Utilization Review Nurse Specialist

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 Opportunity:US Tech Solutions is seeking a skilled Utilization Review Nurse to join our team. The ideal candidate will have experience in clinical utilization review and be able to work independently in a remote setting.Key Responsibilities:• Conduct thorough reviews of patient records to ensure accurate and efficient care.• Collaborate with...

Job Opportunity:US Tech Solutions is seeking a skilled Utilization Review Nurse to join our team. The ideal candidate will have experience in clinical utilization review and be able to work independently in a remote setting.Key Responsibilities:• Conduct thorough reviews of patient records to ensure accurate and efficient care.• Collaborate with...

Job OpportunityWe are seeking a skilled Utilization Review Nurse to join our team at US Tech Solutions.Job Description:Monday to Friday, 8am-4:30pm or 8:30am-5pm, panel interviews will be conducted on MS Teams.Onsite presence is required for the first week, after which work-from-home arrangements will be made, with provided equipment.Key...

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...

{"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...

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 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 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...

Job SummaryWe are seeking a highly skilled Medical Reviewer to join our team at Mindlance. 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 ResponsibilitiesPerforms...

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 OpportunityDenovo Review is seeking a highly motivated and detail-oriented Paralegal to join their team in Columbia, SC. The ideal candidate will have experience in construction law and/or civil litigation, with a strong background in filing in state and federal court.Key Responsibilities:Support attorneys in preparing and reviewing legal documents...

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 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 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 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...

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 SummaryPrisma Health is seeking a skilled Nurse Coding Specialist to join our team. As a key member of our Home Health department, you will be responsible for providing coding and utilization analysis for patients and clinical staff.Key ResponsibilitiesProvide coding education and training to clinical and administrative staff.Conduct thorough analysis of...

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...

Job Summary:Quality Chemical Laboratories (QCL) is seeking highly motivated candidates for qualified analytical data reviewers, lab specialists, and chemists with experience in Mass Spec, LC, GC, QC compendial testing, Wet Chemistry, Microbiology, Sterility, Synthetic Chemistry, Pharmaceutical Formulation, Metrology, and Sample Log-In Associates.Key...