Utilization Review Specialist

Job Description Additional Job Information Physical Requirements • Climbing - 26-75% • Grasping, Pinching and Holding - 26-75% • Lifting or Carrying - 26-75% • Pushing or Pulling - 26-75% • Reaching Overhead - 0-25% • Sitting - 76-100% • Squatting, Bending, Kneeling - 26-75% • Standing - 26-75% • Walking or Moving - 0-25% • Weights Lifted...

Job DescriptionJob DescriptionExternal Quality Review (EQR) SpecialistsPart-time As NeededRemoteWho We Are:Constellation Quality Health, formerly CCME, is a non-profit health care quality organization and QIO-like Entity certified by the Centers for Medicare & Medicaid Services (CMS) founded by physicians in 1983. Headquartered in North Carolina’s Research...

Performs medical reviews using established criteria sets and/or performs utilization management of professional, inpatient or outpatient, facility benefits or services, and appeals. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical claims and utilization practices. May provide any of the...

Performs medical reviews using established criteria sets and/or performs utilization management of professional, inpatient or outpatient, facility benefits or services, and appeals. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical claims and utilization practices. 80% May provide any of the...

Duties: Performs medical reviews using established criteria sets and/or performs utilization management of professional, inpatient or outpatient, facility benefits or services, and appeals. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical claims and utilization practices. 80% May provide any of...

"All candidates must be directly contracted by ASK Consulting on their payroll and cannot be subcontracted. We are unable to provide sponsorship at this moment".Job Title: Medical Reviewer ILocation: Columbia, SC- 29229Duration: 12 months contract pay scale is $20-$23/hr Job Description:Note: Please share this job posting within 40miles of Columbia, SC-...

Job Responsibilities Assists and represents the Assistant Director of Rights of Way for Utilities and Railroads in supervising and establishing practices and procedures for utility, and railroad coordination in conjunction with highway projects with limited supervision. This includes preparing, negotiating, reviewing, and approving agreements, reviewing...

Medical Billing Specialist In-Office Position.Medical Billing Specialist. The ideal candidate will be responsible for all aspects of billing including accounts receivables, managing claims from the time of claim submission to payment posting, etc. Qualifications:Medical Billing Certification.3+ years of previous medical collections experience with general...

Job Responsibilities The South Carolina Judicial Branch, Court of Appeals, Office of the Clerk invites applications for an Appeals Specialist I. With one-on-one training and supervision, an Appeals Specialist I manages a caseload according to the South Carolina Appellate Court Rules (SCACR) and established court policies and procedures. ESSENTIAL DUTIES...

*SIGN-ON BONUS: $5,000 if Licensed Registered Nurse (RN) ESSENTIAL FUNCTIONS:Provide consultation and guidance regarding admissions and patient length of stay to a variety of payers. Secure authorizations with insurance companies for inpatient treatment and continue to obtain authorizations for duration of patient stay. Evaluate the utilization program for...

Inspire health. Serve with compassion. Be the difference. Job Summary To provide our patients a seamless entry in to the Prisma Health experience. The Referral Specialist interfaces with patients and physician office team members to accurately authorize various consultations, procedures and tests. The Referral Specialist utilizes each patient's preferred...

Inspire health. Serve with compassion. Be the difference. Job Summary To provide our patients a seamless entry in to the Prisma Health experience. The Referral Specialist interfaces with patients and physician office team members to accurately authorize various consultations, procedures and tests. The Referral Specialist utilizes each patient's preferred...

Summary Duties This position serves as a Supervisory Inventory Management Specialist for non-expendable (NX) assets/materials for the Logistics Service within the VA Health Care System supervising multiple supply or material classes/series and recognized as the Material Management Division's subject matter expert serving as an advisor and...

Job Type Full-time Description AdaptHealth Opportunity - Apply Today! At AdaptHealth we offer full-service home medical equipment products and services to empower patients to live their best lives - out of the hospital and in their homes. We are actively recruiting in your area. If you are passionate about making a profound impact on the quality of patients'...

Summary THIS IS A NATIONAL GUARD TITLE 32 EXCEPTED SERVICE POSITION.This National Guard position is for a GS LOGISTICS MANAGEMENT SPECIALIST (TITLE 32), Position Description Number D in SPMD 2242 and is part of the MO HHD 175th Military Police Battalion.APPOINTMENT FACTORS: This is an Indefinite/Permanent (may retain current tenure if on-board) Excepted...

Inspire health. Serve with compassion. Be the difference. Job Summary To provide our patients a seamless entry in to the Prisma Health experience. The Referral Specialist interfaces with patients and physician office team members to accurately authorize various consultations, procedures and tests. The Referral Specialist utilizes each patient's preferred...

Job DescriptionJob DescriptionProduction Specialists work in a dynamic, creative and fast-paced environment to create and assemble sign and graphic products for many different business applications. Creative work is performed within the FASTSIGNS Center sign production area that is fully equipped with top-of-the-line sign-making equipment.Position...

Join us as our Physician Advisor (Medical Director) of Utilization Management and help shape the future of healthcare delivery through effective resource utilization, exceptional patient care, and evidence-based practices.Lexington Medical Center is currently seeking a highly qualified and experienced Medical Director of Utilization Management to join our...

Inspire health. Serve with compassion. Be the difference. Job Summary The ACTT Substance Abuse Specialist provides direct and indirect substance use counseling services to patients and their families using individual, group, and family therapy. Provides comprehensive substance use assessment, risk assessments, treatment planning and coordination with the...

About Us Howard Community College (HCC) is an exciting place to work, learn, and grow! We are proud to have received the Great Colleges to Work For honor for 12 consecutive years, 2009-2020. Howard Community College values diversity among its faculty, staff and student population. We are an innovative institution that is committed to responding to the...