Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Clinical Peer Reviewer - Utilization & Compliance

$122.91k - $188.02k

Healthfirst

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

Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Clinical Peer Reviewer - Utilization & Compliance in Florida, NY vacancy
  •  ...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

    Fabergent

    Florida, NY
    2 days ago
  •  ...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,... 
    Suggested
    Full time
    Work at office
    Remote work
    Work from home
    Home office

    TEEMA Solutions Group

    Florida, NY
    13 hours ago
  •  ...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

    AdventHealth

    Florida, NY
    3 days ago
  • 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... 
    Suggested
    Full time
    Contract work
    Part time
    For contractors
    Live in
    Work at office
    Local area
    Remote work
    Monday to Friday
    Flexible hours

    Paradigm

    Florida, NY
    3 days ago
  •  ...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... 
    Suggested
    Remote work
    Monday to Friday
    Flexible hours

    Hyre Harper Co.

    Florida, NY
    4 days ago
  •  ...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 work
    Weekend work

    Miami Children’s Hospital

    Florida, NY
    2 days ago
  •  ...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.... 
    Apprenticeship
    Work at office

    Houston Methodist

    Florida, NY
    13 hours ago
  •  ...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... 

    Sight360

    Florida, NY
    2 days ago
  •  ...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... 

    Jupiter Medical Center

    Florida, NY
    2 days ago
  •  ...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 job
    Work at office
    Local area
    Immediate start
    Flexible hours
    Night shift

    Petco Animal Supplies, Inc.

    Florida, NY
    1 day ago
  •  ...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 office
    Remote work
    2 days per week

    Ensemble Health Partners

    Florida, NY
    13 hours ago
  • $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 time
    Work experience placement
    Local area
    Shift work

    AdventHealth

    Florida, NY
    2 days ago
  •  ...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... 

    DaMar Staffing

    Florida, NY
    1 day ago
  •  ...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 work
    Remote work

    TalentFish

    Florida, NY
    3 days ago
  •  ...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 work
    Local area
    Remote work

    TalentFish

    Florida, NY
    13 hours ago
  • 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

    kozmetickesluzby.vecnakraska.sk - Jobboard

    Florida, NY
    3 days ago
  • 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 office
    Remote work

    HealthCare Support

    Florida, NY
    13 hours ago
  • $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 work
    Remote work

    Lee Health

    Florida, NY
    13 hours ago
  • $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 pay
    Monday to Friday

    Strive Physical Therapy & Sports Rehabilitation

    Chester, NY
    13 hours ago
  • 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

    DaMar Staffing

    Florida, NY
    1 day ago
  • $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 pay
    Full time
    Work at office
    Monday to Friday

    DaMar Staffing

    Florida, NY
    3 days ago
  •  ..., 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

    Alina Community Center

    Florida, NY
    13 hours ago
  • 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... 
    Freelance
    Work at office

    Dane Street

    Florida, NY
    1 day ago
  • 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 job
    Work at office

    Healthcare Support Staffing

    Florida, NY
    1 day ago
  •  ...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

    Centrum Health

    Florida, NY
    2 days ago
  •  ...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 work
    Work at office
    Shift work

    United Health Group

    Middletown, NY
    3 hours ago
  • 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

    Sage Dental

    Florida, NY
    1 day ago
  •  ...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 time
    Currently hiring
    Local area

    Akumin

    Florida, NY
    2 days ago
  •  ...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,... 

    DaMar Staffing

    Florida, NY
    1 day ago
  •  ...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 income
    Full time
    Work at office
    Monday to Friday
    Weekend work

    Prelude Fertility

    Florida, NY
    1 day ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Clinical Peer Reviewer - Utilization & Compliance. Be the first to apply!