Orthopedic Medical Appeals Advisor (Board-Certified)
Dane Street
Dane Street is seeking a Physician Reviewer/Advisor to apply clinical expertise in reviewing insurance appeals and both prospective and retrospective claims. You will interpret the medical necessity of services in line with client criteria, nationally recognized guidelines, and standards of care. You will maintain credentialing, state licenses, and any special certifications required to perform the job, and you will participate in addressing quality assurance issues, regulatory matters, or #J-18808-Ljbffr Dane Street
- ...consulting firm seeks a Physician Reviewer/Advisor to leverage clinical expertise in reviewing insurance appeals and claims. Responsibilities include analyzing medical records, ensuring compliance with... .... Candidates must have board certification and active practice...SuggestedExtra incomeFlexible hours
$82.5k - $166.1k
...license required: Registered Nurse - State Board Work in accordance with corporate and... ...degree in Informatics Oncology Certified Nurse (OCN) and/or Biotherapy certification... ...package which includes the following: ~ Medical, dental, and vision insurance, including...SuggestedTemporary workWork experience placementLocal areaRemote workFlexible hours$120.2k - $140k
...including Axway Secure Transport (ST), eClinical Elluminate, Eclipse (medical coding), and EAST — across the full engagement lifecycle:... ...as they relate to downstream SAS programming environments.SAS Certified Platform Administrator or SAS Certified Deployment Specialist credential...SuggestedPermanent employmentLocal areaRemote workVisa sponsorship$90k
...Security+ CE CompTIA Cybersecurity Analyst (CySA+) Systems Security Certified Practitioner (SSCP) GIAC Security Essentials Certification (... ...for you and your dependents. Health Benefits: Multiple medical plans, dental, vision, FSA and HSA options to fit your needs. Parental...SuggestedContract workImmediate start- ...Company Overview UnityTec is an SBA-certified Woman-Owned Small Business (WOSB) delivering high-impact professional and technical... ...to join our team. You will serve as a strategic cybersecurity advisor responsible for developing, consolidating, and assessing IT security...Suggested
- ...recommendations. Develops care plan, including discharge plan, incorporating medical plan of care. Participates in identification of cases of abuse,... ...Social Worker - Social Work Certification and Licensure Board Additional Job Description: Masters degree in Social Work or a...Local areaShift work
$79.1k - $158.2k
...custom projects within area of focus. Develop and leverage trusted advisor relationships to bring business opportunities. Drive innovation... ...benefits package which includes the following: # Medical, dental, and vision insurance, including expert medical opinion...Temporary workFlexible hours- ...Description: Are you a seasoned healthcare planner with a passion for shaping cutting-edge healthcare environments? We are seeking a Medical Planner to lead and engage with clients and teams, delivering innovative solutions and leveraging state-of-the-art healthcare...
- ...planning components with appropriate referral to clinical case management or crisis intervention as appropriate. Enhancement of Medical Appropriateness and Quality of Care: Using holistic approach consults with case managers, supervisors, Medical Directors and/or other...Full timeLocal areaRemote workMonday to Friday
- ...their Columbus, OH/Remote location. Responsibilities: Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health/behavioral health programs to overcome barriers to meeting goals and objectives; presents cases at...Immediate startRemote work
- OneDigital | Resourcing Edge, a premiere HR/Talent services company, has partnered directly with The DesignGroup, a 50+ year award-winning architecture firm. DesignGroup has a growing healthcare practice. We're seeking a remote Healthcare Planner who's a “thought...Work at officeRemote work
- ...landscape, is highly desirable. Certifications DoD 8140 (DoDD 8570) IAT Level II Baseline Certification (At least one of these) Cisco Certified Network Associate Security (CCAN-Security) COMPTIA Cybersecurity Analyst (CySA+) Certified Network Defender (CND) COMPTIA...Full timeContract workTemporary workWork at officeLocal areaMonday to FridayWeekend workDay shiftAfternoon shift
- ...on changes. Applicants need at least seven years of experience in the field and relevant certifications such as DoD 8140 and Cisco Certified Network Associate Security. This full-time role offers a competitive benefits package, including health and dental coverage, 401K,...Full time
- Senior Healthcare Recruitment ConsultantTransform Your Career as a Senior Healthcare Recruitment Consultant with UsWelcome to MLR, where we are redefining the future of healthcare staffing and recruiting. With over two decades of industry experience under our belts, we...Permanent employmentImmediate startRemote workShift work
$82.5k - $166.1k
...preceding factors as well as internal peer equity. Oracle US offers a comprehensive benefits package which includes the following: ~ Medical, dental, and vision insurance, including expert medical opinion ~ Short term disability and long term disability ~ Life...Temporary workVisa sponsorshipFlexible hours- The Ohio Department of Medicaid is seeking a Medicaid Health Systems Specialist to join the Network Management team in Columbus. You will assess provider compliance, review applications and coordinate with the BCI office to ensure timely enrollments. This full-time role...Full timeWork at office
- Datavant is seeking a Provider Practice Coding Consultant to guide clinical coding practices, ensure compliance, and improve reimbursement outcomes across hospitals and alternative care settings. You will review records, assign CPT/ICD-10 codes, conduct quality reviews,...
