- Elevance Health (IN)
- …work in.** The **Physical Therapist Reviewer ** is responsible for performing medical record reviews specific to services billed related to physical therapy ... **Physical Therapist Reviewer ** **Work schedule: M-F 7:30am to 4:30pm EST.**...will make an impact:** + Conducts medical review /claim review of beneficiary health records… more
- Citizens (Johnston, RI)
- Description The Real Estate & Insurance Risk Reviewer will be the primary reviewer and point of contact with RMs/PMs in the completion of property insurance ... interaction with RM/PMs and CLO as Subject Matter Expert in assisting them review a borrower's property insurance package both on annual renewals and a transactional… more
- Commonwealth Care Alliance (Boston, MA)
- …medical necessity of services + Communicates results of reviews verbally, in the medical record , and through official written notification to the primary care ... + Experience with prior authorization and retrospective reviews + Proficiency reviewing clinical/ medical records and determining medical necessity based on… more
- Lee County Board of County Commissioners (Fort Myers, FL)
- Site Plan Reviewer Print (https://www.governmentjobs.com/careers/leecounty/jobs/newprint/5015210) Apply Site Plan Reviewer Salary $26.92 - $36.06 Hourly ... for administering the Lee County Land Development Code and coordinating the review and analysis of applications for development orders, limited development orders,… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …to appropriate guidelines. This position requires strong clinical judgment, ability to analyze medical records and apply medical knowledge to make the ... regulatory timeframes.The TeamAs an integral part of the Appeal Review team, the Clinical Appeals Nurse Reviewer ...accreditation standards and timeframes. + Collaborate with the Physician Review Units to assist with medical necessity… more
- Kelly Services (Rochester, MI)
- **Scientist, Data Reviewer - Rochester MI** **Kelly Science & Clinical has an opening for a long-term, contracted, fully-benefitted, Data Reviewer Scientist for ... assigned with little oversight + Presents analytical data to project team for review and discussion + Reviews and approves laboratory test data and documentation… more
- Elevance Health (Nashville, TN)
- …Receiving authorization requests for genetic tests from front-line intake. + Conducting medical necessity review in adherence to guidelines and determining ... **Genetic Counselor Reviewer ** The Genetic Counselor Reviewer (GCR)...whether clinical information presented meets medical necessity criteria or requires physician review … more
- City of New York (New York, NY)
- …for all foster care agencies within the 5 boroughs 2. Participating in all post medical record review quality monitoring and corrective action processes 3. ... services for children newly admitted to foster care - Review medical records at ACS's...in the following areas: Pediatric/Adolescent nursing Chart review / medical audit/ electronic medical record … more
- BJC HealthCare (St. Louis, MO)
- …of preoperative, operative, and postoperative data through effective utilization of medical record system and available clinical information resources + ... About the Role** BJC is hiring for a Surgical/Clinical Reviewer . This is a remote position. Must be located...the hospital community, especially staff in Surgery, Quality, Nursing, Medical Records , and the Information Systems departments… more
- Elevance Health (Nashville, TN)
- …benefits. Works on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or ... **Nurse Reviewer I** **Location:** **Virtual:** This role enables associates...meets medical necessity criteria or requires additional medical necessity review . + Conducts initial … more
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