Top 31 Clinical documentation specialist Jobs in New Hampshire

Clinical Review Specialist
New England Life Care —Concord, NH
- $24 - $25 an hour
- Full-time
- Remote
- Microsoft Outlook
- Writing skills
- Mid-level
- Disability insurance
- Health insurance
Quick Apply
8d
Clinical Quality Specialist
Home Health & Hospice Care —Merrimack, NH
- Part-time
- CPR Certification
- Nursing
- RN License
- Disability insurance
- Health insurance
Quick Apply
12d
Registered Nurse Emergency Services
Frisbie Memorial Hospital —Rochester, NH
- Full-time
- Mid-level
- Pediatrics
- Employee stock purchase plan
- Disability insurance
Quick Apply
Data Support (Temporary- Per Diem- Hybrid/Remote)
1 - North Country Home Health & Hospice —Littleton, NH
- Temporary
- Remote
- CPR Certification
- Writing skills
- BLS Certification
7d
Orthotic and Prosthetic Medical Biller
CBS Medical Billing & Consulting LLC —Exeter, NH
- $22 - $26 an hour
- Full-time
- Remote
- Mid-level
- Commercial
Quick Apply
13d
Supervisory Medical Records Technician (ROI)
US Veterans Health Administration —Manchester, NH
- $63,291 - $82,275 a year
- Online Application
- Background check
- High school
- Pass drug screening
11d
Medical Staff Services Coordinator
Catholic Medical Center —Manchester, NH
- Full-time
- Mid-level
- Employee stock purchase plan
- Disability insurance
Quick Apply
Medical Records Technician (ROI)
US Veterans Health Administration —Manchester, NH
- $41,236 - $66,857 a year
- Online Application
- Acute care
- Background check
- High school
- Health insurance
11d
Med Staff Services Coordinator
Catholic Medical Center —Manchester, NH
- Full-time
- Mid-level
- Employee stock purchase plan
- Disability insurance
Quick Apply
Registered Nurse - Hybrid Eligible with Flexible Schedule
Martin's Point Health Care —Portsmouth, NH
- Full-time
- Nursing
- RN License
- BLS Certification
- Flexible schedule
Quick Apply
5d
Office Nurse - Physiatry
Core Physicians LLC —Exeter, NH
- Full-time
- Nursing
- RN License
- Hospital
- Free parking
- Health insurance
2d
Office Nurse - Urology
Core Physicians LLC —Exeter, NH
- No weekends
- Nursing
- RN License
- Hospital
- Free parking
- Health insurance
Office Nurse - Epping Family (3 days week, with benefits)
Core Physicians LLC —Epping, NH
- Part-time
- Nursing
- RN License
- Hospital
- Free parking
- Health insurance
2d
Office Triage Nurse - ENT Portsmouth
Core Physicians LLC —Portsmouth, NH
- Full-time
- Nursing
- RN License
- Mid-level
- Free parking
- Health insurance
RN/LPN | Practice Registered Nurse | CHMG Primary Care Weekend Triage | Per Diem | Day
Concord Hospital —Epsom, NH
- Part-time
- CPR Certification
- Nursing
- RN License
- Work from home
11d
Oncology Infusion Room RN
New England Cancer Specialists —Portsmouth, NH
- Weekends as needed
- Private practice
- Nursing
- RN License
- Travel reimbursement
- Wellness program
Quick Apply
RN Inpatient Wound & Ostomy Specialist - Per Diem
Southern New Hampshire Health —Nashua, NH
- Part-time
- Nursing
- RN License
- Inpatient
- Paid training
- Disability insurance
7d
Float Registered Nurse RN - Maternal & Child Health - Per Diem
Southern New Hampshire Health —Nashua, NH
- Part-time
- Float pool
- RN License
- BLS Certification
- Paid training
- Health insurance
Emergency Room Registered Nurse (RN) – Rochester, NH
Desort —Rochester, NH
- $68,000 - $98,000 a year
- Online Application
- Nursing
- Medication administration
- RN License
- Health insurance
- Dental insurance
Quick Apply
Staff RN - ECMO Spec / FT, nights
Children's Nebraska —United States
- Overtime
- Nursing
- RN License
- BLS Certification
- Flexible schedule

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clinical documentation specialist jobs near new hampshire

Clinical Review Specialist

New England Life Care -
Concord, NH

Quick Apply

Job Details

Full-time
$24 - $25 an hour
8 days ago

Benefits

Disability insurance
Health insurance
Dental insurance
Paid time off
Vision insurance
403(b)
Life insurance

Qualifications

Customer communication
Utilization management
Resource utilization in healthcare

Full Job Description

New England Life Care (NELC) is one of the fastest growing home infusion therapy companies in New England and is the region’s only non-profit home infusion provider. NELC is a hospital collaborative serving more than 70 hospital systems in Maine, New Hampshire, and Massachusetts. NELC was created by local hospitals to ensure their patients have access to a provider that reflects their commitment to excellence in patient care, quality, and service. Like our owner hospitals, NELC provides patient focused care.

