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Clinical Appeals Supervisor Jobs

Clinical Supervisor Jobs
By PetMedic At , Warwick $31 - $36 an hour
Handle client complaints, escalate to Medical Director or Practice Manager if needed
Minimum 5 years’ experience in veterinary medicine
Experience with supervising and training clinical staff
Excellent communication skills – both verbal and written
Leadership abilities – collaborative, yet able to work independently
Problem-solving and critical thinking skills
Clinical Supervisor Jobs
By Legacy Treatment Services At Pennington, NJ, United States
Medical, vision, dental & life insurance benefits
Free CEU training opportunities, paid training days
Reoccurring Six Month Retention Bonus
$1,500 sign on bonus; $750 at 30 days and $750 at 90 days
3.2 weeks of PTO in first year
403(b) employee participation and employer match
100% Remote - Appeals & Grievances Non-Clinical Specialist - Medicare And Medicaid Knowledge Highly Preferred
By Healthfirst At Utah, United States
Experience working in care management systems, such as CCMS, TruCare or Hyland
Prior experience in a Managed Care or Healthcare environment
Demonstrated ability to be detail oriented, work under pressure, manage tight timeframes and exceptional organizational skills.
Manage all duties within regulatory timeframes
Bachelor’s degree from an accredited institution or relevant work experience
Prior knowledge of Medicare and Medicaid health plans
Clinical Supervisor Jobs
By The Village Network At Uhrichsville, OH, United States
Excellent verbal and written communication skills; strong time management and organizational skills; crisis management skills required.
TVN offers a generous retirement contribution and contributed nearly $1.5 million into employee 403(b) accounts this fiscal year!
Ability to comply with The Village Network requirements for using restraints including sufficient strength and completion of extensive training.
Essential Tasks, Duties, And Responsibilities
and visit the Careers page to explore additional opportunities and take a look at our benefits brochure.
Advancement Opportunities: The village network is a growing organization and we aim to promote from within.
Clinical Appeals Pharmacist - Remote In Us
By UnitedHealthcare At , Minnetonka, 55345, Mn
Pharmacy reimbursement (third party insurance, Medicare Part D formulary management, Medicaid, and Commercial
Position requires excellent record keeping skills, thorough documentation, clear and concise written/verbal communications skills
2+ years of working experience as a licensed Pharmacist
Experience using online clinical references and accessing professional (clinical and regulatory) internet sites
Experience working with onscreen document images
Proven excellent written and verbal communication skills
Clinical Supervisor Jobs
By New York City Criminal Justice Agency At Queens, NY, United States
Provide individual supervision and chart reviews for case management staff
Update computerized case management files with notes and attendance records
Oversee a team of social workers and case managers to provide supervision and services to a population of high-need participants
Ensure compliance with participants documentation and data input to fulfill reporting requirements by funders
Maintain communication with defense attorneys and referral agencies until completion of reporting responsibilities
At least one year of supervisory experience preferred
Clinical Supervisor Jobs
By The Village Network At Bethesda, OH, United States
Excellent verbal and written communication skills; strong time management and organizational skills; crisis management skills required.
10-year history of providing annual bonuses, as well as offering PTO Buybacks.
Ability to comply with The Village Network requirements for using restraints including sufficient strength and completion of extensive training.
Essential Tasks, Duties, And Responsibilities
and visit the Careers page to explore additional opportunities and take a look at our benefits brochure.
Advancement Opportunities: The village network is a growing organization and we aim to promote from within.
Clinical Supervisor Jobs
By The Village Network At Kettering, OH, United States
Excellent verbal and written communication skills; strong time management and organizational skills; crisis management skills required.
TVN offers a generous retirement contribution and contributed nearly $1.5 million into employee 403(b) accounts this fiscal year!
Ability to comply with The Village Network requirements for using restraints including sufficient strength and completion of extensive training.
Essential Tasks, Duties, And Responsibilities
and visit the Careers page to explore additional opportunities and take a look at our benefits brochure.
Advancement Opportunities: The village network is a growing organization and we aim to promote from within.
Clinical Appeals Nurse Jobs
By Netsmart At United States
At least 3 years of case management, concurrent review or utilization management experience
Prepare professional, effective clinical appeals in response to managed care, governmental, or RAC denials for hospital clients.
At least 5 years of clinical experience in acute care setting
Participate in telephonic Administrative Law Judge Hearings and present oral arguments for reversing Medicare denials.
Bachelor of Science degree in Nursing
Proficiency in medical record review
Clinical Supervisor Jobs
By Meridian Behavioral Health, LLC At Sauk Rapids, MN, United States
Provide supervision to counseling staff and assistance with case management of clients admitted to the program
The individual has three (3) or more years of experience providing individual and group counseling to chemically dependent clients.
Provides oversight with the screening and interviewing clients for appropriateness of admission to program
Ensures that the treatment program provides quality clinical services.
Determine need for discharge of clients per policies of program and give appropriate direction to staff members to carry out directive
Lead weekly supervision meetings and assure that meetings are documented.
Clinical Supervisor Jobs
By Odile Psychotherapy Service At New York, United States
Strong organizational, clinical, communication, interpersonal, and problem-solving skills
Knowledge of racial and relational trauma
Provide leadership and oversight of mental health services.
Ensure compliance with regulations, proper documentation, and quality assurance.
Conduct comprehensive diagnostic assessments, develop treatment plans, and implement evidence-based practices.
Maintain accurate and timely clinical records and participate in professional development.
Clinical Supervisor Jobs
By VIP At Honesdale, PA, United States
Minimum of two years of supervisory experience required
Experience with domestic violence and sexual assault preferred
Master’s Degree with LCSW or LPC required
Minimum of two years in a social services field required
Health, dental and vision insurance
Please Send Cover Letter And Resume To
Clinical Supervisor Jobs
By AVENUES RECOVERY CENTER At Maryland, United States
Strong organizational and management skills
Manage clinical program schedule that integrates our curriculum and best practices
Conduct weekly chart audits to ensure adherence to all documentation timelines and requirements
Dedicated to accomplishing tasks and managing responsibilities
Excellent interpersonal skills and observational skills
Strong written and oral communication skills
Clinical Associate Supervisor Jobs
By Maxor National Pharmacy Services, LLC At Plano, TX, United States
General knowledge of budgeting, cost estimating, and fiscal management principles and procedures.
Maintain current knowledge of plan specifications and requirements.
Assist in the development, preparation, and management of formularies, preferred drug lists, prior authorization criteria and step therapy protocols.
Assist the Manager, Formulary Operations in the development of clinical, utilization management, ad hoc and production reports and programs.
Assist Account Managers as needed in the generation of Annual or Quarterly Plan Benefit Review Summary and Recommendation Reports.
Assist Account Managers as needed to address client requests or issues.
Clinical Supervisor Jobs
By Guadalupe Centers At Kansas City, MO, United States

