- Chenega Corporation (Rockville, MD)
- …the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States . + Must be able to travel to clients location occasionally ... **Chenega Professional Services Strategic Business Unit** company, is looking for a Nurse Practitioner-Contract Medical Reviewer (CMR) to support the Department… more
- AmeriHealth Caritas (Washington, DC)
- …When necessary, cases are escalated to the Medical Director for further review . The reviewer independently applies medical and behavioral health guidelines ... on clinical criteria. Using professional judgment, the Clinical Care Reviewer assesses the appropriateness of services, identifies care coordination opportunities,… more
- Adecco US, Inc. (Minneapolis, MN)
- …days **Pay:** $40.50 to $42.50 an hour **Responsibilities of the RN Appeals Reviewer :** . Responsible for conducting thorough reviews of member and provider appeals, ... when appropriate. . You will summarize medical information for review by the Medical Director as needed, ensuring a...and meeting production goals. **Qualifications for the RN Appeals Reviewer :** . Associates degree . Active and good standing… more
- Chenega Corporation (Rockville, MD)
- …of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States . + Because our Physicians (Contract Medical Reviewers) spend significant ... Unit** company, is looking for a Physician- Contract Medical Reviewer (CMR) to support the Department of Health and...& Immunology, Neurology; or License to practice in the US as a physician's assistant or nurse … more
- Zelis (FL)
- …Zelis, we Get Stuff Done. So, let's get to it! A Little About Us Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare ... interests that shape who you are. Position Overview The Inpatient DRG Reviewer will be primarily responsible for conducting post-service, pre-payment and post pay… more
- SSM Health (IL)
- …Wisconsin Department of Safety and Professional Services **Work Shift:** Day Shift ( United States of America) **Job Type:** Employee **Department:** 8746010033 ... safety indicator) or experience with Vizient specialized mortality reviews. **Eligible Remote States :** Candidates are required to reside on one of SSM's approved … more
- SSM Health (MO)
- …Wisconsin Department of Safety and Professional Services **Work Shift:** Day Shift ( United States of America) **Job Type:** Employee **Department:** 8746010033 ... to clinical staff regarding these requirements during the concurrent record review process. + Maintains knowledge of mortality models, observed rate/expected rate… more
- PruittHealth (Norcross, GA)
- **RN certified in OASIS and ICD 10 Reviewer ** **- HOME HEALTH SERVICES** **Must have ICD-10 Certification** **Join the PruittHealth @Home family, where we deliver ... CERTIFICATION, AND EDUCATIONAL REQUIREMENTS** + Current, active, and unrestricted Registered Nurse (RN) licensure in the state of practice **Family Makes … more
- Zelis (NJ)
- …Zelis, we Get Stuff Done. So, let's get to it! A Little About Us Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare ... Zelis standards regarding privacy What you'll bring to Zelis: + Registered Nurse licensure preferred + Inpatient Coding Certification required (ie, CCS, CIC, RHIA,… more
- Katmai (Usaf Academy, CO)
- …same duties as those required of any military or government civil service nurse of similar experience and in similar duty assignments. **ESSENTIAL DUTIES & ... and communicate with facility staff members to facilitate patient care. + Accurately review and confirm completeness of patient chart and report any abnormalities to… more