New England Life Care has and continues to build a diverse, inclusive, and authentic workplace, so if you’re energized by this opportunity, but your experience doesn’t support every qualification in the job posting, we encourage you to apply! You still may be the person we are looking for!

New England Life Care currently has a Remote Clinical Review Specialist opportunity available. This is a remote position with an ideal Monday – Friday from 8:30am until 5:00pm schedule. The ideal candidate for this position will excel in a fast-paced environment, have excellent communication and deductive reasoning skills.

**We are only hiring remote employees for this position that live in Maine, Massachusetts, and New Hampshire.**

Summary:

The Clinical Review Specialist will conduct regular utilization management reviews and provide clinical information as required in order to confirm coverage for each patient.

Benefits:

Career Ladder
Health insurance
Dental insurance
Vision insurance
Generous employer-matched 403(b) savings program
Company paid: Life insurance, Short- and long-term disability insurance
Paid Time Off
And much more!

Primary Responsibilities:

Apply clinical skills and expertise in conjunction with established medical criteria, members’ eligibility and benefit coverage information, in the review of therapy checklists & specialist drug authorization forms, to ensure high-quality, cost-effective care
Maintain a thorough and comprehensive understanding of regulations, payer contracts, product lines, NELC policies & procedures.
Serves as subject matter expert on complex specialty drugs clinical requirements.
Review clinical documentation for long term government payers to ensure they still meet clinical coverage twice a year. Consulting with the Medical Director for all potential denials that do not meet medical necessity or NELC criteria. The decision for a medically necessary denial is within the Medical Director role
Act as a liaison between internal and external customers to resolve systems/process issues and ensure we are obtaining signed physician orders from participating MDs for government payers.
Determine appropriateness and effectiveness of services requested using established medical coverage criteria, guidelines and departmental policies and procedures
Responsible for timely and comprehensive medical review with concise documentation of pertinent facts, decisions and rationale and facilitation of resolution to requests of “urgently needed, not yet rendered services” in compliance with state regulation.
Effectively and accurately communicate coverage decisions to members, providers, and medical groups, following timelines established by regulations and accreditation standards.
Identify and appropriately inform Manager/Supervisor of sensitive or complex cases
Maintains a thorough and comprehensive understanding of state and federal regulations, accreditation standards and payer contracts to ensure compliance.
Develop and maintain positive, effective working relationships with Medical Directors, physicians, vendors, managed care offices and other customers
Maintain confidentiality of member and case information by following Corporate Privacy policies pertaining to protection of member PHI
Perform other duties as assigned

Mandatory and Preferred Requirements:

Medical Assistant certification required
MA or LPN preferred
Associate of Arts degree or higher are preferred
Healthcare experience in a medical setting required
Prior experience in care coordination, home health or home infusion preferred
Experience in managed care environment
Experience in working with established criteria to determine medical necessity and appropriateness of care
Experience in utilization review, utilization management, quality review
Working knowledge of federal / state fraud and abuse laws required
Knowledge of HIPAA Privacy and Security Regulations preferred.

Skills:

Dependability in attendance and job performance required
Excellent verbal and written communication and interpersonal skills
Excellent problem identification and solving skills
Ability to organize and prioritize multiple assignments within workload
Ability to function independently and take independent action, within scope of job responsibilities
Competency in computer skills including Microsoft work, outlook and internet

''It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.''

EOE

Monday – Friday from 8:30am until 5:00pm

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Refine Your Search

clinical documentation specialist jobs in new hampshire

Clinical Review Specialist

Clinical Quality Specialist

Registered Nurse Emergency Services

Data Support (Temporary- Per Diem- Hybrid/Remote)

Orthotic and Prosthetic Medical Biller

Supervisory Medical Records Technician (ROI)

Medical Staff Services Coordinator

Medical Records Technician (ROI)

Med Staff Services Coordinator

Registered Nurse - Hybrid Eligible with Flexible Schedule

Office Nurse - Physiatry

Office Nurse - Urology

Office Nurse - Epping Family (3 days week, with benefits)

Office Triage Nurse - ENT Portsmouth

RN/LPN | Practice Registered Nurse | CHMG Primary Care Weekend Triage | Per Diem | Day

Oncology Infusion Room RN

RN Inpatient Wound & Ostomy Specialist - Per Diem

Float Registered Nurse RN - Maternal & Child Health - Per Diem

Emergency Room Registered Nurse (RN) – Rochester, NH

Staff RN - ECMO Spec / FT, nights

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