Reviewer shall report directly to the Internal Quality Control Director and will be responsible for accessing and reviewing the...Job Family: General Coding Travel Required: None Clearance Required: None What You Will Do: The Coding Quality...
is responsible for regulatory compliance audits, including but not limited to regulatory agencies, Quality metrics, and coding... Cycle. This role is responsible for client facing meetings with the Quality Teams, CDI, and others directly related...
is responsible for regulatory compliance audits, including but not limited to regulatory agencies, Quality metrics, and coding... Cycle. This role is responsible for client facing meetings with the Quality Teams, CDI, and others directly related...
is looking for a Clinical Reviewer to join our growing team. Job Summary Acentra Health is seeking a dedicated and experienced Clinical... Reviewer to join our growing and mission-driven team. his is a meaningful and impactful role with a fantastic team...
balance, continuous learning, and career development. Summary We are seeking a talented individual for a Nurse Reviewer... to ensure documentation supports medical necessity while meeting production and quality goals. Documents decisions...
balance, continuous learning, and career development. Summary We are seeking a talented individual for a Nurse Reviewer... to ensure documentation supports medical necessity while meeting production and quality goals. Documents decisions...
is looking for a Medical Reviewer - Psychiatrist - Must be Licensed in Arkansas - PRN (Remote within the U.S.) to join our growing team... for beneficiaries, contributing to the overall effectiveness and quality of mental health services. Responsibilities: Completes...
Clinical Reviewer plays an integral role in optimizing the patient's recovery journey. The Prior Authorization Clinical... Reviewer is responsible for reviewing pre-authorization requests for skilled nursing and rehabilitative services...
of professional, inpatient or outpatient, facility benefits or services, and appeals. Documents decisions using indicated protocol... of professional, inpatient or outpatient, facility benefits or services, and appeals. Documents decisions using indicated protocol...
Title: Clinical Reviewer RN Location: Remote (must hold an unrestricted Massachusetts RN license) Duration: 5-month... is not required. Overview: We are seeking an experienced Inpatient RN Utilization Reviewer to independently manage a clinically complex...
We bring you tomorrow's opportunity, today. Volt is immediately hiring a Physician Reviewer in Remote within the 5... states of (Illinois, New Mexico, Texas, Montana, or Oklahoma)! As a Physician Reviewer, you will : Job Specifications...
, and apply inpatient reimbursement rules without direct supervision. Collaborates with the Medical Director on complex cases, providing... established quality and productivity standards while managing priorities and workflow autonomously. Contributes to strategic...
. Onsite 1-2 weeks, then will work remote. Will be required to come onsite as needed for meetings and training. Typical day... medical reviews using established criteria sets and/or performs utilization management of professional, inpatient...
. To promote efficient, high-quality clinical practice by providing guidance through collaborating with the team to manage patient... in and collaborate with medical team to provide high-quality and safe patient care. Responsible for successful completion of tasks...
medical records on site, through remote electronic access, telephonically or by fax in a collaborative effort... to facilitate cost-effective, quality care Requests and obtains relevant clinical information from medical care providers...
Health Plan. This physician leader will play a critical role in ensuring the clinical integrity of inpatient and post-acute... care reviews, evaluating medical necessity to support optimal outcomes and regulatory compliance. Location: 100% Remote...
Authorization Clinician is responsible for reviewing all proposed hospitalization, home care, and inpatient/outpatient services... optimal health outcomes. Our Investment in You: Full-time remote work Competitive salaries Excellent benefits Key...