Clinical Review Specialist

Job Title: Clinical Review SpecialistDane Street is seeking a skilled Clinical Review Specialist to conduct Group Health reviews. This role involves a clinical summary, potential calls to treating providers, and responses to questions posed.Key Responsibilities:Conduct thorough clinical reviews of Group Health casesPrepare and submit high-quality clinical...

Key Responsibilities:As a Clinical Review Specialist at Infojini, you will utilize your clinical knowledge to review medical charts for accuracy and sequencing of diagnosis. This involves analyzing Consultation reports, History and Physical reports, Operative reports, Progress reports, and Discharge reports, including complex cases. Required Skills: Epic...

Job Summary:Dane Street is seeking a skilled Clinical Review Specialist to conduct Group Health reviews. This role involves a clinical summary, potential calls to treating providers, and responses to questions posed.Key Responsibilities:Conduct thorough clinical reviews of Group Health casesPrepare clinical summaries and potential calls to treating...

Job Title: Physician Reviewer - Clinical Summary SpecialistAbout the Role:Dane Street is seeking skilled Physician Reviewers to conduct Group Health reviews. As a Clinical Summary Specialist, you will be responsible for creating a comprehensive clinical summary, identifying potential calls to treating providers, and responding to questions posed.Key...

This telework opportunity at Dane Street provides the ability to customize your schedule and caseload within the week while maintaining client-mandated turnaround times.Our reviewers are compensated on a per-case basis as a 1099 independent contractor.Preferred candidates will hold a NY License, and be NY WC Board Certified.JOB SUMMARYAs a Clinical Review...

Medical Review SpecialistWe are seeking a highly skilled Medical Review Specialist to join our team at Concentra. As a Medical Review Specialist, you will be responsible for reviewing medical files and providing recommendations for utilization review, chart reviews, medical necessity, and appropriateness of care.Key Responsibilities:Reviews medical files and...

Job Title: Clinical ReviewerJob Description:We are seeking a skilled Clinical Reviewer to join our team at Greenlife Healthcare Staffing. As a Clinical Reviewer, you will be responsible for conducting utilization reviews up to and including the appeal level. This includes chart screen, completing electronic worksheets, entering the required information, and...

Clinical Review Nurse Role OverviewAt Medix, we are seeking a skilled Clinical Review Nurse to join our team. The successful candidate will act as a liaison between participants and providers, ensuring compliance with regulatory and contractual requirements.Key ResponsibilitiesReview and process service authorization requests from providers in a timely and...

Job Title: Medical Record Review SpecialistAt Spectraforce Technologies, we are seeking a skilled Medical Record Review Specialist to join our team. As a Medical Record Review Specialist, you will be responsible for retrieving medical records with clinical accuracy using remote access to Electronic Medical Record Systems. Your attention to detail and ability...

We are seeking a skilled Document Review Specialist to join our team at KLDiscovery. As a Document Review Specialist, you will play a critical role in reviewing documents for complex litigation matters using our electronic review platform. Your expertise in coding for relevancy, confidentiality, and privilege will be essential in ensuring the accuracy and...

Dane Street, a certified "Great Place to Work" company, is seeking a Physician to provide utilization review services for the Group Health Department.This role requires utilizing clinical expertise to review medical records and provide an interpretation of the medical appropriateness of services in compliance with state regulations, nationally recognized...

Job Summary:Concentra is seeking a skilled Neurologist to join our medical review team as a Telecommute Medical Review Specialist. In this role, you will review health claims and provide medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals.As a Telecommute Medical Review Specialist, you will...

Transforming Diagnostics for a Healthier FutureAt Ortho Clinical Diagnostics, we're united by a shared passion for delivering innovative diagnostic solutions that make a meaningful difference in people's lives. As a Field Application Specialist, you'll play a critical role in driving our mission forward by providing technical and sales support to clinical...

Job Summary:Concentra is seeking a skilled Board Certified Neurosurgeon to join our medical review team as a telecommute medical review specialist. As a medical review specialist, you will be responsible for reviewing health claims and providing medical interpretation and decisions about the appropriateness of services provided by other healthcare...

Job SummaryWe are seeking a highly skilled Claims Review Specialist to join our team at the City of New York. As a Claims Review Specialist, you will be responsible for reviewing, processing, and determining potential SNAP benefit overpayments. This is a critical role that requires strong analytical and communication skills, as well as the ability to work...

Job SummaryHealth First is seeking a skilled Clinical UM Pharmacist to join our team. As a key member of our Utilization Management department, you will play a critical role in ensuring the efficient and effective review of medication requests.Key Responsibilities Monitor and review prior authorization requests for medications to ensure compliance with...

Job SummaryWe are seeking a highly skilled Clinical Pharmacist to join our team as a UM Reviewer. As a key member of our Utilization Management team, you will be responsible for reviewing and approving medication requests, ensuring compliance with regulatory requirements, and developing clinical criteria and medical policies.Key ResponsibilitiesReview and...

{"Responsibilities": "As a Cornerstone Performance Review Specialist, you will be responsible for building all elements of the performance review module in Cornerstone on Demand in the production environment.This includes inputting all competencies, goals, questions, emails, and notifications that will be sent to all participants in the appropriate reporting...

Job Summary:We are seeking a Board Certified Psychiatrist to join our medical review team in a telecommute capacity. As a Psychiatrist Telecommute Medical Review Specialist, you will review health claims and provide medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals.Responsibilities:Reviews...

Drug Utilization Review SpecialistAt destinationone Consulting, we are seeking a highly skilled Drug Utilization Review Specialist to join our team. As a key member of our healthcare recruitment team, you will play a crucial role in evaluating medication use patterns to promote safe and effective medication therapy, ensuring optimal patient outcomes.Key...