Average salary: $52,208 /yearly
More stats ...Job Description
Role: Purchase Reviewer (Resource)
Estimated Duration: 6+ months
Location: Phoenix, AZ (hybrid)
Position Description
The purpose of this position is to provide support to constituents, including education administrators and staff, community...
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...coding staff to ensure contractual compliance. Reports to the Manager, Retrospective UM. Supervises staff who conduct retrospective review of medical claims for appropriate DRG or non-DR coding and processing. Performs independent research and in-depth evaluation of...
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...owned community bank and one of Prairie Business Magazine's 50 best places to work for 10 years running. We are looking for a Credit Review Associate who can clearly identify borrower risk and translate the risk factors into terms others can understand within a narrative...
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Full time
...Job Description
Role: Purchase Reviewer-1153
Estimated Duration: 6+ months
Location: Phoenix, AZ
Position Description
The purpose of this position is to provide support to constituents, including education administrators and staff, community members, education...
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Holiday work
Full time
Casual work
Local area
Shift work
Monday to Friday
...certificate required; associates degree preferred.
Two (2) years relevant credentialing experience preferred.
Two (2) years contract reviewing experience preferred.
Knowledge and understanding of the medical credentialing process, DEA certification, and CAQH and NHSC...
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Local area
...Job Description
Job Description Role: Penalty Review Specialist-1276
Estimated Duration: 6+ months
Location: Phoenix, AZ (hybrid)
Position Description
Primary Duties:
Analyze applicant data for abatement consideration.
Request additional information...
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...accounting systems, making use of current computer technology.
Use automated accounting systems and applications to retrieve and review data files, analyze information, and analyze financial records in conformance to reporting and procedural standards.
Detailed...
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...Generally, work is self-directed and not prescribed; is able to work with less structured and more complex issues.
The Preservice Review/Prior Authorization RN will manage the full array of health care services, spanning both outpatient and Inpatient settings and with...
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Hourly pay
Minimum wage
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...well. We do not lose sight of that. It fuels our passion and drives every decision we make.
Job Posting Title
Clinical Review Pharmacist
The Clinical Staff Pharmacist is responsible for the processing and documenting of Utilization Management requests...
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Visa sponsorship
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...locations to ensure better access to our unique model of care.
Phoenix Medical Psychiatric Hospital is looking for a Utilization Review Coordinator to coordinate patients’ services across the continuum of care by promoting effective utilization, monitoring health...
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Full time
...opportunity for work/life balance needs yet want to stay clinically active?
Join us as an Medical Director to conduct chart and peer reviews from your home office.
This is a Part Time 25 hours a week position
No Call, evening or weekend work...
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Monday to Friday
...Behavioral Health RN - Medical Claim Review - FULLY REMOTE POSITION
MUST HAVE ARIZONA OR COMPACT RN LICENSE
Medix Healthcare
Phoenix, AZ 85016
Monday-Friday 8am-5pm (Employee Time Zone)
$40.00-42.00 hour - FULL TIME
MUST HAVES TO APPLY
~ Arizona RN or...
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Currently hiring
Monday to Friday
...appropriate medical team to promote quality and cost effectiveness of medical care.
+ Performs medical necessity and clinical reviews of authorization requests to determine medical appropriateness of care in accordance with regulatory guidelines and criteria
+...
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...Experienced Document Review Attorney – Remote
Great opportunity for l icensed attorneys with document review experience interested in quality focused e-Discovery. We have some projects anticipated to start soon and others in the pipeline. Please apply to get on...
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Flexible hours
...according to protocol and that all documentation is timely and meets all Federal and State requirements.
+ Ensure second-level reviews have been performed and documented and may confer with medical directors, Health Plan Manager(s), Inpatient Care Coordinators (ICC’...
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Full time
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Shift work
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Monday to Friday
...Health Medical Center
Department: Care Management
Schedule: Regular FT 40 Hours Per Week
Shifts: Mid
As a Valleywise Utilization Review RN Coordinator, you are part of a multidisciplinary team providing exceptional care to our patients. As a Utilization Review RN...