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Clinical Supervisor Jobs
By New Hope Midcoast At Rockland, ME, United States
Provide consultation and guidance to the management of New Hope Midcoast regarding staff and organizational matters
Group facilitation skills and experience
Knowledge of and sensitivity to issues of domestic violence
Effective communication skills, both oral and written
Contribute to the development of client-sensitive policies and procedures that support the agency’s delivery of programs and services
Provide assistance to agency staff with organizational structure matters
Clinical Supervisor Jobs
By Pulse Clinical Alliance At San Francisco, CA, United States
Experience: 2 years in a substance user disorder setting/Methadone/Outpatient clinic
Full medical benefits, vacation & sick leave
Experience with AVATAR billing system, experience with Methasoft preferred
Pay Rate: Up to $85,000 a year
Medical license in LCSW, LPC, or LMFT
Master's degree or higher in Psychology, Social Work, Counseling, or a related field.
Clinical Supervisor Jobs
By AHMC HealthCare At Riverside, CA, United States
Assists the Clinical Director to manage the unit communication process by
Manages appropriate patient care assignment based on the competency of staff, acuity of patient and continuity of care.
Manages shift productivity every 4 hours
Demonstrates understanding of the unit patient population including, illness, disabilities, disease, nutrition, treatment and interventions, and continuum of care needs.
Assumes responsibility and accountability for unit operations, including but not limited to
Outstanding customer service to patients, family members, physicians and the public
Clinical Supervisor Jobs
By Easterseals Southern California At San Diego, CA, United States
Expert knowledge of scientifically-validated methodologies and approaches found to benefit children with ASD; familiar with current related research findings.
The benefits of both a team environment, with the security of a large organization
Responsible for meeting productivity requirements set forth in annual budget. Lead/attend meetings and conduct on-going staff trainings.
Three years of related professional experience working with children with Autism Spectrum Disorders (ASD) in a multi-disciplinary team setting preferred.
Familiar with the field of early intervention; knowledge of other community resources and agencies that serve children.
Strong clinical, administrative, and leadership skills.
Clinical Appeals Nurse Rn Wfh
By HCA Healthcare At Nashville, TN, United States
At least 1 year of case management experience required
Relevant education may substitute experience requirement
Education assistance (tuition, student loan, certification support, dependent scholarships)
Family support through fertility and family building benefits with Progyny and adoption assistance.
Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.
Demonstrate the ability to interpret medical payer policy requirements.

