- Molina Healthcare (Long Beach, CA)
- … medical necessity and appropriate/accurate billing and claims processing. * Evaluates medical records and/or medical notes providing clinical expertise ... Experience** Minimum three years clinical nursing experience. Minimum one year Utilization Review and/or Medical Claims Review . **Required License,… more
- The County of Los Angeles (Los Angeles, CA)
- …direction, administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one of ... for and the effective conduct of the system to review patients' medical charts to ascertain the...SECURITY NUMBER: Please include your Social Security Number for record control purposes. Federal law requires that all employed… more
- The County of Los Angeles (Los Angeles, CA)
- …authorization for the issuance of denial letters. + Reviews, retrospectively, utilization review records for completeness, use of appropriate codes, correctness ... physician advisor for follow up on referrals. + Reviews, retrospectively, Utilization Review Records for completeness, use of appropriate codes, correctness of… more
- Sevita (Suisun City, CA)
- …diploma or equivalent + Six months of general office experience; experience in medical records preferred + Ability to manage/prioritize multiple tasks + ... Join us today, and experience a career well lived. ** Records Coordinator** **Compensation - $17.87 per hour** Do you...computer index + Assist in copying and distribution of record information per policy + Maintain supply of forms,… more
- Sevita (CA)
- …diploma or equivalent + Six months of general office experience; experience in medical records preferred + Ability to manage/prioritize multiple tasks + ... facing out of home placements or reunification. **Program Administration Records Coordinator** Our mission at Sevita is to create...computer index + Assist in copying and distribution of record information per policy + Maintain supply of forms,… more
- Ventura County (Ventura, CA)
- …is responsible for the leadership and direction in planning, and coordinating medical reviewer staff to ensure appropriate, professional, and cost-conscious ... and Peer Review systems and programs + Direct patient care medical practice experience + Administrative experience + National Committee for Quality Assurance… more
- UCLA Health (Los Angeles, CA)
- …including inspections of clinical areas, patient care practices, and administrative processes + Review medical records of services in preparation for health ... include: + Travel to various clinic sites and schedule and conduct medical record and facility site audits + Conduct thorough facility site reviews and… more
- Centene Corporation (Sacramento, CA)
- …concurrent review findings, discharge plans, and actions taken on member medical records in health management systems according to utilization management ... projects within utilization management as part of the clinical review team + Partners and works with Medical...by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA… more
- Dignity Health (Rancho Cordova, CA)
- …**Position Summary:** This position is responsible for monitoring Dignity Health Medical Foundation inpatient admissions and concurrent review for appropriate ... the continuum of healthcare. Responsibilities may include: - Concurrently review patient's records to collect data to...services using clinical judgment and established guidelines. Refer to Medical Directors for review depending on case… more
- The County of Los Angeles (Los Angeles, CA)
- …geology investigationsby acting as project manager, technical lead, technical peer reviewer ; determining needs and requirements pertaining to the investigation (eg, ... information about a conviction history, any convictions or court records which are exempted by a valid court order...you preparing for the test, we advise you to review all related materials that you deem necessary. +… more