Average salary: $66,382 /yearly
More statsSearch Results: 11,054 vacancies
...Manager, Retrospective UM. Supervises staff who conduct retrospective review of medical claims for appropriate DRG or non-DR coding and... ...Availability to work any shift
•Works remotely, with up to 10% travel
•Ability to meet mandatory contract compliance timelines
•...
Travel
Remote job
Contract work
Temporary work
Local area
Shift work
...ensure better access to our unique model of care.
Overview:
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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...members, Valenz engages early and often for smarter, better, faster healthcare. About our Opportunity:
As the Clinical and Bill Review Advisor at Valenz Health, you will play a pivotal role in guiding and advising on our internal clinical and bill review processes....
Suggested
Holiday work
Immediate start
Remote job
Flexible hours
Overview of Responsibilities (NOT limited to the following):
Verifying insurance information
Updating insurance information
Contacts insurance plans to determine eligibility, obtains coverage, benefit information, and prior authorizations for services
EOBs
...
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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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Holiday work
Full time
...We do not lose sight of that. It fuels our passion and drives every decision we make.
**Job Posting Title**
Physician Clinical Reviewer- GI- REMOTE
**Job Description Summary**
Key member of the utilization management team, and provides timely medical review of...
Suggested
Remote job
Work experience placement
Internship
Local area
...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 when needed....
Suggested
Contract work
...a part of the #1 full truckload carrier in the nation. Be a part of Swift Transportation.
Job Responsibilities: What you will do
Review violations, log and follow up to ensure compliance.
Are to include but are not limited to the following, other duties may be assigned...
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Local area
...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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Holiday work
Local area
Visa sponsorship
Work visa
Weekend work
...core to our business.
Join Evolent for the mission. Stay for the culture.
**What You'll Be Doing:**
As a Physician Clinical Reviewer, Hematology and Medical Oncology you will be a key member of the utilization management team. We can offer you a meaningful way to...
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...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 partners...
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Holiday work
Full time
Contract work
Casual work
Local area
Shift work
Monday to Friday
...Health Medical Center
Department: Care Management
Schedule: Regular FT 36 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...
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Hourly pay
Shift work
...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...
Suggested
Remote job
Hourly pay
Full time
Flexible hours
...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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Holiday work
Remote job
Flexible hours
...Custard Insurance Adjusters, Inc.
Property Claims Reviewer/QA
Phoenix, AZ
We are growing our company and looking for highly skilled... ...Must be able to operate a computer and smart phone. Occasional travel by airplane is required.
Contact with others.
Inside...
Travel
Full time
Remote job
Work from home
Flexible hours
Monday to Friday
...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
As the Clinical and Bill Review Advisor, you will play a pivotal role in guiding and advising on our internal clinical and bill review processes. Your expertise and insights will be crucial in informing strategic decisions and enhancing operational efficiencies.
What...
Holiday work
Full time
Immediate start
Remote job
Flexible hours
...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...
For contractors
Remote job
...Job Description
Job Description Summary:
The Registered Nurse will utilize standard criteria to review post-service and prepayment reviews of Outpatient Behavioral Health claims. The nurse will utilize HCPC Codes to ensure claims are being charted for correct processing...
Local area
Remote job
...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
