Clinical Utilization & Reimbursement Specialist
Mary Free Bed Rehabilitation Hospital
Mary Free Bed Rehabilitation Hospital is seeking a detail-oriented Utilization Review/Reimbursement Specialist to coordinate utilization management across preadmission, admission, continued stay, and discharge. You will handle prior authorizations, complex case reviews, and denial management to ensure appropriate inpatient access. Responsibilities include data capture of denial outcomes, education support, and developing relationships with key payers. #J-18808-Ljbffr Mary Free Bed Rehabilitation Hospital
$39.4 - $51.47 per hour
...of overall quality and completeness of clinical documentation in patient record through... ...preferred. Certified Clinical Documentation Specialist (CCDS) or Certified Documentation... ...to address documentation gaps impacting reimbursement or quality measures. Maintains a level...ReimbursementFull timeTemporary workPart timeFlexible hours$145.6k - $270.4k
...Rheumatology Institutional Specialist (IS) will be responsible for... ...brands to help drive appropriate utilization of approved products.... ...disease states, sharing approved clinical data with physicians and... ...and bill, specialty pharmacy, reimbursement and/or medical calling on HCPs...ReimbursementFull timeLocal areaRemote workHome officeVisa sponsorshipRelocation package$115.26k - $149.16k
...DescriptionAs a Area Prevention Specialist within Gilead's HIV... ...account management, strong clinical acumen, and customer-centric... ...access and optimize product utilization through effective account planning... ...with Medical Scientists, Field Reimbursement Managers, Market Access...ReimbursementFull timeFor contractorsLocal areaFlexible hours$20 per hour
...to in ways that fully develop and utilize each person's talent and strengths. Position Per Diem Peer Specialist - NYC Full-Time/Part-Time Per... ...Scholarship Programs, Licensure Reimbursement and Possible Internship/Clinical Supervision. Referral Bonuses are...ReimbursementDaily paidFull timePart timeInternshipLive inLocal areaFlexible hoursDay shiftAfternoon shift$75k - $95k
...Regenerative Surgical Specialist - Metro New York City Location: New York... ...closely with hospitals and clinics, captures new accounts while nurturing... ...Inform and educate customers on reimbursement of Kerecis products as applicable Utilize all marketing and all related...ReimbursementFlexible hours$165k - $180k
...treatments. The Rare Disease Specialist (RDS ) will play a critical... ...awareness, adoption, and utilization through high-impact, in-... ...delivering scientific and clinically focused messaging and patient... ...marketing support, product access, reimbursement navigation, and accurate,...ReimbursementLocal areaNight shift$107.36k - $166.75k
Neuroscience Specialist Otsuka America Pharmaceutical Inc. is a global... ...and communicate complex clinical and product information. Valid... ...staff on payer guidelines and reimbursement procedures to increase pull through Effectively utilizes promotional materials Selling...ReimbursementTemporary workWork at officeLocal areaWorldwideFlexible hoursNight shift$80 per hour
...part-time consulting opportunity for United States-based healthcare professionals experienced in prior authorization, utilization management, clinical review, medical necessity criteria, payer authorization workflows, documentation review, and healthcare operations.This...Hourly payPart timeFor contractorsWork at officeRemote workFlexible hours$72k - $85k
...Description The Senior Platform Specialist is responsible for... ...with end-users and the Privia Clinical IT team to understand functional... ...to ensure proper utilization of the EHR Assist with ongoing... ...offices are eligible for expense reimbursement to offset this cost. Privia...ReimbursementFor contractorsWork experience placementWork at officeLocal areaRemote workWork from homeHome office$25.42 - $30.97 per hour
...needed. The Prior Authorization Specialist role belongs to the Revenue... ...maximizing BMC hospital reimbursement. This role requires adherence... ...authorization requests that require clinical judgment to Prior... ...For any insurance updates, utilize any available resources to validate...ReimbursementFull timeContract workWork at officeImmediate startRemote workFlexible hours$83k - $120k
...Work with a New Career Opportunity Now Hiring - Lead MDS/Clinical Reimbursement Coordinator-Whippany, NJ CareOne at Hanover Salary Range $... ...establish clear goals, and satisfy all regulatory requirements. Utilization Review & Triple-Check Coordination:Lead the weekly...ReimbursementFull timeTemporary workPart timeWork at officeImmediate startFlexible hoursShift work$20 - $30 per hour
A behavioral healthcare organization is seeking a Utilization Review Specialist to conduct clinical auditing and negotiate authorizations. The ideal candidate has a Bachelor's degree in Social Work or Nursing and 1-2 years of healthcare experience. Responsibilities include...- ...remote opportunity. This role requires conducting independent Utilization Reviews for just 1-2 hours per week, with no minimum commitment... ..., Board Certification in Gastroenterology, and 5 years of clinical experience. Adherence to HIPAA regulations and company policies...Remote workFlexible hours
$25 - $30 per hour
...referral services team, a Referral Specialist will serve as the primary... ...closely with data entry, reimbursement, nurse coordination, and... ...pharmacy/medical benefits, clinical history, and/or prescription... ...effective communication skills when utilizing technology for written...ReimbursementWork at officeMonday to FridayNight shift$90k - $110k
