Evaluation Reviews Specialist

Job Title: RN Utilization Review SpecialistSouth Central Health System is seeking a highly skilled RN Utilization Review Specialist to join our team. As a key member of our Medical Staff Office, you will play a critical role in ensuring the quality and safety of patient care.Responsibilities:Collect and prepare data from medical records for OPPE and FPPE...

Job Title: Clinical Utilization Review SpecialistJoin Centene Corporation, a leading healthcare company, as a Clinical Utilization Review Specialist. In this role, you will play a critical part in ensuring the quality and appropriateness of care for our 28 million members.Job Summary:We are seeking a highly skilled Clinical Utilization Review Specialist to...

Billing Review Specialist Job DescriptionAt Enterprise Solutions Inc, we are seeking a highly skilled Billing Review Specialist to join our team. As a key member of our revenue cycle team, you will play a critical role in ensuring the accuracy and efficiency of our billing processes.Key Responsibilities:Verify insurance benefits and eligibility for...

Billing Review Specialist Job DescriptionEnterprise Solutions Inc is seeking a highly skilled Billing Review Specialist to join our team. As a key member of our team, you will be responsible for ensuring the accuracy and completeness of patient billing information.Key Responsibilities:Verify insurance benefits and eligibility for patientsEnsure completion of...

What we offer Excellent health benefits plan, which includes medical, vision and dental options 401(k) with company match Company profit sharing plan Generous paid time-off and paid holidays Paid parental leave Company-paid mental health benefit through Headspace 2 free on-site fitness rooms Employee Assistance Program Employee Resource Groups ...

Job Title: Image Review Audit Validation SpecialistThe Image Review Audit Validation Specialist plays a crucial role in ensuring the accuracy and quality of the image review process. This position is responsible for validating reviewed images from the Image Review and Image Review Audit teams to ensure that they meet the required standards.Key...

Job SummaryWe are seeking a skilled Clinical Utilization Review Specialist to join our team at Trinity Health Of New England. As a key member of our healthcare team, you will be responsible for performing utilization review and payer notification, establishing partnerships with site BPCI RN, and educating patients, families, and care teams about financial...

Job Title: Senior Grants Management SpecialistLooper Consulting, LLC is seeking a highly skilled Senior Grants Management Specialist to join our team. As a key member of our Operations Management division, you will be responsible for overseeing the planning and implementation of activities related to Federal Notice of Funding Opportunity (NOFO) and Technical...

Job SummaryAs a Registered Nurse Utilization Review Specialist at the University of Texas Southwestern Medical Center, you will play a critical role in ensuring the delivery of high-quality, cost-effective patient care. Your expertise will be utilized to conduct medical necessity reviews for acute care services, utilizing evidence-based guidelines to...

Job Title - Department Loan Review Officer - Loan Review Location This position is 100% remote within the Bank's footprint. Employee will work full time remote outside of a WesBanco location (may occasionally attend in person meetings, although primary functions of the role are performed remotely). Market Upper Ohio Valley Work Hours per Week 37.5 ...

Internal Auditor & Credit ReviewerFCS Financial is seeking a detail-oriented professional to enhance our dynamic team as an Internal Auditor & Credit Reviewer. This role is key in protecting the organization from methods or activities that could put the organization at unacceptable risk.Key Responsibilities:Evaluate and improve the effectiveness of risk...

A company is looking for a Medical Affairs Specialist to support the Document Review Committee process across multiple Therapeutic Areas. Key Responsibilities: Coordinate compliance and operational tasks for the Document Review Committee process Facilitate the review process by ensuring research documents meet readiness and compliance standards ...

Job SummaryAs a Clinical Psychologist at Kaiser Permanente, you will play a critical role in providing mental health assessment, diagnosis, and treatment services to adult and child members. You will collaborate with a multidisciplinary team to develop and implement individualized treatment plans, ensuring the best possible outcomes for our patients.Key...

Job SummaryThe Care Management Coordinator, in collaboration with the Care Manager, assists in coordinating the utilization review and discharge planning tasks. This role is responsible for organizing and overseeing the administrative aspects of utilization review and discharge planning and other assigned duties within the Care Management...

Description:The Conditions Specialist is responsible for the pre-purchase review of Conventional, Non-Conforming, FHA, and VA loan files to ensure file contains the designated set of documentation.• Be an integral part of the pre-purchase review of Conventional, Non-Conforming, FHA, and VA loans files• Ensure each file contains the designated set of...

Job Title: Image Review SupervisorAt Bickham Services Unlimited, LLC, we are seeking a highly skilled Image Review Supervisor to join our team. As an Image Review Supervisor, you will play a critical role in ensuring the accuracy and timeliness of image processing for toll violation enforcement.Key Responsibilities:Supervise and monitor the work of assigned...

Job SummaryThe National Health Care for the Homeless Council is seeking a highly skilled Evidence and Evaluation Coordinator to support the Health Care for the Homeless (HCH) field by evaluating training activities, developing and disseminating knowledge, increasing visibility of HCH-related research through publications and external collaborations, and...

A company is looking for a Testing Evaluator. Key Responsibilities: Perform tests in a professional manner Enter data on the testing platform in a timely manner Create and review test items Required Qualifications, Training, and Education: Native fluency in the target language College Degree Experience with Microsoft Office Suite Minimum...

Why work at TidalHealth? Looking for a rewarding place to work? Choose TidalHealth. Our hospitals have been named among the Top 5 percent of all U.S. hospitals by Healthgrades and a five-star hospital by the Centers for Medicare & Medicaid Services. Located just 30 minutes from the beach, TidalHealth offers the widest array of specialty and subspecialty...

General Summary of PositionMedStar Health is looking for a Coding Specialist III with experience in Transplant Surgery coding to join our REMOTE team with the MedStar Medical Group!  To qualify for a level III Coding Specialist, you must have 5-7 years medical-professional coding experience and your CPC certification.   As a Coding Specialist III you will...