- Martin's Point Health Care (Portland, ME)
- …from external sources. + Creates and maintains a tracking system to document records of annual primary source verification activities, ensuring compliance with ... regulatory requirements. + Maintains a robust medical record review program to assess the quality of care provided by healthcare providers. + Develops and implements… more
- Molina Healthcare (Dallas, TX)
- …reports and automated configuration processes/solutions + Assist manager in establishing peer review standards and methodology + Leads peer reviews + Leads the ... of large, complex, critical configuration maintenance processes/solutions + Research and review new tools and techniques and provide recommendations to management +… more
- CareFirst (Baltimore, MD)
- …and/or social determinant of health needs. Engage members and providers to review and clarify treatment plans ensuring alignment with medical benefits and policies ... working in Care Management, Discharge Coordination, Home Health, Utilization Review , Disease Management or other direct patient care experience. **Preferred… more
- CVS Health (Harrisburg, PA)
- …service, resolve patient billing questions, and report potential trends to Leadership for review . We will support you by offering all the tools and resources you ... empathy and a sense of urgency when appropriate. + Accurately and consistently document each interaction in the appropriate Revenue Cycle system. + Record, review… more
- Insight Global (Chicago, IL)
- …self-service ad-builder, image distribution, among many other marketing channels * Review , approve, and uploaded marketing assets, ensuring that they adhere to ... we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/. Skills and… more
- Molina Healthcare (Nampa, ID)
- …JOB DUTIES:** + Work cross functionally with various departments to capture and document requirements, build reporting solutions, and educate users on how to use ... rate tracking and supplemental data impact reporting. + Develop Medical Record Review project reporting to track progress and team productivity reporting. +… more
- US Tech Solutions (May, OK)
- …completing criteria based prior authorizations as per policy and procedure. + Review and process prior authorization requests in accordance with clinical guidelines, ... effectively with providers, prescribers, and patients regarding authorization decisions. + Document all authorization activity accurately in system tools. + Ensure… more
- Ankura (TN)
- …of claim methodology and work product + Assisting with data-gathering activities including document review and supervision, and quality control of data entry ... work planning and budgeting + Preparing client communications for senior-level review + Coordinating administrative functions including time tracking and bill… more
- Insight Global (San Diego, CA)
- …property appraisals, and making sound lending decisions. Responsibilities: Thoroughly review and analyze loan applications, including credit reports, income ... and guidelines. Make sound lending decisions within established authority limits. Document all underwriting findings and decisions clearly and concisely. Meet… more
- Carrington (Boston, MA)
- …with preparing discovery responses and coordinating with business units. + Review various legal documents for accuracy and completeness including gathering ... information required, making corrections and resolving discrepancies. + Manage document subpoenas by collecting responsive records and preparing formal responses. +… more