Coding Denial Reviewer

Job OverviewEGO Inc DBA Brault is a privately-held, family-owned business specializing in practice management, billing, and coding services exclusively for acute care independent physician practices.We are seeking skilled professionals with multi-specialty coding experience to provide accurate coding services to our physician and healthcare system...

Job OverviewUnder general oversight, this role is pivotal in evaluating medical record documentation against billing standards and providing guidance to departments and faculty on the accurate documentation of medical records for patient services.Key Responsibilities- Conduct thorough quality assessments of coding practices to ensure that documentation...

Vivo HealthStaff is searching for a Utilization Review RN for a hybrid position for a health plan in San Francisco. It is a hybrid position with 1-2 days per week on-site required. Collaborates with the physician, nurse case manager, social worker, and other members of the health care team to meet individualized patient outcomes. Performs concurrent, and...

Job DescriptionJob DescriptionVivo HealthStaff is searching for a Utilization Review RN for a hybrid position for a health plan in San Francisco. It is a hybrid position with 1-2 days per week on-site required.Collaborates with the physician, nurse case manager, social worker, and other members of the health care team to meet individualized patient outcomes....

Job SummaryThe Texas Department of Aging & Disability Services is seeking a highly skilled Nurse II - Utilization Review Specialist to join our team. As a key member of our Utilization Review team, you will play a critical role in ensuring that individuals served in our waiver programs and Community Attendant Services receive the appropriate type and amount...

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. The Prior Authorization LVN ensures that prior authorization requests from patients and providers are completed in a timely...

ABOUT MARINHEALTH Are you looking for a place where you are empowered to bring innovation to reality? Join MarinHealth, an integrated, independent healthcare system with deep roots throughout the North Bay. With a world-class physician and clinical team, an affiliation with UCSF Health, an ever-expanding network of clinics, and a new state-of-the-art...

About the Role:The Clinical Utilization Specialist is responsible for conducting thorough reviews of assigned admissions, continued stays, and discharge planning to ensure compliance with established clinical criteria and regulatory requirements.Key Responsibilities:Perform admission, concurrent, continued stay, and retrospective reviews using established...

Job SummaryWe are seeking a highly skilled Case Management Nurse to join our team at the County of San Mateo Medical Center. As a Utilization Review Case Management Nurse, you will play a critical role in ensuring that patients receive the highest quality care while also optimizing resource utilization.Key ResponsibilitiesManage patient admission and ongoing...

Job Description: This position’s headquarters can be located in any available HHSC LTCR office in the state of Texas and reports to the Quality Assurance Regional Program Manager. Under the supervision of the Quality Assurance Regional Programs (QARP) Manager, the QARP Compliance Reviewer (CR) reviews certification and licensure forms that resulted...

Job SummaryInsight Global Healthcare is seeking a skilled Medical Record Coding Specialist to join our team. As a key member of our healthcare team, you will be responsible for reviewing, interpreting, and assigning diagnostic and procedural codes based on medical record documentation.Key ResponsibilitiesCode Review and Assignment: Review medical records to...

Opportunity Overview:For those passionate about transforming health care, this position offers a chance to contribute to innovative health programs that span the entire spectrum of care. We are committed to Caring. Connecting. Growing together.The Pre-Service Review Nurse LVN plays a critical role in ensuring that prior authorization requests from patients...

Job Title: Utilization Review RNJob Description As a member of the Utilization Management team, the Utilization Review RN plays a crucial role in managing care, cost, and outcomes across the continuum of patient care, including acute inpatient stays and post-acute facility stays. You will coordinate continuing care and outside services for value-based risk...

Position Title: Outpatient Coding Specialist at CHRISTUS HealthAre you dedicated to ensuring precise coding of outpatient diagnoses and procedures? Become a part of our team at CHRISTUS Health, a leading provider in pediatric healthcare.Overview:Ensure high-quality ICD-10-CM and CPT coding for outpatient encounters.Accurately abstract patient information...

Job DescriptionJob DescriptionA-Line staffing is hiring a Fully Remote Concurrent Review Nurse in California!If interested APPLY NOW for IMMEDIATE consideration!!Concurrent Review Nurse Details:Location: 100% Fully Remote – must live and be licensed in state of CaliforniaSchedule: Monday-Friday 8:00am-5:00pm PSTConcurrent Review Nurse CompensationThe pay...

Job OverviewPOSITION SUMMARYCSG Consultants Inc. is seeking a Lead Plans Reviewer to join our Building Plan Review Department. This full-time role is designed for a hybrid work environment. The Lead Plans Reviewer will be responsible for evaluating plans for commercial, residential, and industrial projects. A comprehensive understanding of construction...

Position Overview:Accountable for the creation, execution, and upkeep of a comprehensive quality management strategy across the organization, focusing on enhancing the overall quality, thoroughness, relevance, and precision of documentation and coding for professional services. Collaborates closely with senior leadership in the Revenue Cycle and evaluates...

Job SummaryOptum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best.Key ResponsibilitiesClinical Case Reviews - 75%Perform...

About TRB and Associates, Inc.TRB and Associates, Inc. is a leading municipal services consulting firm that provides expert services to clients throughout California. We are seeking an experienced and motivated Electrical Plan Review Engineer to join our team.Job SummaryThe Electrical Plan Review Engineer will be responsible for reviewing complex building...

Make a Difference in HealthcareFamily Health Centers of San Diego (FHCSD) is dedicated to delivering outstanding healthcare services to all individuals, particularly those in underserved communities with limited access to medical care. Established over 50 years ago by a community advocate, FHCSD has evolved into one of the largest community health...