Healthcare Utilization Review Specialist - Claims & Coding
Cobalt Benefits Group LLC
Cobalt Benefits Group LLC is seeking a Utilization Review Specialist in Minnesota. The ideal candidate will coordinate reviews of group renewal information and process claims based on medical necessity. Responsibilities include reviewing claims, supporting department operations, and maintaining compliance with standards. The role necessitates a background in healthcare or related fields and requires strong reading comprehension and communication skills. Comprehensive benefits package and competitive hourly wage are offered. #J-18808-Ljbffr
$22 - $24 per hour
...Summary Reporting to the Utilization Review Manager, the Utilization Review Specialist will coordinate... ...information, process claims for medical necessity,... ...processing based upon coding. This position involves... ...ideal for detail‑oriented healthcare para‑professionals who...ClaimsHourly payTemporary workFlexible hours- ...Medication Access Specialist We are relentless... ...is to transform healthcare through pharmacy,... ...burdens. Gather and review necessary... ...ensuring accurate claim processing and reimbursement... .... Proficient in utilizing CoverMyMeds for... ...authorization, and healthcare coding, utilizing...ClaimsFull timeWork at officeRemote workWork from home
- ...RN Utilization Review By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for... ...utilization review software. Communicates and works with claim examiners as needed to provide clinical information to resolve...ClaimsWork at office
$19 - $27 per hour
...Medical Billing Specialist Tareen Dermatology is... ...hands-on experience in claim submission, denial management... ...in a fast-paced healthcare environment. This... ...: Reviewing visit coding, posting charges, payments... ...payment lapses occur. Utilizes collection agencies to...ClaimsHourly payLive inWork at officeRemote work$73k - $75k
...Fortune Best Workplaces in Financial Services & Insurance RN Utilization Review PRIMARY PURPOSE: To provide timely, evidence-based utilization... ...in utilization review software. Communicates and works with claim examiners as needed to provide clinical information to resolve...ClaimsWork at officeFlexible hours$19.55 - $20.9 per hour
...Senior Patient Access Specialist Ensemble is a... ...We recognize that healthcare requires a human... ...physician order while utilizing an overlay tool... ...services. Reviews eligibility responses... ...applicable insurance plan code, enters benefit... ...with a clean claim rate including pre...ClaimsWork at officeLocal areaRemote work- ...Description: CASH POSTING SPECIALIST Do you want to share your passion for healthcare? Are you looking for... ...organization and utilize your skills for a company... ...processing of all patient claims. This role offers plenty... ...payments, and to review and provide status updates...ClaimsMonday to FridayFlexible hours
$17 - $18.15 per hour
...Patient Access Specialist Ensemble is a leading... ...We recognize that healthcare requires a human... ...orders, and utilizing an overlay tool while... ...future services. Reviews eligibility responses... ...insurance plan code, enters benefit data... ...with a clean claim rate. Responsible...ClaimsFull timeWork at officeLocal areaRemote workShift workNight shiftAfternoon shift$51.2k - $70.4k
...Intake Specialist This is where your work makes a difference... .... We are redefining healthcare delivery to make a... .... This role utilizes online payer portals,... ...necessity for reimbursement; reviews the prescribed therapy... ...to support clean claims and revenue accuracy...ClaimsTemporary workWork at officeLocal areaWork visaFlexible hours- ...mission is to transform healthcare through pharmacy, and... ...to add a Medication Specialist to our Specialty Pharmacy... ...investigation reviews to determine patient coverage... ...funds that could be utilized to reduce patient financial... ...of CPT and ICD coding is highly desired; Knowledge...Full timeRemote workWork from home
$49.6k - $68.2k
...principle. We are redefining healthcare delivery to make a greater impact... ...will perform Reimbursement Specialist duties for assigned territory... ...rework and allow for clean claims. Gather clinical documentation... ...you can protect yourself, review our Recruitment Fraud Notice.ClaimsFull timeTemporary workWork at officeWork visaMonday to FridayFlexible hours3 days per week$95.17k - $149.56k
...quality recoverable claims for the benefit of... ...clinical reviews of medical records... ...evaluate issues of coding and DRG assignment... ...substantiate conclusions. Utilizes audit tools and... ...Certified Coding Specialist and/or CIC as a... ...communities – and making healthcare simpler. We are a...ClaimsFull timeTemporary workWork experience placementLocal area1 day per week$20.02 - $25.78 per hour
...and administrative processes that healthcare providers utilize to capture, bill, and collect... ...and appealing denied and rejected claims Preparing, reviewing, and transmitting claims using billing... ...~ Familiarity with ICD-10 coding ~ Competent with computer systems...ClaimsHourly payTemporary workWork experience placementLocal areaImmediate startRemote workFlexible hours- ...customized schedules and caseload while conducting medical reviews for health claims. Ideal candidates must have an unrestricted TX license and... ..., ensuring proper credentialing, and communicating with healthcare professionals. The role is within a Monday to Friday business...ClaimsFor contractorsRemote workMonday to Friday