$32 per hour
Locations: Tampa, FL (Preferred), Plano, TX or Columbus, OH Compensation: $32/hr Duration: 12 months with the potential to extend up to two or more years Policy and standards for corporate oversight There are 2 major projects needing support Building an Audit History that...Live in$45k - $60k
...road) Candidate must be located in Columbus, OH area (Additional Commissions, Bonuses, and Allowances) Company Overview Blackstone Medical Services is dedicated to providing exceptional at-home sleep testing for sleep apnea. We support healthcare providers with the...Full timeWork at office- ...recommendations. Develops care plan, including discharge plan, incorporating medical plan of care. Participates in identification of cases of abuse,... ...Social Worker - Social Work Certification and Licensure Board, LPCC - Licensed Professional Clinical Counselors - American...Local areaShift work
$260k
Senior Healthcare Recruitment ConsultantColumbus, OH $260,000 - $1,300,000 a yearFull TimeSenior Healthcare Recruitment Consultant — Cultivate Your Unique Brand with Unmatched ResourcesAt MLR, we blend technological innovation with expertise in healthcare staffing and ...Permanent employmentContract workRemote work$68.97k - $113.31k
...serve as a clinical expert supporting the evaluation of short-term and long-term disability claims. In this role, you will analyze medical information, assess functional capacity, collaborate with healthcare providers, and provide clinical guidance that supports claim decisions...Full timeTemporary workH1bRemote workVisa sponsorshipWork visaFlexible hours$60k - $85k
...Assists with the documentation on procedures and usage of the firm’s virtual platforms Interprets National Association of State Boards of Accountancy (NASBA) standards in order to advise internal clients on the appropriate design mechanisms to track participation Effectively...Work at office- Remote Healthcare Recruiting ConsultantEmbark on a rewarding journey as a remote healthcare recruiting consultant — connecting talents to transform livesWhat if your next career choice was not just a job, but a meaningful journey that you design yourself? Imagine holding...Remote jobSecond jobShift work
- Summary The incumbent - a Health Systems Specialist in the Medical Staff Office under the Chief of Staff at a VA Medical Center (VAMC) - conducts analytical reviews - manages data - and advises VAMC leadership on Credentialing and Privileging (C&P) processes. Please be...Permanent employmentWork at officeRemote workRelocation packageMonday to Friday
- The Ohio State University Wexner Medical Center is seeking a Marketing Consultant in the Growth Marketing and Reputation Strategy team. This role supports planning, coordination and implementation of marketing programs for assigned areas, managing projects and aligning...
- ...realizing those goals.This Opportunity is Perfect ForExperienced recruiters looking to elevate their career and broaden their horizons.Medical sales professionals or healthcare veterans eager for a change.Agency recruiters growing weary of administrative burdens and limited...Permanent employmentContract workImmediate startRemote work
- Nationwide is seeking an Internal Audit Consultant to strengthen governance, policy and methodology in a hybrid Columbus, OH role with on-site presence required several days each week. You’ll lead engagements from planning to completion, apply analytics and data visualization...
- Randstad USA is seeking a detail-oriented Policy and Standards Analyst to build and run an auditable history of policy and standards changes. This role blends meeting administration with structured cataloging, version control, and knowledge management. The ideal candidate...
- Technical/Functional Skills Analyst - Guidewire Policy Center experience (Must) Knowledge of rating module & P&C Insurance projects (Only commercial) - Preferable Experience Required Offshore coordination experience is Mandatory Roles & Responsibilities Liaison with ...Full time
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