Average salary: $116,921 /yearly
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...Description
Summary:
In a High Reliability Organization, the Peer Review Nurse, reporting to the Director of Quality, is responsible for organizing and coordinating Medical Staff Peer Review activities of hospital. This individual, as a designee of the Chief Medical...
Medical
Full time
Under general supervision of the Director of Case Management, the Utilization Review Nurse provides a clinical review of cases using medical necessity criteria to determine the medical appropriateness of inpatient and outpatient services. Provides feedback and assistance...
Medical
Permanent employment
Temporary work
Description
IntroductionCorpus Christi Medical Center Bay Area is committed to investing in the latest technology enabling nurses to work more efficiently. Are you passionate... ...application for Registered Nurse Clinical Reviewer position and spend more time at the...
Medical
Permanent employment
Full time
Temporary work
Part time
Flexible hours
The Professional Review Nurse provides analysis of medical services to determine appropriateness of charges on multiple types of medical bills and review of medical reports to determine appropriateness of medical care.Clinical and/or technical expertise is utilized to address...
Medical
Minimum wage
Full time
Local area
Flexible hours
...Radiation Oncology Preservice Review Nurse RN - Remote
Optum is a global organization that delivers care, aided by technology to help... ..., using applicable benefit plan documents, evidence-based medical policy and nationally recognized clinical guidelines and criteria...
Medical
Hourly pay
Holiday work
Full time
Work experience placement
Immediate start
Remote job
Home office
Weekend work
Afternoon shift
$18 - $19 per hour
...MUST HAVE Knowledge of CPT, ICD-9/10 and HCPCS codes along with commonly used concepts and practices in Workers Compensation medical bill review/auditing . Prepares and compiles medical provider bill data for Workers Compensation clients.
The successful candidate...
Medical
Full time
...Description
Healthcare Administrative Assistant - Medical Review/Program Integrity Coordinator
Dallas, TX
(Hybrid schedule with 2... ...with information from the meeting.
Work with the Lead MR nurses to compile and send out overpayment packets to the Medicare Administrative...
Medical
Hourly pay
For contractors
Remote job
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...flexible and experienced physicians for our medical reviewstream division. This telecommute... ...:
Relying on clinical background, reviews health claims providing medical interpretation... ...agencies, carriers, employers, nurses and health care professionals.
-Medical...
Medical
Contract work
Temporary work
For contractors
Remote job
Flexible hours
Monday to Friday
Position Description
Position Overview
The Wastewater Plan Reviewer works as a team member in support of the Watershed Protection Group... ...offered only to employees in regular (full-time) positions:
* Medical Coverage
* Dental Coverage
* Vision Coverage
* Wellness Plan
*...
Medical
Holiday work
Full time
Part time
Local area
Flexible hours
...Description
Job Description POSITION SUMMARY
The Demand Review Nurse Auditor is responsible for conducting a comprehensive review... ...to ensure that all services billed are supported by the medical records. The Nurse Auditor will oversee processing of the Demand...
Medical
Local area
...Job Description Description: Job Summary
Responsible for analyzing medical records for medical-legal reviews. After analyzing provided clinical documentation, Utilization Review Nurses must create a professional executive report that includes a summary, appropriate...
Medical
...data analytics, technology solutions, audit, investigation, and medical review.
At IntegrityM, we offer a culture of opportunity,... ...Requirements
Minimum three (3) years’ experience practicing nursing as a licensed Registered Nurse
Minimum of three (3) years...
Medical
Full time
Remote job
Flexible hours
...licensed Counselor to join our Utilization Review department at our Arlington location!... ...provide clinical information needed to support medical necessity criteria for appropriate level... ...of: Social Work, Psychology, Psychiatric Nursing, Marriage and Family and Child Counseling...
Medical
Holiday work
Full time
Flexible hours
Monday to Friday
The Itemization Review Manager is responsible for the overall aspects of the medical review team including personnel hiring, quality assurance of product, workflow,... ...license required.
•Bachelor's or master's degree in nursing or other healthcare related field preferred
•...
Medical
Full time
Flexible hours
Night shift
*Longevity Pay
*Regular Service Retirement
*Telephonic Interviews Will Not Be Accepted
*Work Site Visits Will Be Conducted
*No Study Material
*Moderate Overnight Travel
MINIMUM QUALIFICATIONS:
1. Bachelor's degree from a college or university...
Suggested
Full time
Night shift
...**What You'll Be Doing:**
As a Oncology, Physician Clinical Reviewer you will be a key member of the utilization management team. We... ...reviewer in Oncology cases, that do not initially meet the applicable medical necessity guidelines, as well as other requests when providers,...
Medical
...Responsible for review, auditing and data-entry of medical bills for multiple states and lines of business.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
* Responsible for auditing medical bills to ensure that they are appropriate and adhere to the State Fee Schedules,...
Medical
Hourly pay
Minimum wage
Full time
Local area
Flexible hours
...the pediatric and adolescent population, is seeking a Utilization Review Coordinator (RN)
ESSENTIAL FUNCTIONS:
1. Responsible for... ...means.
LICENSEAND CERTIFICATION:
•Currentstate Registered Nurse or Licensed Vocational Nurse license is required.
•BLScertification...
Title: RN Utilization Review II
Description: The RN Utilization Review II is responsible... ...for services. The RN Utilization Review Nurse collaborates as necessary with other members... ...and treatment plans and apply medical necessity criteria in order to determine...
Medical
Permanent employment
Immediate start
Job Title: Registered Nurse Utilization Review
Location: Irving, TX, 75038
Duration: 13 Weeks
Shift: Monday - Friday 8 am - 5 pm
Pay Rate... ...of clinical information and treatment plans and apply medical necessity criteria to determine the appropriate level of care...
Medical
Permanent employment
Temporary work
Local area
Shift work
Monday to Friday
