Utilization Review Specialist

About the JobUtilization Review SpecialistAt Staffosaurus, we are seeking a highly skilled Utilization Review Specialist to join our team. As a Utilization Review Specialist, you will play a critical role in ensuring that our clients receive the best possible care while minimizing costs.ResponsibilitiesObtain preauthorization for admissions and continued...

About StaffosaurusStaffosaurus is a leading provider of billing management services, dedicated to delivering high-quality, cost-effective solutions to our clients. Our mission is to ensure that our clients receive maximum insurance reimbursements in the shortest possible time, while maintaining the highest level of professionalism, ethics, and...

About the RoleAt Staffosaurus, we are seeking a highly skilled Clinical Utilization Review Specialist to join our team. As a key member of our healthcare management team, you will play a critical role in ensuring that our clients receive the best possible care while minimizing costs.Key ResponsibilitiesConduct thorough reviews of patient records to determine...

About StaffosaurusStaffosaurus is a leading provider of billing management services, dedicated to delivering exceptional results for our clients. Our mission is to provide innovative solutions that maximize insurance reimbursements and streamline the billing process.Job SummaryWe are seeking a highly skilled Utilization Review Specialist to join our team....

About the JobStaffosaurus is a leading Billing Management Company that prioritizes the best interests of its clients. Our mission is to provide a low-cost RCM solution that maximizes insurance reimbursements in the quickest possible time, while maintaining the highest level of professionalism, ethics, and transparency.Job SummaryThe Utilization Review...

About the RoleAt Staffosaurus, we are seeking a highly skilled Clinical Utilization Review Specialist to join our team. As a key member of our healthcare management team, you will play a critical role in ensuring that our clients receive the highest level of care and reimbursement.Key ResponsibilitiesPerform utilization review to ensure appropriate...

Utilization Management Nurse ReviewerThe Utilization Management Nurse Reviewer plays a vital role in healthcare systems by ensuring the effective and appropriate utilization of medical services. This position entails the assessment of medical records, treatment plans, and patient data to ascertain the necessity and appropriateness of medical procedures,...

Date Posted: 2024-07-30 Country: United States of America Location: Florida - Remote WHY JOIN FCS At Florida Cancer Specialists & Research Institute, we believe our people are our strength and we invest in them. In addition to having a positive impact on the people and communities we serve, associates benefit from significant professional opportunities,...

Position Overview:As a vital member of the Utilization Management team at Saviance Technologies, your primary responsibility will be to conduct thorough inpatient medical necessity and utilization assessments. This role is crucial in ensuring that our members receive the appropriate care they require at the right time. Key Responsibilities:Your daily...

Job OverviewAs a key member of our clinical team, the Clinical Review Nurse Specialist is responsible for evaluating medical documentation to confirm medical necessity and the appropriate level of care. This role involves utilizing MCG/InterQual guidelines, state and federal regulations, billing, and coding standards, as well as Molina policies to ensure...

About the RoleThe Facility Compliance Review team at Blue Shield of California reviews post-service prepayment facility claims for contract compliance, industry billing standards, medical necessity, and hospital-acquired conditions/never events. As a Utilization Management Nurse, Senior, you will report to the Senior Manager, Facility Compliance Review. In...

Job OverviewThe Utilization Management Nurse Reviewer is integral to healthcare operations, focusing on the efficient and appropriate use of medical services. This role involves reviewing patient records, treatment plans, and relevant information to assess the necessity and suitability of medical interventions, tests, and procedures.In collaboration with...

Job OverviewPosition SummaryUtilizing extensive clinical expertise, the incumbent will be responsible for evaluating documentation to confirm medical necessity and the appropriate level of care in accordance with MCG/InterQual standards, state and federal regulations, billing and coding guidelines, as well as Molina policies. This role involves validating...

Utilization Management Nurse ReviewerThe role of the Utilization Management Nurse Reviewer is vital in ensuring the effective and appropriate utilization of healthcare services. This position is responsible for analyzing medical documentation, treatment protocols, and patient data to assess the necessity and appropriateness of medical interventions,...

Job DescriptionJob DescriptionAbout Children of America (COA): About Children of America (COA): We are a special blend of people, principles, and pride that creates a diverse and strong community. Our diverse and dedicated team is the backbone of COA's strength. Children of America is seeking a motivated and experienced Billing Specialist to join our...

Your Role The Utilization Management team reviews the inpatient stays for our members under the guidelines for nationally recognized levels of care. The Utilization Management Nurse, Senior will report to the Utilization Management Nurse Manager. In this role you will be assigned a list of inpatient facilities and review clinical information provided by the...

Company Overview:A progressive construction firm is on the lookout for a talented Cost Estimation Specialist to enhance their team.Why Join Us?We offer a range of benefits including:- Comprehensive health benefits- A balanced work-life environment- Opportunities for career advancement- A supportive company culturePosition Overview:We are in search of a...

Job SummarySaviance Technologies is seeking a highly skilled Care Review Clinician I to join our Utilization Management team. As a key member of our team, you will be responsible for conducting inpatient medical necessity and utilization reviews, ensuring our members receive appropriate care when they need it.Key Responsibilities:Conduct thorough reviews and...

TRB and Associates, Inc. is seeking a qualified and driven building plan review specialist with a valid registration as a civil, structural, mechanical, or architectural engineer (California registration preferred). The successful candidate should possess at least two years of experience in plan evaluation and/or design for commercial, industrial, and...

TRB and Associates, Inc. is seeking a qualified and driven Building Plans Review Specialist with a valid registration as a civil, structural, mechanical, or architectural engineer (California registration preferred). The successful candidate will possess at least two years of relevant experience in reviewing plans and/or design for commercial, industrial,...