review,registered nurse,clinical knowledge,managed care,accreditation standards, About Company: UST is a global digital... and recommend alternative treatments, service levels, and length of stays using approved clinical protocols Analyze, research...
Operations Manager for Appeals is responsible for managing and overseeing operations related to clinical appeals, ensuring... Registered Nurse (Active License) Minimum 1 year in a Manager role Work Experience Experience in managing teams handling Clinical...
in Nursing Experience: Minimum of 2 years of BPO clinical experience (specifically in utilization management, appeals management..., and the appropriateness of treatment settings in accordance with applicable medical policies and clinical guidelines...
,utilization review,registered nurse,clinical knowledge,communication skills,customer service management,microsoft office... is seeking a highly motivated Utilization Review Registered Nurse (RN) to join our team. In this role, you will conduct...
Association (AHA) Coding Clinic for International Classification of Diseases, Clinical Modification American Health Information..., as part of the coding process, to assess the presence of clinical evidence/indicators to support diagnosis code and MS-DRG...
Association (AHA) Coding Clinic for International Classification of Diseases, Clinical Modification American Health Information..., as part of the coding process, to assess the presence of clinical evidence/indicators to support diagnosis code and MS-DRG...
Association (AHA) Coding Clinic for International Classification of Diseases, Clinical Modification American Health Information..., as part of the coding process, to assess the presence of clinical evidence/indicators to support diagnosis code and MS-DRG...
license (USRN license is a PLUS) Must have Dialysis Training Certification Good working knowledge with Clinical Appeals... UM request for services against established clinical review criteria, referring cases not meeting criteria to a physician...
Nurse license 3 months clinical experience (480 hours of working experience as a RN) Work experience as an active RN license...Grievance & Appeals Creates complete appeal records for external appeal reviews, using standardized Independent Review...
or Associate Nursing Degree or Nursing Diploma Holds current and unrestricted US Registered Nurse license 3 months clinical...Grievance & Appeals Creates complete appeal records for external appeal reviews, using standardized Independent Review...
Operations Manager for Appeals is responsible for managing and overseeing operations related to clinical appeals, ensuring... Registered Nurse (Active License) Minimum 1 year in a Manager role Work Experience Experience in managing teams handling Clinical...
that handle Utilisation Management and clinical denials. Hands-on experience in appeals/denials, utilisation review, or related... regulations. Qualifications: Bachelor's Degree in Nursing with an active and valid US Registered Nurse (USRN) license. At least 1...
or Associate Nursing Degree or Nursing Diploma Holds current and unrestricted US Registered Nurse license 3 months clinical...Grievance & Appeals Creates complete appeal records for external appeal reviews, using standardized Independent Review...
license (USRN license is a PLUS) Must have Dialysis Training Certification Good working knowledge with Clinical Appeals... UM request for services against established clinical review criteria, referring cases not meeting criteria to a physician...
, visit Vee Healthtek. USRN Case Manager Nurse Overview: Responsible for coordinating patient care, liaising with physicians... authorizations, denial letters, and appeals. Qualifications BS Nursing graduate: USRN - NY license required . Minimum 2 years...
Holds current and unrestricted US Registered Nurse license 3 months clinical experience (480 hours of working experience...+ business community. Please do not contact the recruiter directly. Grievance & Appeals Creates complete appeal records...
involved in clinical appeals or utilization review processes. Ability to manage large teams (up to 1 OM and 100 staff... US Registered Nurse license (Compact License preferred). Minimum 1 year of experience in an Operations Manager or similar...
and recommend alternative treatment, service levels, length of stays, etc. using approved clinical protocols Analyze, research..., respond to and prepare documentation related to retrospective review requests and appeals in accordance with local, state...