Are you looking for a challenging and rewarding role in healthcare? We are seeking an experienced Clinical Appeals Supervisor to join our team! As a Clinical Appeals Supervisor, you will be responsible for managing the appeals process for our healthcare organization, ensuring that all appeals are handled in a timely and accurate manner. You will also be responsible for developing and implementing strategies to improve the appeals process, as well as providing guidance and support to staff. If you have a passion for healthcare and a commitment to excellence, this could be the perfect opportunity for you!

Overview:

A Clinical Appeals Supervisor is responsible for overseeing the appeals process for clinical claims and ensuring that all appeals are handled in a timely and accurate manner. The Clinical Appeals Supervisor is also responsible for providing guidance and direction to staff members who are responsible for processing appeals.

Detailed Job Description:

The Clinical Appeals Supervisor is responsible for overseeing the appeals process for clinical claims. This includes reviewing appeals, determining the appropriate course of action, and ensuring that all appeals are handled in a timely and accurate manner. The Clinical Appeals Supervisor is also responsible for providing guidance and direction to staff members who are responsible for processing appeals. The Clinical Appeals Supervisor is responsible for ensuring that all appeals are handled in accordance with applicable laws and regulations. The Clinical Appeals Supervisor is also responsible for monitoring staff performance and providing feedback and guidance as needed.

What is Clinical Appeals Supervisor Job Skills Required?

• Excellent communication and interpersonal skills
• Strong organizational and problem-solving skills
• Ability to work independently and as part of a team
• Knowledge of applicable laws and regulations
• Ability to manage multiple tasks and prioritize workload
• Proficiency in Microsoft Office Suite

What is Clinical Appeals Supervisor Job Qualifications?

• Bachelor’s degree in healthcare administration, business administration, or related field
• At least 5 years of experience in healthcare appeals or related field
• Knowledge of healthcare reimbursement and appeals processes
• Knowledge of healthcare coding and billing
• Knowledge of medical terminology

What is Clinical Appeals Supervisor Job Knowledge?

• Knowledge of healthcare reimbursement and appeals processes
• Knowledge of healthcare coding and billing
• Knowledge of medical terminology
• Knowledge of applicable laws and regulations

What is Clinical Appeals Supervisor Job Experience?

• At least 5 years of experience in healthcare appeals or related field
• Experience in managing and supervising staff
• Experience in developing and implementing policies and procedures

What is Clinical Appeals Supervisor Job Responsibilities?

• Oversee the appeals process for clinical claims
• Review appeals and determine the appropriate course of action
• Ensure that all appeals are handled in a timely and accurate manner
• Provide guidance and direction to staff members who are responsible for processing appeals
• Monitor staff performance and provide feedback and guidance as needed
• Ensure that all appeals are handled in accordance with applicable laws and regulations
• Develop and implement policies and procedures related to appeals
• Maintain records of appeals and ensure accuracy of data