UNKNOWN

FEED

Job duties include but are not limited to: understanding insurance contract terms, reviewing claim denials and underpayments to determine if additional payment amounts can be expected, analyzing medical records and determining if a member or an Independent Review organization (IRO) appeal is necessary, understanding payer medical policy guidelines, preparing IRO appeal documentation which may include correcting and resubmitting claims, gathering additional information, reviewing medical records, acting as a liaison between healthcare providers for any additional medical documentation or clarification, and submitting provider, member and IRO/ALJ appeals in a timely manner. Extensive review of medical records for medical necessity criteria, filing written letters of appeal on denied claims, filing complaints with state Department of Insurance, acting as a liaison between healthcare providers for any additional medical documentation or clarification, and submitting appeals in a timely manner.

YEAR

Ensemble Health Partners

Denials RN Coordinator

Works in a consultative role to provide safety assessments of patients or visitors, educate/support caregivers in de-escalation techniques, recommend environmental management for patient safety, review medication records, assist with updating the plan of care and provide guidance to all caregivers within Akron City Hospital for early and rapid intervention in order to promote better outcomes such as reduced workplace violence in the hospital and reduced time for transfers to Behavioral Health, if indicated. Ability to work well within a team environment by accepting and offering honest and constructive feedback; by supporting team goals and encouraging other team members and by collaborating with patient care team members to solve problems, create new methods and/or reduce costs.

HOUR

Summa Health System

RN - PT -Behavioral Emergency Response Team

IRecruitee

As part of Optum, SCA Health is redefining specialty care by developing more accessible, patient-centered practice solutions for a network of more than 370 ambulatory surgical centers, over 400 specialty physician practice clinics and numerous labs and surgical hospitals. Our work spans a broad spectrum of services, all designed to support physicians, health systems and employers in delivering efficient, value-based care to patients without compromising quality or autonomy.

Surgical Care Affiliates (SCA) partners with leading physicians, hospitals and health systems to develop and implement surgical services strategies across the country. With approximately 5,000 teammates, SCA operates more than 185 surgical facilities, including ambulatory surgery centers, surgical hospitals, and hospital surgery departments, in partnership with approximately 2,000 physicians and in affiliation with 45+ health systems. 
 
At SCA, we put Clinical First. Our mission is to care for our patients, serve our physicians and improve healthcare in America by offering clinical systems, service line growth strategies, benchmarking processes, and efficiency programs that create measurable advantage for surgical facilities&mdash;clinically, operationally and financially. 
 
An industry leader, SCA recently created industry-wide clinical outcomes reporting procedures, using metrics endorsed by the National Quality Forum. All SCA facilities pursue accreditation through The Joint Commission (TJC), the American Association of Ambulatory Surgery Centers (AAASC) or the Accreditation Association for Ambulatory Health Care (AAAHC). 
 
Our facilities focus on short-term care and primarily provide non-emergency surgical procedures in many specialties, including orthopaedics, ophthalmology, gastroenterology, pain management, and otolaryngology, among others. Our facilities provide physicians with the logistics and support staff necessary to perform these procedures. 
 
SCA is deeply committed to our core values of clinical quality, integrity, service excellence, teamwork, accountability and continuous improvement.

Surgical Care Affiliates LLC

OR RN PRN - Chardon ASC

The ideal candidate will provide high-quality nursing care, support patient health and wellness, and collaborate with healthcare professionals to ensure excellent patient outcomes. CHC is a non-profit social service agency in the Akron area whose mission is to treat, inspire, support and empower individuals and families impacted by the disease of addiction.

Registered Nurse

SummaCare Inc

RN - FT - Behavioral Emergency Response Team

Develop and maintain a good working rapport with inter-departmental personnel, as well as other departments within the facility to ensure that nursing services and activities can be adequately maintained to meet the needs of the residents. • Assist the Director and/or Infection Control Coordinator in identifying, evaluating, and classifying routine and job-related functions to ensure that tasks in which there is potential exposure to blood/body fluids are properly identified and recorded.

PACS Group

LPN Pt/Prn

Develop and maintain a good working rapport with inter-department personnel, as well as other departments within the facility to ensure that nursing services and activities can be adequately maintained to meet the needs of the residents. • Assist the Director and/or Infection Control Coordinator in identifying, evaluating, and classifying routine and jobrelated functions to ensure that tasks in which there is potential exposure to blood/body fluids are properly identified and recorded.

Registered Nurse PRN/PT

Register Nurse Full Time

Founded in 2001, Constellation Schools grew out of a community’s desire to offer an educational choice that balanced academic achievement with life skills, character education, and social-emotional learning. Over the years, Constellation Schools garnered many awards including the US Department of Education’s Blue Ribbon award and multiple School of Promise and Momentum awards from the Ohio Department of Education.

Constellation Schools

School Nurse (Cleveland)

SCA Health

[AW]-iCims

PACS

RN Part-Time

ea_via_bold

Develop and maintain a good working rapport with inter-departmental personnel, as well as other departments within the facility to ensure that nursing services and activities can be adequately maintained to meet the needs of the residents. Assist the Director and/or Infection Control Coordinator in identifying, evaluating, and classifying routine and job-related functions to ensure that tasks in which there is potential exposure to blood/body fluids are properly identified and recorded.

Clinical Nurse Liaison Jobs in Cleveland, OH

Denials RN Coordinator Ensemble Health Partners

RN - PT -Behavioral Emergency Response Team Summa Health System

OR RN PRN - Chardon ASC Surgical Care Affiliates LLC

Registered Nurse CHC

RN - PT -Behavioral Emergency Response Team SummaCare Inc

RN - FT - Behavioral Emergency Response Team SummaCare Inc

LPN Pt/Prn PACS Group

Registered Nurse PRN/PT PACS Group

Register Nurse Full Time PACS Group

School Nurse (Cleveland) Constellation Schools

OR RN PRN - Chardon ASC SCA Health

RN Part-Time PACS

LPN Part-Time PACS

LPN Pt/Prn PACS

Register Nurse Full Time PACS

LPN 3Rd Shift PACS

LPN PACS

RN PACS

PRN RN PACS

Registered Nurse Prn/Pt PACS

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