JOB SUMMARY. The Quality Control Analyst is responsible for claims auditing and identifying examiner and system errors. This position also handles the auditing of claims special projects including risk pool, shared risk, Health Plan. ESSENTIAL DUTIES AND RESPONSIBILITIES. Include the following. Others may be assigned. Understands, interprets. . and applies coding and reimbursement guideline. provider and Health Plan contracts for professional cla...
JOB SUMMARY. The Senior Director of Client Finance and Analysis is responsible for delivering insights to clients and internal operations based on analysis of financial and clinical data. This position ensures development of financials and analytics including measurement of key metrics, and provides qualitative analytics to identify trends and provide actionable solutions designed to optimize overall performance. Additionally, the individual will...
As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities, and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare exper...
Position Summary. The purpose of the Prior Authorization Technician is to work cooperatively with licensed clinical staff to provide patients and physicians with accurate and timely determination of the prior authorization requests based on clinical guidelines. The Prior Authorization Technician will assist in maintaining compliance of the prior authorization processes and turnaround time requirements. Position Reports to. This position reports t...