- ...Utilization Review Coordinator Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a... ...as necessary. Enters demographics and UR information into claims or clinical management system; maintains data integrity. Obtains...ClaimsWork at officeFlexible hours
- ...Medicaid Program Integrity Review Supervisor Job Class: Human... ...Medicaid Program Integrity Review Specialists. The team reviews behavioral... ...to Medicaid to ensure claims are accurate and meet program... ...standards; basic understanding of healthcare coding and billing as it applies to...ClaimsTemporary workWork experience placementLocal areaRemote work
- ...Clinical Denials Nurse Specialist The Clinical... ...a comprehensive review of clinical documentation... ...Collaborates with Coding Denials Specialist... ...in high-dollar claim denial review and... ...records and utilizes screening criteria... ...of experience in a healthcare revenue cycle or clinic...ClaimsTemporary workWork at officeLocal areaRelocation package
- ...As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise and reviews insurance appeals... ...prospective and retrospective claims. The Physician Reviewer will... ...of services provided by other healthcare professionals in compliance with...ClaimsExtra income
$223.8k - $313.1k
...Director relies on medical background and reviews health claims. The Medical Director work... ...Emergency Medicine, or those experienced in Utilization Review are encouraged to apply. Role... ...encourage personal wellness and smart healthcare decisions for you and your family...ClaimsBi-weekly payFull timeTemporary workApprenticeshipWork at officeLocal areaRemote workWork from homeHome officeMonday to FridayWeekend work- ...A dynamic healthcare assessment firm is seeking skilled medical reviewers in Cardiology for a telework opportunity. As an independent contractor, responsibilities include evaluating medical records and providing clinical summaries while maintaining a flexible schedule....For contractorsRemote workFlexible hours
- ...Physician Reviewer/Advisor For Independent Medical Exams (Ime) As... ...Medical Exams (IME), you will utilize clinical expertise and... ...prospective and retrospective claims. The Physician Reviewer will... ...of services provided by other healthcare professionals in compliance with...Claims
- ...HealthPartners is seeking a Revenue Cycle Coding Specialist to join Park Nicollet in Minnesota.... ...coding for provider services in various healthcare settings, ensuring accurate assignments... ...and conducting audits to address denied claims. The ideal candidate will hold relevant...Claims
- ...Certified Radiologist for Record Reviews- Minneapolis, MNBoard-... ...Medical Exams (IME), you will utilize clinical expertise and reviews... ...prospective and retrospective claims. The Physician Reviewer will... ...of services provided by other healthcare professionals in compliance with...ClaimsExtra incomeContract workPart timeRemote work
- ...A healthcare solutions provider in the United States is seeking a licensed psychologist to conduct Medical Disability Examinations (MDE) for veterans filing mental health disability claims. Responsibilities include comprehensive mental health assessments and writing medical...Claims
$68k - $80k
...Workplaces in Financial Services & Insurance Claims Adjuster - Workers Comp This role... ...are properly documented and claims coding is correct. May process complex lifetime... ...appropriate treatments recommended by utilization review. Maintains professional client relationships...ClaimsContract workFlexible hours$22.98 per hour
...Medical Billing & Coding Coordinators Maximus is seeking two (2) Medical... ...Coordinators to support our Independent Bill Review (IBR) Program. This role is ideal... ...working in a medical office or healthcare setting Knowledge of claims processing and reimbursement...ClaimsRemote jobFull timeHome office- ...Our mission is to transform healthcare through pharmacy, and our vision... ...PST) The Medication Access Specialist Supervisor is an essential... ...The supervisor will also review medication authorizations, conduct... ...healthcare prior authorization/coding. Proficiency in Office...Full timeWork at officeRemote work
- ...Claim This position is responsible for reviewing estimates, evaluating, and negotiating 1st and 3rd party auto physical damage claims, including both personal... .... Electronically audits vehicle estimates utilizing technical expertise and information gathered to accurately...ClaimsContract workLocal area
- ...Revenue Cycle Coding Specialist Park Nicollet is looking to hire a Revenue Cycle Coding Specialist to join our team! Come join us as a Partner... ...retrospective chart documentation audits relative to denied claims, provider request and patient complaints. Required...ClaimsWork at office
$16.37 - $21.4 per hour
...Identify OEM paint codes, enter formulas on the... ...manufacturer specifications Utilize color matching tools (... ...and call summary to be reviewed by the Store Manager,... ...with Installer Service Specialist to coordinate and route... ...in the case of a labor claim or PBE warranty. Assist...ClaimsHourly payMinimum wageContract workLocal areaFlexible hours
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