To provide quality case management services to all patient populations and their families. To serve as a member of the interdisciplinary team supporting the organization’s treatment program and philosophy and assure the deliverance of quality treatment to patients and their families. To proactively monitor and optimize reimbursement for organization services.
• Maintain appropriate records of the Utilization Review Department.
• Prepare and submit appeals.
• Attends mandatory training.
• Conducts admission reviews and pre-certs.
• Conducts concurrent and extended stay reviews.
• Prepares and submits appeals to third party payors.
• Schedules and conducts treatment team meetings to provide total case management of the patient by reading and discussing written progress notes from charts and communicating any state or local agency legal requirement for case management with the interdisciplinary team.
• Participates in activities which enhance professional growth and development.
• Demonstrates conduct in keeping with CCBH’s ethical standards.
• Complies with facility safety, infection control and security program.
• Supports facility service excellence standards.
Graduate of accredited RN program with current RN license, or a Masters in Counseling/Social Work or related field. Experience in psychiatric nursing preferred; high school, preferably college level reading, writing, and math skills. Excellent telephone, computer, and communication skills. Knowledge of health care service delivery systems and third party reimbursement; understanding of admission and discharge function. Familiar with medical terminology, diagnostic terms and treatment modalities; knowledge of medical record keeping; strong interpersonal, organizational, evaluative, and time management skills; policy interpretation skills. Must be familiar with applicable standards and regulations. Flexible; pays attention to detail; able to comprehend psychiatric evaluations, consults, labs, etc.; responsiveness to deadlines; assertiveness, persistence and persuasiveness; able to work with minimal direction or supervision.
...MondayFriday, 8:00 AM5:00 PM Location: Fully onsite in Humble, TX Position Overview We are seeking an experienced Medical Billing Specialist to support a growing cardiology practice in Humble, TX . This fully onsite role is responsible for end-to-end...
Temporary Retail Sales Associate every Saturday - Schedule: 10:30 a.m. - 5:00 p.m. Salary = $29.91 per hour Position Duties and Responsibilities Greet and welcome visitors; offer helpful directions to a variety of offerings. Match offerings to the interests...
...General Rigging Estimator PSC Crane & Rigging Location: Columbus Ohio About PSC Crane & Rigging PSC Crane & Rigging is a 4 th generation, family-owned company specializing in safe, expert crane, rigging, and heavy lift solutions and projects. We partner...
...motivated individual to work as a Research Assistant within a highly creative and dynamic research team of scientists, engineers, and life science entrepreneurs. Our team works on a diverse array of projects that span genomics, bioengineering, cancer biology and neuroscience...
...POSTAL CLERK NO EXPERIENCE REQUIRED PAID TRAINING PROVIDED JOB SECURITY The Postal Service is the largest government related agency in terms of employees.The Postal Service currently employs nearly 1 million people and is hiring nationwide.There...