds. This includes working closely with the clinical team, including the utilization...

**Remote work from Illinois, Wisconsin, Indiana, Missouri, Iowa, or Ohio** **Description** The **Rev Audit Contract Appeals RN** reflects the mission, vision, and values of NM, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines, and all other regulatory and...

Responsibilities JOB SUMMARY: Performs timely, daily pre-certifications, to secure initial authorization based on payer's criteria and in accordance with the hospital wide Utilization Management Plan. Coordinates with the Business Office, Admissions Department and Utilization Management Department. Obtains billing and insurance information, verification of...

Responsibilities JOB SUMMARY: Performs timely, daily pre-certifications, to secure initial authorization based on payer's criteria and in accordance with the hospital wide Utilization Management Plan. Coordinates with the Business Office, Admissions Department and Utilization Management Department. Obtains billing and insurance information, verification of...

Mac Properties is a dynamic and growing private residential real estate company with operations in the metropolitan areas of Chicago, St. Louis and Kansas City. We are hiring a Front Desk Coordinator in Hyde Park! We have 2nd and 3rd shift available and the pay rate is $17/hour. JOB OVERVIEW: A Front Desk Coordinator brings positive energy to each...

Mac Properties is a dynamic and growing private residential real estate company with operations in the metropolitan areas of Chicago, St. Louis and Kansas City. We are hiring a Front Desk Coordinator in Hyde Park! We have 2nd and 3rd shift available and the pay rate is $17/hour. JOB OVERVIEW: A Front Desk Coordinator brings positive energy to each...

**Maintenance & Utilities Manager** **Chicago, Illinois** **Position is 100% on-site** **Skills and Certifications**: Engineering / Bachelors Degree Authorized to work in the US without sponsorship Strong TPM experience The Utilities Maintenance Manager is directly responsible for improving the total uptime performance of the site’s Utilities assets...