Search Results: 30,589 vacancies
...Utilization Review Nurse
Per Diem
1648 Huntingdon Pike
Nursing RN/LPN
Day
SUMMARY OF JOB:
To review each admission for appropriate assignment of level of care based upon clinical guidelines as well as to review documentation for continued stays daily and provide...
Suggested
...Network ** **Job Description :****
**GENERAL OVERVIEW:**
This position is responsible for covering vast roles within the Utilization Review management team that include managing bill processing, downgrades, entry into the system including reg, insurance verification...
Suggested
Remote job
Local area
...regardless of a patient's ability to pay for health care.
The Utilization Review Nurse will be responsible for substantiating medical... ...Physician Advisors.
Works collaboratively with the Denials Specialist and Physician Advisors to manage retrospective appeals and documents...
Suggested
...Monday-Friday 8:00 am - 4:30 pm.
Deliverables/Principal Results Expected:
• Perform admission, continued stay and discharge reviews on all managed care clients.
• Maintain positive relationships with referral sources and insurance companies.
• Track...
Suggested
Remote job
Local area
Work from home
Flexible hours
Shift work
Monday to Friday
Overview Utilization Review Nurse
Berkshire Hathaway GUARD Insurance Companies, an A+ Superior rated Insurance company is seeking a... ...customer service. Become part of our dynamic, growing managed care specialist team.
Berkshire Hathaway GUARD offers a collaborative...
Suggested
Holiday work
Night shift
Weekend work
...providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care.
The Utilization Review Assistant is responsible for taking the data provided to their department and using it to communicate necessary information...
Suggested
...This is a remote position.
The Review and Evaluation Nurse will be responsible for performing prospective, concurrent, or retrospective utilization review/medical management for all services provided by our organization. This role entails evaluating the appropriateness...
Suggested
Contract work
Remote job
Fine-Tune Your Search!
Filter the job list with Smart Tags that match your preferences
Paid training(21)
Afternoon shift(40)
No experience(25)
Tuition reimbursement(20)
Work from home(42)
Weekly pay(22)
Immediate start(68)
Remote job(114)
Day shift(28)
Weekend work(48)
GDIT - Senior Full Stack - Code Review / Security Specialist
How the Senior Full Stack - Code Review / Security Specialist will make an impact:
Architecting, designing, coding, testing, implementing and troubleshooting Windows and web based software solutions in T-...
Suggested
Holiday work
Permanent employment
Immediate start
Remote job
Worldwide
...characteristics. If you need special accommodation for the application process, please contact Human Resources. Know Your Rights:
The Utilization review tech essentially works to coordinate the utilization review and appeals process as part of the denial management initiatives....
Suggested
Full time
Work experience placement
...Job Description
Job Description Job Title: Remote Dental Hygienist (Utilization Review/Prior Auths)
Location: 5-8 weeks training onsite in Harrisburg, PA then remote!
Shift: MON-FRI 8am-4pm
Pay: $34.00/hr.
Scheduled Pay: Bi-Weekly
Benefits: Health...
Suggested
Remote job
Weekly pay
Temporary work
Work from home
Shift work
...You will be responsible for conducting thorough retrospective reviews to ensure that all dental services align with state and federal... ...license in good standing.
Demonstrate understanding of utilization review processes.
High School Diploma or GED.
Why Join Us...
Suggested
Hourly pay
Full time
Remote job
...Utilization Management RN
Responsibilities
004005
Join the mission of Improving Lives as a Utilization Management RN at Jefferson Health. With more than 42,000 employees, we're the second largest employer in Philadelphia and the largest health system in the Philadelphia...
Suggested
...Responsibilities
Foundations Behavioral Health is currently hiring a full-time Utilization Review Coordinator to support our UM Department in Doylestown, PA. This is a Monday-Friday full-time position offering full-time benefits and competitive pay.
The...
Suggested
Full time
Local area
Currently hiring
Monday to Friday
Responsible for accurately transposing and reconciling clinical documentation from the EMR into the payer specific systems to provide information for proper risk adjustment of patients and increase revenue to the health plans and internal organization. This function requires...
Suggested
...Under the direction of the Manager of Medical Record Review Operations, the HEDIS Data Reviewer is responsible for performing... ...abstraction criteria to medical records to determine compliance.
•Utilizing various software applications to support department operations...
Suggested
Work experience placement
...Job Description
Job Description JOB SUMMARY
Position Title: Utility Assistance Specialist
Program: Outreach/ Utility Assistance
Classification: Non-exempt / Hourly
DUTIES AND RESPONSIBITIES
Program Implementation
Determine eligibility and enroll customers...
Hourly pay
Full time
For contractors
Relocation bonus
$68k - $80k
...Utilization Review Nurse /Workers Comp
Location - King of Prussia, PA
Job Purpose:
Review Workers Compensation requests submitted by the provider, requestor, claimant or carrier to determine the medical necessity of the treatment utilizing clinical expertise and...
Immediate start
...placement to appropriate level of care prior to hospitalization utilizing medical necessity criteria and third party payer guidelines. (3... ...Maintains a working knowledge of care management, utilization review changes, authorization changes, contract changes, regulatory requirements...
Full time
Contract work
Local area
Immediate start
...Job Description Description: RETTEW seeks a Subsurface Utility Locator/Geophysical Specialist to support our highly dynamic and specialized... ...motivated and qualified candidate.
Responsibilities:
Review and comprehend utility as-builts, construction plans, and...
Full time
For subcontractor
Relocation bonus
Flexible hours
Night shift
...and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care.
The Charge Review Specialist, Physician Billing is responsible for all revenue capture for physician practices including, but not limited to, charge review...
