- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and ... payers. Meet or exceed established benchmarks for productivity while maintaining quality . + Identify and provide feedback, including identification of trends, to… more
- Sedgwick (San Francisco, CA)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Senior Estimate Review Specialist **PRIMARY PURPOSE** **:** To review all estimates ... on property restoration scope. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + **Conducts quality reviews of contra** ctor documentation for repair estimates to… more
- HonorHealth (AZ)
- …because it does. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization of health care ... services with the goal of maintaining high quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of… more
- Kemper (Mcallen, TX)
- …work-life balance can be highly motivating and productive. **Position Summary:** As Desk Review Specialist , you will be reviewing incoming auto damage demands ... adherence to claims procedures and guidelines prescribed by the company to produce a high- quality work product. + Complete all demand reviews in a timely manner as… more
- Hunterdon Health Care System (Flemington, NJ)
- Position Summary The Utilization Review Specialist monitors adherence to the hospital's utilization review plan to ensure the effective and efficient use of ... reimbursement. 2. Works with medical and clinical staff to improve overall quality and completeness of clinical documentation. 3. Communicates and educates medical,… more
- SSM Health (Fond Du Lac, WI)
- …Commission and other regulatory agencies, along with best practices for peer review and strategies for successful outcome-based quality initiatives internally ... applies clinical knowledge to ensure the medical staff peer review process is effective in evaluating issues related to...as needed. + Supports the measurement and monitoring of quality indicators and progress towards metrics primarily at the… more
- Huntington National Bank (Columbus, OH)
- Description Summary: The Credit Review Officer reports to a Credit Review Group Manager or Team Lead. The ideal candidate is a proven credit risk professional ... knowledge of the methodologies and techniques for performing credit risk review engagements and continuous monitoring activities associated with a strong independent… more
- JE Dunn Construction Company (Atlanta, GA)
- Senior Quality Specialist Location: Kansas City, MO, US, 64106Austin, TX, US, 78704Dallas, TX, US, 75254Atlanta, GA, US, 30339 **Best People + Right Culture. ... to join us in our pursuit of building perfection.** **Role Summary** The Senior Quality Specialist - Doorframe Hardware Specialist will complete routine… more
- Orbis, Inc. (Philadelphia, PA)
- Quality Assurance Specialist for Command Level I Program NSWCPD Code 00Q Philadelphia, PA Responsibilities: Position is for the Quality Assurance ... Quality Management System (QMS) and website repositories. The Quality Assurance Specialist will be part of...review procedures, and work processes IAW applicable NSWCPD Quality Management Systems Quality Management Procedures. -… more
- JE Dunn Construction Company (El Paso, TX)
- Senior Quality Specialist , Mission Critical Location: El Paso, TX, US **Best People + Right Culture. These are the driving forces behind JE Dunn's success.** ... alongside our diverse team of industry professionals._ **Role Summary** The Senior Quality Specialist will complete routine activities to monitor and coordinate… more