...positionsPosition DescriptionThe Regional Colorectal Specialist (RCS) is responsible for providing... ...to promote our Gel technologiesProvide clinical expertise and support for all products... ...dental and vision coverage Education reimbursement program 401(k) program with...ReimbursementLocal areaImmediate start$169k - $228.6k
...technology on AWS Generative AI as part of the Specialist Solutions Architect team in the Go-To-... ...(compute, memory, I/O), optimizing utilization, and tuning system-level performance-... ...Accounts, Adoption and Surrogacy Reimbursement coverage), 401(k) matching, paid time...ReimbursementFlexible hours$207k - $275k
...important new frontiers. As a Solution Specialist for Data Services, you are the person... ...including egress cost modeling and GPU utilization commitments, to support large... ...AccountHealth Savings AccountTuition Reimbursement Ability to Participate in Employee Stock...ReimbursementPermanent employmentFull timeTemporary workCasual workWork at officeFlexible hours$96.3k - $178.8k
The PositionSurgical Device Specialist (SDS), Ophthalmology - NY MetroAn ever-transforming... ...area to identify and address their clinical and business goals and challenges in support... ...Portfolio, competitive landscape, reimbursement, and Genentech Patient Support Services...ReimbursementFull timeLive inLocal areaRelocation packageNight shiftWeekend workAfternoon shift$207k - $275k
...services need a market-maker. As a Solution Specialist for AI Runtime Services, you open new... ..., including throughput modeling, GPU utilization commitments, and SLA structures that... ...AccountHealth Savings AccountTuition Reimbursement Ability to Participate in Employee...ReimbursementPermanent employmentFull timeTemporary workCasual workWork at officeFlexible hours$101.6k - $177.8k
...product direction and help our customers tap into new markets by utilizing GenAI along with AWS Services. You will be working directly... ...Line, Flexible Spending Accounts, Adoption and Surrogacy Reimbursement coverage), 401(k) matching, paid time off, and parental leave...ReimbursementLocal areaWorldwideFlexible hours$162.7k - $220.2k
...experienced Information Technology Assurance Specialist to join our fast-paced FSI Security and... ...cloud assurance best practices and utilizing AWS AI solotions-Bring industry... ...Spending Accounts, Adoption and Surrogacy Reimbursement coverage), 401(k) matching, paid time off...ReimbursementWorldwideFlexible hours$162.7k - $220.2k
...managers to influence product direction and help our customers utilize Amazon AI Services, working backwards from key customer use... ...Advice Line, Flexible Spending Accounts, Adoption and Surrogacy Reimbursement coverage), 401(k) matching, paid time off, and parental leave....ReimbursementWorldwideFlexible hours- ...establishing an account by gathering demographic, insurance, and clinical information to ensure appropriate patient scheduling and... ...regulatory forms accurately.* Secures signatures to ensure timely reimbursement, which includes consents signed specific to service(s) being...ReimbursementWork at officeLocal areaShift work
- Orison-Solutions-LLC is seeking an experienced Registered Nurse (RN) - Utilization Review to assess medical necessity, appropriateness, and level of care for patients. The RN will review clinical documentation, apply established guidelines, and collaborate with physicians...
- ...as a Medicaid Eligibility Verification Specialist in its Bureau of Case Integrity and Eligibility... ...of adjustment for Federal and State reimbursements as established by case record entries... .../ORMD units -Create case records utilizing screenshots from Welfare Management System...ReimbursementPermanent employmentFull timeWork at office
$25 per hour
...+ Hospitals Maternal Fetal Medicine Specialist (Perinatologist) Physician Affiliate... ...risk pregnancies, while contributing to clinical excellence, education, and system-wide... ...Annual Continuing Medical Education (CME) Reimbursement. Generous Annual Paid Time Off (PTO)...ReimbursementHourly payDaily paidFull timeImmediate startRemote workVisa sponsorshipFlexible hoursNight shiftWeekend work- ...revenue cycle challenges and improving reimbursements for patient care. Our clients include physician... ...We are looking for an experienced Clinical Documentation Integrity Consultant to... ...Consultant or CDI and Inpatient Coding Specialist ready to contribute to our mission and...ReimbursementRemote workFlexible hours
- ...Housing Specialist New York City | Full-Time We are seeking a Housing Specialist to assist very low-income veterans, young... ...Calculate housing-assistance payments, tenant rental amounts, utility reimbursements, and rent increases in accordance with program guidelines...ReimbursementPermanent employmentFull timeTemporary workInterim roleWork at officeRelocation
$24.04 per hour
...off ~ Personal and Sick Days ~ Health insurance and health reimbursement account ~ Dental and vision plans ~ Flexible spending... ...housing paperwork in an orderly fashion. Always maintains clinical appropriateness. Qualifications What do I need to apply...ReimbursementHourly payPermanent employmentFull timeLive inLocal areaFlexible hoursWeekend work$24.05 - $36.21 per hour
...to conduct innovative translational and clinical research that is driving a revolution... ...the globe. Exciting Opportunity at MSK: Specialist I, Insurance Receivable At MSK, the... ...balances and securing accurate, timely reimbursement. The role works across hospital and professional...ReimbursementWork at office
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