RN Utilization Review Specialist

Job SummaryMedix is seeking a skilled Utilization Review Nurse to join our team. As a Utilization Review Nurse, you will play a critical role in ensuring that patients receive necessary and effective care while optimizing resource utilization.Key ResponsibilitiesAssessment and Review: Conduct thorough assessments of patient care, review medical records and...

Job Summary:MedStar Medical Group is seeking a skilled Utilization Review Nurse to join our team. As a Utilization Review Nurse, you will play a critical role in ensuring that patients receive the most appropriate and cost-effective care.Key Responsibilities:Conduct thorough admission, concurrent, and retrospective case reviews to identify opportunities for...

Clinical Review Specialist Job DescriptionWe are seeking a highly skilled Clinical Review Specialist to join our team at Healthcare Legal Solutions. As a Clinical Review Specialist, you will play a critical role in ensuring the accuracy and completeness of medical records and claim documentation.Key Responsibilities:Examine and interpret medical records and...

Clinical Review Specialist Job DescriptionThe Clinical Review Specialist plays a crucial role in ensuring the accuracy and completeness of medical records and claim documentation. This position is responsible for reviewing and interpreting medical records and claim documentation to assist with the appeals of denied insurance claims.Key...

Position OverviewRole SummaryThe Medical Claims Review Specialist plays a crucial role in the thorough examination and interpretation of clinical records and claim documents to facilitate the appeals process for denied insurance claims. Key responsibilities include composing appeal letters grounded in clinical expertise and knowledge. This role offers the...

Overview:Are you a skilled and experienced Board Certified Psychiatrist looking for a flexible work arrangement? We are seeking a talented professional to join our medical review team as a Telecommute Medical Review Specialist.This role provides the opportunity to work from home and customize your schedule within a Monday - Friday work week and within...

Job Title: Orthopedic Surgeon Telecommute Medical Review SpecialistJob Summary:We are seeking a highly skilled and experienced Orthopedic Surgeon to join our medical review team as a telecommute specialist. As a medical reviewer, you will be responsible for reviewing health claims and providing medical interpretation and decisions about the appropriateness...

Position OverviewRole SummaryThe Clinical Review Specialist plays a crucial role in the meticulous evaluation and interpretation of medical documentation and claims to facilitate the appeal process for denied insurance claims. This position involves composing appeal letters grounded in clinical expertise and understanding. The role is primarily remote, with...

Job SummaryWe are seeking a skilled and experienced physician to join our medical review team as a Telecommute Physician Advisor. As a key member of our team, you will be responsible for reviewing health claims and providing medical interpretation and decisions about the appropriateness of services provided by other healthcare...

OverviewWe are seeking a Board Certified Pain Medicine physician to join our medical review stream division as a telecommute medical review specialist. This role offers the flexibility to customize your schedule and caseload within a Monday - Friday work week and within business hours.ResponsibilitiesReviews medical files and provides recommendations for...

Job TitleDocument Reviewer Level IIJob TypeFull-timeLocationDC US (Primary)CategoryOperationsEducationProfessionalTravelJob DescriptionWe are seeking a highly skilled Document Reviewer Level II to join our team at Catawba Corporations. As a key member of our operations team, you will play a critical role in supporting the NRC Declassification Program.Key...

Job Title: Subsurface Utility Engineering SpecialistAre you interested in a career that combines technical skills with outdoor work? T2 Utility Engineers is seeking a Subsurface Utility Engineering Specialist to join our team in Ashland, VA.Job Summary:We are looking for a highly motivated and detail-oriented individual to assist our team in conducting...

Job DescriptionJob Summary:The Clinical Review Specialist will be responsible for conducting thorough clinical reviews and interpretations of medical records and claim documentation to support the appeals of denied insurance claims. This role requires a strong understanding of medical necessity and the ability to apply clinical judgment to complex medical...

Job Summary:Medical Solutions is seeking a skilled Registered Nurse to fill a Case Management position in Richmond, VA. As a travel nurse, you will have the opportunity to work in a dynamic and fast-paced environment, utilizing your expertise to make a positive impact on patient care.Responsibilities:Provide high-quality patient care in a Case Management...

Job Title: Medical AssistantWe are seeking a highly skilled and detail-oriented Medical Assistant to join our team at Specialist Office. As a Medical Assistant, you will play a vital role in providing exceptional patient care and supporting our healthcare team.Key Responsibilities:Greets patients and prepares them for physical examination, ensuring a...

Overview of the RoleUnder the supervision of the Director of Utilization Management and Appeals, the Clinical Review Nurse plays a crucial role in the management of utilization processes. This position involves evaluating patient insurance and status to ensure the effective execution of utilization reviews based on payer-specific guidelines. The nurse...

Overview of the RoleUnder the supervision of the Director of Utilization Management and Appeals, the Clinical Review Nurse plays a pivotal role in managing utilization processes. This position involves evaluating patient insurance status to ensure the effective execution of utilization reviews in accordance with payer-specific guidelines. The nurse utilizes...

About the RoleWe are seeking a skilled Utility Locator Specialist to join our team at MasTec Communications Group. As a key member of our team, you will play a critical role in identifying, locating, and marking the location of subsurface utilities to minimize accidental damage or disruption of service due to construction excavation activities.Key...

Job Title: Medical Nurse ReviewerWe are seeking highly skilled Medical Nurse Reviewers to support our Department of State contract. As a Medical Nurse Reviewer, you will play a critical role in ensuring the health and well-being of Afghan nationals who are pending emigration to the United States.Key Responsibilities:Review medical exams of Afghan nationals...

Job Title: Medical Nurse ReviewerWe are seeking highly skilled Medical Nurse Reviewers to support our Department of State contract. As a Medical Nurse Reviewer, you will play a critical role in ensuring the health and well-being of Afghan nationals who are pending emigration to the United States.Key Responsibilities:Review medical exams of Afghan nationals...