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
- ...respond with your updated profile if interested. Title: Clinical Care Reviewer Location: Doral, FL Duration: 3 months Job Related Skills... ...preferably critical care (e.g. ER, ICU) Experience with Utilization Review and/or Prior Authorization Familiar with Interqual...Suggested
- ...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
- ...inpatient surgery and other procedures. You will ensure accurate DRG assignments reflecting patient acuity and procedures, review documentation for compliance, and support revenue cycle performance. The ideal candidate has 4+ years acute care coding experience, knowledge of...Suggested
- Bilingual Clinical Coordinator Assistant Join to apply for the Bilingual Clinical Coordinator Assistant role at Paradigm . Paradigm... ...Assist Clinical Coordinators with daily activities, ensuring compliance with established policies and procedures. Fluent in both English...SuggestedFull timeContract workPart timeFor contractorsLive inWork at officeLocal areaRemote workMonday to FridayFlexible hours
- ...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...SuggestedRemote workMonday to FridayFlexible hours
- ...Participate in year-end inventory. Works under the supervision of the Clinical Supply Supervisor and under the direction of the Manager of... ..., and patient. Demonstrates the ability to effectively utilize various computer software programs for duties and patient supply...Shift workWeekend work
- ...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....ApprenticeshipWork at office
- ...to manage front desk operations, schedule patient visits, verify insurance, and handle payments while ensuring policy compliance. Travel between clinic locations and overtime may be required based on needs. Responsibilities include maintaining EMR records, greeting patients...
- ...common interests that can be used to build rapport with others. Peer Support Provides 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...
- ...hospitals, hundreds of preventive care clinics and eight distribution centers. In 1999,... ...appointments from callers or visitors and reviewing on-line bookings. Greet all visitors to... ...products and/or services that the practice utilizes. For a more detailed overview of Petco...Odd jobWork at officeLocal areaImmediate startFlexible hoursNight shift
- ...Jupiter Medical Center two days per week, with remote work the remainder and travel as needed. You will review patient records, assign diagnoses and DRGs, discuss documentation with physicians, and educate clinical staff on coding guidelines to support #J-18808-Ljbffr...Work at officeRemote work2 days per week
$49.72k - $92.47k
...City MAITLAND State Florida Postal Code 32751 Job Description Reviews clinical documentation and coding during ambulatory encounters to... ...completeness, and accuracy of documentation. Supports coding compliance, accurate reporting, and improved patient outcomes. Maintains...Full timeWork experience placementLocal areaShift work- ...Tampa General Hospital is seeking a Coder 2 to join its Coding Department. Under supervision, you will review medical records, assign ICD-9/ICD-10 codes, and use encoder systems to determine MS-DRG/APC groupers. You will abstract data into billing systems and ensure...
- ...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
- ...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
- 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 job
- Job Description Analyze, verify, and code medical records from surgical procedures received by Anesthesia departments. These records are then submitted to the Reimbursement Department for claim submission and billing. Qualifications ~ Current CPC, CCS, CCA, ...Work at officeRemote 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$18 - $20 per hour
...of affiliated brands, Care Coordinators are the heartbeat of the clinic. They are the first voice a patient hears and the first face... ...scheduling, insurance verification/authorization, and phone calls Review, schedule, and follow up on incoming referrals by gathering...Hourly payMonday to Friday- Memorial Healthcare System seeks a Hospital-based Inpatient Coder to code inpatient encounters using electronic records and encoder software, with the potential for a remote work setup. Responsibilities include sequencing diagnoses and procedures per Official Coding Guidelines...Remote job
$20 per hour
...Experience Position Summary Magnolia Medical Clinic, P.A. is seeking a detail-oriented and... .... Key Responsibilities Coding & Charge Review Review and validate provider... ...eligibility and benefits verification processes Compliance & Reporting Maintain HIPAA compliance at...Hourly payFull timeWork at officeMonday to Friday- ..., and the ability to work in a fast-paced clinical environment. Responsibilities include coding ICD-10-CM, CPT and HCPCS, reviewing documentation for accuracy, addressing denials... ...and billing staff while maintaining HIPAA compliance and up-to-date payer #J-18808-Ljbffr...Work at office
- Calling all bill review professionals, CPC coders, AAPC, and DRG coders! Dane Street is looking for highly motivated Coders, bill reviewers... ...group health side of our business enables you to apply your clinical knowledge to review reports accompanying medical records to...FreelanceWork at office
- 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...Remote jobWork at office
- ...ACA Marketplace, Medicare, and Medicaid. NeueHealth delivers clinical care to health consumers through our owned clinics - Centrum Health... ...Coder, or Certified Professional Coder, is responsible for reviewing a patient’s medical records after a visit and translating the...Work at office
- ...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....Temporary workWork at officeShift work
- Sage Dental is the leading Dental Support Organization (DSO) in the Southeast, and we are continuing to grow!At Sage, people are at the core of everything we do. We are looking for dynamic and talented professionals who fit our culture of innovative technology, constant...Work at office
- ...and customers.Ensures accurate documentation of patient visits in various electronicsystems and on written documents.May assist the clinical staff with documentation and image delivery to the patient, physician, or contracted customer.Performs all duties within HIPAA...Part timeCurrently hiringLocal area
- ...coding experience to join our team. You will assign ICD-10-CM/PCS codes for inpatient records, ensure accurate DRG assignment, and review documentation for alignment with regulatory rules. Responsibilities include maintaining productivity, applying CMS/IPPS guidelines,...
- ...correspondence, facilitating communication between patients and clinical staff, and scheduling appointments. Hours: Monday - Friday 7 a.... ...to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor. #J-18...Extra incomeFull timeWork at officeMonday to FridayWeekend work
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