Utilization Review Specialist Jobs in USA

About the job Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco our investors include Benchmark General Catalyst Peter Thiel Adam DAngelo Larry Summers and Jack Dorsey. Position: Document Review Expert Type: Contract Compensation: $35$4...

Job Title: Utilization Review ManagerLocation: Chicago Job Type: Full-TimeReports to: Director of Revenue Cycle Manager; In Direct Reporting to Chief Clinical OfficerDirect Reports: none subject to change in futureAbout Us:God Restoring Order (GRO) Community is a mental healthcare provider that spec...

ID: Shift: Day 5x8-Hour (08:30 - 17:00) Description: Shift: 5x8 hour daysYears of Experience: 2 preferredUnit accepts first time travelersThe Case Manager is responsible for medical necessity review discharge planning and utilization review. Identifies and communicates changes in the patients plan...

About the OrganizationLotus Healthcare Billing is a behavioral health billing operation based in Boca Raton Florida supporting treatment programs through insurance authorization utilization review and payer communication. The team works closely with clinical staff to ensure that patients can access...

*Shifts are weekdays.The Utilization Reviewer reflects the mission vision and values of NM adheres to the organizations Code of Ethics and Corporate Compliance Program and complies with all relevant policies procedures guidelines and all other regulatory and accreditation standards.Responsibilities:...

Position SummaryWe are seeking a detail-oriented and analytical Document Review Specialist to join our this role you will be responsible for reviewing auditing and maintaining accurate records across various systems and documents. The ideal candidate will possess strong organizational skills excell...

Benefits:401(k) matchingDental insuranceEmployee discountsHealth insurancePaid time offTraining & developmentVision insurancePosition Description:Assists in defining and reviewing the Project Requirement Document scope of work and schedule including interim housing requirementsMakes value engineerin...

*Shifts are weekdays.The Utilization Reviewer reflects the mission vision and values of NM adheres to the organizations Code of Ethics and Corporate Compliance Program and complies with all relevant policies procedures guidelines and all other regulatory and accreditation standards.Responsibilities:...

Job Summary: We seek a highly skilled and experienced Registered Nurse with specialties in Medical/Surgical ICU ER Psychiatric Labor & Delivery PACU Operating Room. The Registered Nurse will be responsible for providing skilled nursing care case management and hospice care to individuals facing adva...

This position is responsible for:Routine case management discharge planning swing bed coordinator and utilization review and screening potential admissions to the facilities swing bed programknowledgeable of criteria for Medicare Medicaid HMO swing bed and private insurance coverageInitiate ongoing...

This position is responsible for: Routine case management discharge planning swing bed coordinator and utilization review duties. Evaluating and screening potential admissions to the facilities swing bed program knowledgeable of criteria for Medicare Medicaid HMO swing bed and private insurance cove...

This position is responsible for: Routine case management discharge planning swing bed coordinator and utilization review duties. Evaluating and screening potential admissions to the facilities swing bed program knowledgeable of criteria for Medicare Medicaid HMO swing bed and private insurance cove...

Scope of workProvides health information interacts and acts as a resource for providers for complex clinical situations to ensure appropriate use of preservice and concurrent acute medical and/or behavioral health care services. Assesses appropriateness of preservice and concurrent requests for admi...

DescriptionHybrid:Our physical office is in Olympia WA. We offer flexible work schedules and locations. This is a hybrid position where most of the work can be done remotely. However you must reside in the state of Washington and travel to in-person activities meetings and events as needed for busin...

ID: Shift: Day 5x8-Hour (09:00 - 17:00) Description: Required Certs: BLS and CA LicensePreferred Certs: BSN or MSNRequired Skills: Utilization review care coordination acute hospital ER/ICU audits data abstraction quality improvement HIPAA Joint Commission preparationRequired experience: 5 years -...

Job Title: Registered Nurse Utilization Review (RN-UR)Location: Syracuse NY 13210 Schedule: Day Shift Duration: 14 WeeksCompensationLocal Candidates: $2000 $2300 per weekTraveler Candidates: $2500 $2800 per weekPosition OverviewWe are seeking an experienced Utilization Review Registered Nurse (RN...

The Utilization Reviewer reflects the mission vision and values of NM adheres to the organizations Code of Ethics and Corporate Compliance Program and complies with all relevant policies procedures guidelines and all other regulatory and accreditation standards.Responsibilities:Responsible for utili...

The Utilization Review Coordinator reflects the mission vision and values of NM adheres to the organizations Code of Ethics and Corporate Compliance Program and complies with all relevant policies procedures guidelines and all other regulatory and accreditation standards.Responsibilities:The Utiliza...

JOB SUMMARYThe RCM Aging Specialist is responsible for follow-up on aged accounts by working insurance A/R aging reports (60/90/120 days) to identify unpaid or underpaid claims and ensure timely accurate reimbursement from insurance companies. This role requires strong payer communication skills eff...

Work Location:New York New York United States of AmericaHours:40Pay Details:$97240 - $145600 USDTD is committed to providing fair and equitable compensation opportunities to all colleagues. Growth opportunities and skill development are defining features of the colleague experience at TD. Our compen...