Medical Review 2

Summary: The main function of a Medical Reviewer is to ensure accuracy and compliance of healthcare documentation and information to confirm they meet regulatory standards. Job Responsibilities: Perform medical record abstraction & enter findings into Database. Identify Pursuit Opportunities & Track progress. Call provider offices & hospitals to request...

Summary: The main function of a Medical Reviewer is to ensure accuracy and compliance of healthcare documentation and information to confirm they meet regulatory standards. Job Responsibilities: Perform medical record abstraction & enter findings into Database. Identify Pursuit Opportunities & Track progress. Call provider offices & hospitals to request...

Description About SCAN SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation's leading not-for-profit Medicare Advantage plans, serving more than 280,000 members in California, Arizona, Nevada, Texas...

About SCAN SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation's leading not-for-profit Medicare Advantage plans, serving more than 280,000 members in California, Arizona, Nevada, Texas and New...

Description Title: RN, Coordinator Quality Peer Review Location: Long Beach Department: Q uality Assurance Status: Full-time Shift: Day Pay Range* : $53.97/hr - $78.24/hr  MemorialCare is a nonprofit integrated health system that includes four leading hospitals, award-winning medical groups – consisting of over 200 sites of care,...

Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior...

**JOB DESCRIPTION**Care Review Clinician, Inpatient Review- Behavioral HealthFor this position we are seeking a RN (Registered Nurse) who lives in and must be licensed for the state they reside. Strong inpatient medical and analytical experience is needed. Excellent computer multi-tasking skills and good productivity is essential for this fast-paced role....

**EMERGENCY ROOM ADMISSIONS REVIEW NURSE** **_PERMANENT SHIFT WILL BE :_** **_12 hour NIGHT SHIFT: 7:30PM (in the evening) - 08:30AM (in the morning) PACIFIC HOURS NON EXEMPT, 3 days a week will rotate._** **_This department runs 24 / 7 / 365 days a year. Rotating weekends and holidays will be required._** **_This position supports our California...

Job SummaryWe are seeking a highly skilled LPN Medical Reviewer to join our team at PGBA. As a Medical Reviewer, you will play a critical role in evaluating medical records to determine medical necessity and performing utilization management of professional, inpatient, outpatient facility benefits or services and appeals.Key ResponsibilitiesEvaluate medical...

WHO WE ARE: AMAZING INDIVIDUALS WORKING FOR POSITIVE PEOPLE at AIDS Healthcare Foundation! Does the idea of doing something that really makes a difference in peoples lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees? If so, AIDS Healthcare...

Job DescriptionJob DescriptionChanging Lives Shaping The FutureCertified Direct Support Professional II Caregiver- Hiring Now! Whittier- MUST have DSP 1 & DSP 2 CERTIFICATES Job Title : Certified Direct Support Professional II Caregiver (DSP2) Hourly Rate : $18.50-$22.00 Shifts Needed : Overnight/PM Shift (Open) Job Status : Full Time/ Part TimeWork...

*Tuesday - Saturday shift, work hours are 8am-5pm Pacific Time Zone*Remote role - CA LVN requiredAbout SCANSCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation's leading not-for-profit Medicare...

Job Title: Registered Nurse Job Specialty: CVOR Job Duration: 13 weeks Shift: Day 4x10-Hour (06:00 - 16:30) Guaranteed Hours: Experience: Minimum 2 years required; Travel experience required License: California License in hand required Certifications: ACLS, BLS Must-Have: Nursys report attached (pulled within 2 weeks), flu vaccine required (medical/religious...

Job Posting: Document Review Paralegal - Mesothelioma Cases Location : Huntington Beach, CA Schedule : Full-time, Monday to Friday, 8:00 AM to 5:00 PM Salary : $30-$35 per hour Type : Long-term Temporary with potential for Temp-to-Hire Overview Adams & Martin Group has partnered with a consulting firm located in Huntington Beach CA and are...

DetailsClient Name MemorialCare Long Beach Medical Center - AH Job Type Travel Offering Nursing Profession RN Specialty CVOR Job ID 29342574 Job Title Registered Nurse - CVOR @ Long Beach Memorial Medical Center Weekly Pay $2995.0 Shift DetailsShift Day - 10x4 - 06AM Scheduled Hours 40 Job Order DetailsStart Date 11/18/2024 End Date 02/17/2025 Duration 13...

Job ID: 24-146276Position Type: Full time Location: VirginiaWork Type: Remote Est. Pay Range: $28.19/hr. to $30.90/hr.20% travel potential to go onsite to pick up hard copy records. We are sourcing, there are no targeted resources. This is a WFH role in Virginia. Must be in or near to VA.Position Summary: "Participates in the collection and review of medical...

*Tuesday - Saturday shift, work hours are 8am-5pm Pacific Time Zone*Remote role - CA LVN requiredAbout SCAN SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation's leading not-for-profit Medicare...

Details Client NameMemorialCare Long Beach Medical Center - AH Job TypeTravel OfferingNursing ProfessionRN SpecialtyER Job ID29437425 Job TitleRegistered Nurse - ER @ Long Beach Memorial Medical Center Weekly Pay$2288.0 Shift Details ShiftNight - 12x3 - 07PM Scheduled Hours36 Job Order Details Start Date12/02/2024 End Date03/03/2025 Duration13 Week(s) Job...

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. ***POSITION IS REMOTE BUT CANDIDATE MUST RESIDE IN STATE OF FLORIDA***Position...

Responsibilities:Parameters of the provider's contract obligations.Audit claims processing quality, develops, maintains and runs standard reportsAssist the Claims Supervisor/Director in reviewing the quality auditing tracking/reporting (financial and procedural)Coordinating with various departments to resolve disputes or issuesMaintain the Claims department...