Hourly pay
Shift work
...Custard Insurance Adjusters, Inc.
Property Claims Reviewer/QA
Phoenix, AZ
We are growing our company and looking for highly skilled team members to grow with us! We are looking for motivated individuals who are passionate about quality work and providing superior...
Full time
Remote job
Work from home
Flexible hours
Monday to Friday
...Job Description
Job Description
General Purpose
To review and bill Loss Control Inspections and ensure they meet Afirm/Davies quality control standards, customer specific requirements, and industry standards.
Essential Duties and Responsibilities:
~ Reviews...
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...do not lose sight of that. It fuels our passion and drives every decision we make.
Job Posting Title
Physician Clinical Reviewer, MRx – Oncology – REMOTE
Summary
Key member of the utilization management team, and provides timely medical review of service...
Work experience placement
Internship
Local area
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...required
Bachelor’s degree in nursing preferred
Minimum three (3) years of clinical nursing and/or Care Management experience is required
Orthopedic experience required.
Clinical review, utilization review, or quality assurance review experience preferred...
Part time
...Become a part of our caring community and help us put health first
The Claims Review Representative 2 makes appropriate claim decision based on strong knowledge of claims procedures, contract provisions, and state and federal legislation. The Claims Review Representative...
Weekly pay
Holiday work
Full time
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Temporary work
Apprenticeship
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Work from home
Home office
...statutes, rules, and compliance with policies and procedures.
The primary duties for this position include the following:
Review account expenses and complete account closures
Conduct audits on randomly selected accounts to assess program compliance...
Holiday work
Full time
Casual work
Local area
Immediate start
Shift work
Monday to Friday
...abuse in government programs. Results are achieved through data analytics, technology solutions, audit, investigation, and medical review.
At IntegrityM, we offer a culture of opportunity, recognition, collaboration, compassion and supporting our community. We thrive...
Full time
Remote job
Flexible hours
...Responsibilities
Utilization Review (UR) Coordinator Opportunity.
Position: PRN (as needed)
This position is on-site and cannot be done remotely.
For nearly 60 years, Calvary Healing Center has provided a full continuum of care, specializing in addiction...
Relief
Local area
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Registered Nurse RN Utilization Management Care Reviewer Remote Location Remote in Phoenix, AZ : Primary City/State: Arizona, Arizona Department Name:
Utilization Mgmt Work Shift:
Day Job Category:
Clinical Care Find your path in health care. At Banner Health...
Full time
Remote job
Shift work
Monday to Friday
...patients using clinical skills and utilizing CMS criteria upon admission to SNF and periodically through the patient stays
+ Review targets for Length of Stay ( LOS ), target outcomes, and discharge plans with providers and families
+ Complete all SNF...
Contract work
Local area
Home office
$20 - $35 per hour
...We are searching for an experienced Seasonal Tax Reviewer to join our team on a 100% remote basis. The successful candidate will have the opportunity to work remote and work 20-25 hours per week.
Top Reasons to Work with Us
This is a great opportunity to work remotely...
Hourly pay
Full time
Seasonal work
Local area
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...care.
~Provide direction in leadership for the medical program in collaboration with the Health Services Supervisor
~ Monitor and review operations and standards of care delivered to\ninmates/residents.
~ Interview inmates/residents and make decisions on...
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For contractors
Shift work
...responsible for all aspects of projects from start to finish with the assistance of your estimating team. Responsibilities:
Review plans and specifications to prepare comprehensive cost estimates
Knowledgeable of construction systems and disciplines, knowledgeable...
For subcontractor
...Job Title:
Sr. Credit Risk Review Officer
Location:
Scottsdale
What you'll do:
This position is responsible for planning and executing quarterly continuous credit file examination of assigned reviewable units or risk segments. The Senior Credit Risk Review...