Clinical Peer Reviewer - Utilization & Compliance
$122.91k - $188.02kHealthfirst
Healthfirst is seeking a Medical Peer Reviewer in the Town of Florida, NY, to consult on medical necessity within utilization management. This vital role involves reviewing authorization requests and ensuring compliance with Healthfirst's regulations. The ideal candidate holds a valid medical license (M.D. or equivalent) and has expertise in utilization management. This position offers a salary range of $122,907 - $188,020 based on experience, as well as comprehensive benefits including health coverage, life insurance, and retirement contributions. #J-18808-Ljbffr Healthfirst
- ...Quality Data Coordinator to work remotely in Florida. This full-time position involves coordinating medical record reviews, ensuring the accuracy and compliance of health information, and liaising with external agencies. The ideal candidate should have an Associate's...SuggestedFull timeRemote work
- ...The Senior Clinical Coder serves as a subject matter expert in medical coding and DRG validation... ...in ensuring coding accuracy, regulatory compliance, and appropriate reimbursement across... ...conduct detailed retrospective claims reviews, provide expert-level coding analysis,...SuggestedFull timeWork at officeRemote workWork from homeHome office
- ...with executive-level admin tasks, scheduling, and regulatory compliance. The role coordinates provider operations, credentialing, and... ...include supporting documentation, billing compliance, and coordination with Revenue Cycle, HR, and clinical leadership. #J-18808-Ljbffr...Suggested
- ...electronic medical record while maintaining compliance with established rules and regulatory... ...appropriately to requests to code or review coded accounts for accuracy. Initiates queries... ...and/or procedures as appropriate, utilizing the established physician query process....SuggestedApprenticeshipWork at office
- ...become an integral part of our team! You will compile data, compute charges, and prepare invoices. Codes diagnoses and procedures utilizing the coding systems on an automated encoder/grouper program. Accurately abstracts key data elements from patient records for data reporting...SuggestedFull timeWork at officeMonday to Friday
- Remote Clinical Documentation Improvement (CDI) Specialist This is... ...outcomes. Key Responsibilities Review medical records to ensure... ...improve documentation integrity. Utilize EPIC for chart review and... ...practices for documentation. Ensure compliance with all applicable...Remote jobMonday to FridayFlexible hours
- ...supervision. Work Schedule: Monday - Friday 7am to 3:30pm. Rotating Saturdays Job Responsibilities Observe and report any performance, compliance or staffing related issues to supervisors Manage and monitor patient flow, wait times, inventory levels and information logs...Temporary workWork experience placementCasual workInternshipMonday to FridayFlexible hours
- ...Registered Nurse, the unit secretary provides administrative support utilizing technical and interpersonal skills with patients, visitors,... .... Provides administrative support and assists the medical and clinical teams with requests and tasks. Makes sure every guest...Part timeWork at officeNight shift
- At Houston Methodist, the Clinical Documentation Specialist RN position is responsible for improving the overall quality and completeness... ...for adults in an acute care hospital setting Coding and utilization review experience preferred Licences and Certifications Required...Permanent employment
- ...common interests that can be used to build rapport with others.Peer SupportProvides guidance and feedback to help others strengthen... ...different tasks be performed when circumstances change. I have reviewed these job requirements and verify that I can perform all essential...Full time
- New Paradigm Staffing is looking for an Entry-Level Medical Records Clerk to join their remote team in Florida. The role involves organizing electronic medical records, ensuring accuracy, and following HIPAA guidelines. This position is perfect for detail-oriented individuals...Remote work
- ...Complete UHDDS data abstraction as required. Maintain detailed logs of work performed and submit reports as directed. Ensure coding compliance with established regulations and institutional guidelines. Perform additional duties as assigned by management. #J-18808-Ljbffr...Contract workLocal areaRemote work
- A healthcare organization is looking for a Medical Coder to work remotely from Florida. The candidate will be responsible for abstracting data from medical records into system software and coding diagnoses and procedures according to standardized guidelines. A minimum of...Remote work
- ...certification and at least 3 years of coding experience. You will assign diagnostic codes using ICD-10-CM-PCS or CPT-4 standards and ensure compliance with guidelines. Strong attention to detail and proficiency with coding software are essential. Successful candidates will work...Contract workRemote work
$20.5 - $27.85 per hour
Minimum to Midpoint Pay Rate: $20.50 - $27.85/ hour This is a remote position. Incumbents, who reside in Florida only, may work remotely. There may be occasional situations that require work to be performed on-site at an assigned Lee Health location. Summary ...Casual workRemote work- A healthcare staffing agency in the United States seeks a medical coding specialist to analyze and code surgical records from Anesthesia departments. This position requires various coding certifications and at least 2 years of relevant experience. After a training period...Work at officeRemote work
$18 - $20 per hour
...of affiliated brands, Care Coordinators are the heartbeat of the clinic T he y are the first voice a patient hears and the first... ...scheduling, insurance verification/authorization, and phone calls Review, schedule, and follow up on incoming referrals by gathering...Hourly payMonday to Friday- A healthcare organization seeks a Bilingual Clinical Coordinator Assistant. This remote position requires fluent English and Spanish,... ...clinical coordinators, maintaining medical records, and ensuring compliance with policies. Competitive benefits including health insurance...Remote work
$16 - $29 per hour
...by inclusion, talented peers, comprehensive... ...participates in training, review classes and projects as... .... + Communicates with clinical staff to keep patient... ...order or credit card in compliance with our policies and... ...addressed in a timely manner. Utilize Reply All when needed....Hourly payMinimum wageFull timeTemporary workWork experience placementWork at officeLocal areaShift work- Overview UF Health Spanish Plaines Hospital is part of the UF Health Central Florida system, a not‑for‑profit health care organization providing inpatient acute hospital services. Responsibilities Provides pharmaceutical care services to patients, physicians, and staff...
