Medical Claim Review Nurse Integrated Resources, IncMedical Claim Review NurseDallas, TXRemoteu>Preferred: Certified Coding Specialist (CCS), Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Inpatient Coder (CIC), Clinical Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC), or other advanced HIM/coding certifications. Clinical Validation Reviewer: Performs focused clinical reviews of inpatient and outpatient claims to verify that coded diagnoses, procedures, revenue codes, and corresponding reimbursement methodologies accurately reflect the patient’s documented clinical condition, services rendered, and billed charges.
Utilization Review Nurse Health Plans - HP Utilization Management CHRISTUS HealthUtilization Review Nurse Health Plans - HP Utilization ManagementIrving, TXPerform provider outreach to address post-hospital discharge services, redirection to in-network providers for appropriate steerage, durable equipment usage, and utilization of other medical services and/or procedures and other necessary telephonic follow-up. This nurse effectively communicates with internal and external clinical professionals, efficiently organizes the financial insurance care of the patients, and relays clinical data to insurance providers and vendors to obtain approved certification for services.
Utilization Review Nurse - Remote Tenet Healthcare CorpUtilization Review Nurse - RemoteFrisco, TXRemote$64,168–$96,262.40 / yearli>Excellent verbal communication skills with the ability to communicate with members and communicate professionally with individuals who serve in a variety of functions, i.e. physicians, client managers, customer service staff, CCCS executive management, other CCCS Medical Management nurses, hospital utilization review nurses, etc. Adherence to regulatory and departmental timeframes for review of requests received 3. Responsible for the effective and sufficient support of all utilization management activities to include prospective/ pre-certification review of inpatient and outpatient medical services for medical necessity and appropriateness of setting according to established policies.
Nursing Program Compliance Nurse Texas Health and Human Services CommissionNursing Program Compliance NurseDenton, TX$7,532.75–$8,886.16Collaborates with the Nurse Educator to develop educational materials and provide education to nurses on such topics as Quality Improvement Plans (QIPs), Corrective Actions Plans (CAPs), areas of deficiency within the nursing department and what is needed to address deficiencies. Ability to provide patient care; to prepare and maintain records; to organize, coordinate, and evaluate nursing activities and delivery of health services; to interpret policies and procedures; to interpret health care regulations; to recognize patterns of medical necessity treatment; and to provide technical assistance and consultation to others.
Physical Nutritional Management Team Nurse (PNMT RN) Texas Health and Human Services CommissionPhysical Nutritional Management Team Nurse (PNMT RN)Denton, TX$7,532.75–$8,886.16As assigned, collaborates with others to create and deliver specialized training/in-service material to prevent or decrease the opportunity for injury or illness for at-risk individuals on topics such as risk guidelines, aspiration pneumonia, PNMP philosophy content and procedures, positioning, lifting and transferring, dining/eating/oral intake and monitoring procedures. Ability to provide patient care; to prepare and maintain records; to organize, coordinate, and evaluate nursing activities and delivery of health services; to interpret policies and procedures; to interpret health care regulations; to recognize patterns of medical necessity treatment; and to provide technical assistance and consultation to others.
Nurse II Texas Health and Human Services CommissionNurse IIARLINGTON, TX$4,801.16–$7,761.50Based on the in-person, teleconference or telephoneinterview assessment, desk review and evaluation of services, the UR nurse uses program knowledge and nursing expertise todetermine appropriateness and quality of services, cost effectiveness of the service plan, validates determinations of health serviceneeds, and makes service authorization decisions. Reviews, evaluates, and documents services provided to aged and disabled persons and persons withintellectual disability to validate service needs, service provision, determines appropriateness, quality, and cost effectiveness ofservices.
RN Case Manager Supervisor Texas Health and Human Services CommissionRN Case Manager SupervisorDenton, TX$7,532.75–$8,886.16Attends various meetings as assigned and depending upon the needs of the SSLC such as: morning medical meeting, IDTs in the absence of the assigned RN Case Manager, medical provider meetings, human rights committee, level of supervision meetings, transition meetings, pre-placement visits, Quality Assurance/Quality Improvement (QAQI), and/or skin integrity/wound care meetings. Additional Information: Applicants must pass a fingerprint criminal background check, pre-employment drug screen, and registry checks including the Client Abuse/Neglect Reporting System (CANRS), Nurse Aide, Medication Aide and Employee Misconduct and HHS List of Excluded Individuals/Entities (LEIE).
Sales Development Representative - Demand Generation Qt Group PlcSales Development Representative - Demand GenerationDallas, TXp>b''rn rn Sales Development Representative - Demand Generation rn rnrn rn rn rn rnrn nn n n n n nn nn n nnnnnnnnnnnnnnnnn nn n nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnrnrn rn rn nnn nnnnn n n Skip to main contentn nnnrn. Qt Group (Nasdaq Helsinki:xe2x80xafQTCOM) is a global software company, trusted by industry leaders and over 1.5 million developers worldwide to create applications and smart devices that users love.xe2x80xafWe help our customers to increase productivity through the entire product development lifecycle - from UI design and software development to quality management and deployment.