- TEKsystems (Orlando, FL)
- …Data Entry Specialists. In this role, you will be responsible for processing incoming medical review cases. You will extract relevant data from submitted forms ... stage of case review . Key Responsibilities + Receive and log incoming medical review cases. + Extract and input data into Microsoft Word and Excel documents.… more
- University of Miami (Miami, FL)
- …initial assessment of cases referred to the Team by DCF, law enforcement or medical providers + Review the interviews of children and their caregivers prior ... or consults as indicated or at the request of the Medical Director. + Be available to review Hotline reports to determine which cases are mandatory referrals to… more
- HCA Healthcare (Largo, FL)
- …career path, we encourage you to apply for our RN Clinical Nurse Coord Medical ICU opening. We review all applications. Qualified candidates will be contacted ... the career opportunities as a(an) RN Clinical Nurse Coord Medical ICU you want in your current role? We...colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
- Molina Healthcare (Orlando, FL)
- …with ad hoc projects. **Job Duties** + Performs the role of the HEDIS medical record review overreader/auditor which includes ongoing review of records ... and data entered by the abstraction team during the annual HEDIS medical record review as well as all other HEDIS/HEDIS like project. Mentors entry-level… more
- ChenMed (Pembroke Pines, FL)
- …Participate in surveys, studies and special projects as assigned. + Conduct concurrent medical record review using specific indicators and criteria as approved ... and other healthcare facilities. + In conjunction with the PCP, hospitalist, Medical Director of Transitional Care, insurance case manager and the hospital case… more
- University of Miami (Medley, FL)
- …to assure proper Medicare Severity Diagnostic Related Groups (MS-DRG) assignment. + Review medical record documentation for major complications and comorbidities ... data collection, and research purposes. CORE JOB FUNCTIONS + Review , analyze, and interpret the entire electronic medical... Review , analyze, and interpret the entire electronic medical record (EMR) to identify all diagnoses and procedures… more
- Highmark Health (Tallahassee, FL)
- …action to prevent further improper payments.Forwards case to the Credentialing and/or Medical Review Committee, law enforcement and regulatory agencies. + ... internal and external law enforcement and regulatory agencies, Credentialing or Medical Review Committee. + Engages in delivery of audit results and overpayment… more
- Sedgwick (Tallahassee, FL)
- …clinical review of referred claims; documents decision rationale; and completes medical review of all claims to ensure information substantiates disability. ... consult providers and employees; to provide case direction; and to ensure medical information substantiates the need for absence from work. **ESSENTIAL FUNCTIONS and… more
- Carnival Cruise Line (Miami, FL)
- …team to assess fitness for duty per International Maritime Health guidelines. + **Crew Medical Claims Management** + Review crew cases of high risk and escalate ... care coordination and utilization reviews. Operationally, the role supports shipboard medical teams, participates in the 24/7 duty rotation, and manages ship… more
- Wellpath (West Palm Beach, FL)
- …and assisting with civil commitments when necessary. Psychiatrists also participate in medical review committees and deliver consultations to facility staff. ... * Growth and training **Perks and Benefits** In addition to comprehensive benefits including medical , dental, vision, paid time off, and 401k, we foster a work, life… more