$17 - $19 per hour
Overview The Customer Service Specialist (CSS) is the first point of contact for patients and other patrons arriving at the medical centers. This position assists with patient check-in, check-out, answering phones and entails the following duties & responsibilities: Key...Hourly payFull timeApprenticeshipWork experience placementLocal areaMonday to FridayFlexible hoursDay shift- Benefits Paid time off Health insurance About the Role Join our dynamic team at Urological Consultants of Florida PA as a Bilingual Front Desk professional! In this pivotal role, you will be the first point of contact for our patients, ensuring a warm welcome and seamless...Work at office
- ...management organization is seeking a full-time remote Bilingual Clinical Coordinator Assistant. This role involves performing administrative tasks, supporting clinical coordinators, and ensuring compliance with healthcare protocols. Candidates must have at least three years...Remote jobFull time
$16 - $29 per hour
...teams in meeting financial, clinical and service goals. Schedule:... ...Attends/participates in training/review classes and projects as... ...management decisions Supports peer-to-peer training initiative for... ...Provides After visit Summary in compliance with ACO guidelines Schedules...Hourly payMinimum wageFull timeTemporary workWork experience placementWork at officeLocal areaImmediate startMonday to FridayWeekend work- ...Cleveland Clinic Martin North Hospital is seeking a caregiver to support the CVICU with admissions, rounds and patient assistance. This role emphasizes both clinical tasks and clerical coordination to ensure smooth unit operations. The position requires a High School...
$22 per hour
Schedule and Compensation Schedule: PRN/Per Diem, 12hr shifts (6am - 6:30pm) Compensation: $22 per hour Plus shift differentials for night and weekend shifts Position Position: Unit Secretary - Per Diem Location: Miami Lakes, FL Hospital: Select Specialty Hospital - Miami...Hourly payDaily paidFull timePart timeReliefShift workNight shiftWeekend work- ...have several positions we need to fill! Depending on department you would be working in, you will performroutine administrative and clinical assignments andto keep the medical facilityrunning smoothly. Responsibilities would include but not be limited to: Handle all...
- AdventHealth in Florida is seeking a full-time Patient Registration Specialist. You will answer calls, register patients, verify insurance, and collect copays while maintaining accurate medical records. A sample 2-week schedule mirrors day/weekend coverage with weekday...Full timeWeekend workWeekday work
- ...professional growth and advancement If you are a dedicated and compassionate Scheduler with a passion for Otolaryngology we encourage you to review the requirements below and apply for this exciting opportunity today. Required Education and Experience High school graduate or...
- AssistRx, Inc. is seeking an Insurance Verification Specialist to help patients access medications. You will work with healthcare providers and payers to verify coverage, assist with prior authorizations, and navigate complex reimbursement issues. Role involves documenting...
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Clinical Peer Reviewer - Utilization & Compliance. Be the first to apply!
- medical reviewer Florida, NY
- remote clinical documentation specialist Florida, NY
- clinical documentation specialist Florida, NY
- medical records clerk Florida, NY
- medical records administrator Florida, NY
- clinical reviewer Florida, NY
- medical records reviewer remote Florida, NY
- medical record assistant Florida, NY
- medical records reviewer Florida, NY
- health records assistant Florida, NY

