Job Opportunities in United States

Location: METROHEALTH MEDICAL CENTER
Biweekly Hours: 80.00
Shift: 8a-430p


The Metro Health System is redefining health care by going beyond medical treatment to improve the foundations of community health and well-being: affordable housing, a cleaner environment, economic opportunity and access to fresh food, convenient transportation, legal help and other services. The system strives to become as good at preventing disease as it is at treating it. Founded in 1837, Cuyahoga County’s safety-net health system operates four hospitals, four emergency departments and more than 20 health centers.


Summary:

Advocates for the patient and ensures that appropriate and necessary healthcare services are covered by insurance. Reviews clinical criteria to support patient care inquiries regarding the appropriateness of requested treatments, procedures, and therapies for patients of The Metro Health System (MHS). Analyzes medical records, reviews insurance policies, and consults with healthcare providers to gather the necessary information required for the appeal process when appropriate. Participates in on-going efforts to identify and educate providers regarding evidence-based and cost-effective alternatives for care delivery. Upholds the mission, vision, values and customer service standards of the MHS.