Medical Reviewer

Job SummaryWe are seeking a highly skilled Medical Reviewer to join our team at Hornet Staffing, Inc. As a Medical Reviewer, you will be responsible for performing medical reviews using established criteria sets and/or performing utilization management of professional, inpatient or outpatient, facility benefits or services, and appeals.Key...

Job Description:We are seeking a skilled Medical Reviewer to join our team at US Tech Solutions. As a Medical Reviewer, you will be responsible for performing medical reviews using established criteria sets and/or performing utilization management of professional, inpatient or outpatient, facility benefits or services, and appeals.Key...

{"Responsibilities": "As a Medical Reviewer with US Tech Solutions, you will be responsible for performing medical reviews using established criteria sets and/or performing utilization management of professional, inpatient or outpatient, facility benefits or services, and appeals. You will document decisions using indicated protocol sets or clinical...

About the RoleUS Tech Solutions is seeking a highly skilled Medical Reviewer to join our team. As a Medical Reviewer, you will be responsible for reviewing medical claims and determining the medical necessity of services. You will work closely with our team to ensure that all claims are processed efficiently and accurately.Key ResponsibilitiesReview medical...

Job Title: Medical Claims ReviewerExperis is seeking a skilled Medical Claims Reviewer to join our team. As a Medical Claims Reviewer, you will be responsible for conducting medical reviews using established criteria sets, performing utilization management of professional, inpatient or outpatient, facility benefits or services, and addressing appeals.Key...

Job Title: Medical Claims ReviewerJob Summary:We are seeking a skilled Medical Claims Reviewer to join our team at Experis. As a Medical Claims Reviewer, you will be responsible for conducting medical reviews using established criteria sets, performing utilization management of professional, inpatient or outpatient, facility benefits or services, and...

Job Title: Medical Reviewer ILocation: RemoteDuration: 5 months assignment with possible extensionsShift: M - F, 8 am - 4:30 pmJob Summary:As a Medical Reviewer I, you will perform medical reviews using established criteria sets and/or perform utilization management of professional, inpatient or outpatient, facility benefits or services, and appeals. You...

Job Title: Medical Reviewer ILocation: RemoteDuration: 3 months assignment with possible extensionsShift: M - F, 8:30 am - 5:00 pmSummary: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...

Job Title: Medical Review NurseUS Tech Solutions is seeking a skilled Medical Review Nurse to join our team. As a Medical Review Nurse, you will play a critical role in ensuring the quality and accuracy of medical reviews and utilization management services.Responsibilities:Perform medical reviews using established criteria sets and/or perform utilization...

Medical Reviewer II Job DescriptionWe are seeking a highly skilled Medical Reviewer II to join our team at BlueCross BlueShield of South Carolina. As a Medical Reviewer II, you will play a critical role in ensuring the accuracy and quality of medical claims and utilization practices.Key Responsibilities:Perform medical claim reviews for complex services,...

Job SummaryWe are seeking a highly skilled and experienced Medical Review Director to lead our medical review team. As a key member of our organization, you will be responsible for directing and overseeing the operations of the medical review team to ensure regulations are met and contractual obligations are maintained.Key ResponsibilitiesDirect and oversee...

Job SummaryWe are seeking a highly skilled and experienced Medical Review Director to lead our medical review, clinical pricing, and re-determination teams. As a key member of our leadership team, you will be responsible for directing and overseeing operations to ensure performance expectations, compliance standards, and budgetary limits are maintained.Key...

About UsCapitol Bridge, LLC is a subsidiary of Capitol Bridge and its affiliated companies. Our mission is to deliver high-quality services and solutions to our customers, including the federal government. We strive to provide innovative ideas and exceptional customer service.Job OverviewThe Medical Reviewer will be responsible for reviewing Medicare denials...

Job Opportunity: Utilization Review NurseUS Tech Solutions is seeking a skilled Utilization Review Nurse to join our team. As a Utilization Review Nurse, you will be responsible for conducting thorough reviews of patient care to ensure that services are medically necessary and meet the highest standards of quality.Key Responsibilities:Conduct panel...

Job Title: Nurse Practitioner/Physician AssistantWe are seeking a highly skilled and dedicated Nurse Practitioner or Physician Assistant to join our team at Doctors Care/UCI Medical Affiliates, Inc.About UsDoctors Care/UCI Medical Affiliates, Inc. is a leading provider of non-medical management and administrative services to urgent care centers and physical...

Job SummaryLexington Medical Center seeks a highly skilled Medical Physicist to join our Radiation Oncology team. As a key member of our department, you will be responsible for establishing radiation policies and protocols, calibrating and commissioning equipment, and maintaining accreditation of the department.Key ResponsibilitiesImplement programs for...

Job Title: Medical ReviewerCapitol Bridge, LLC is seeking a highly skilled Medical Reviewer to join our team. As a Medical Reviewer, you will be responsible for reviewing Medicare denials for Part A inpatient hospital stays under the Alexander vs. Azar ruling to determine eligibility for appeal.Key Responsibilities:Perform independent review of requests for...

Job SummaryWe are seeking a highly skilled and experienced Medical Review Director to join our team at Palmetto GBA. As a key member of our leadership team, you will be responsible for directing and overseeing operations in the medical review, clinical pricing, and re-determination areas.Key ResponsibilitiesDirect and oversee operations in the medical...

Radiation Oncology Medical Physicist Job SummaryLexington Medical Center is seeking a highly skilled Radiation Oncology Medical Physicist to join our team. As a key member of our Radiation Oncology department, you will be responsible for establishing radiation policies and protocols, calibrating and commissioning equipment, and achieving and maintaining...

Job Title: Assoc. Medical StaffAt CSL Plasma, we are committed to ensuring that people with rare and serious diseases are able to live normal, healthy lives. As an Assoc. Medical Staff, you will play a critical role in evaluating donor suitability for automated pheresis procedures.Responsibilities:Evaluate donor suitability for automated pheresis procedures...