- TEKsystems (Canoga Park, CA)
- Position: Utilization Review Nurse Work Enviroment: Hybrid work schedule Schedule: Full time position, Flexible start time of 7-8 am, 5 days x 8hrs , no weekends, ... RN or LVN with an active license to help address claims retro review . This role focuses on reviewing inpatient and outpatient claims for medical necessity… more
- TEKsystems (Canoga Park, CA)
- …RN or LVN with an active license to join our team as a Utilization Review Nurse. In this role, you will conduct retrospective reviews of inpatient and outpatient ... reviews for inpatient and outpatient claims. + Prepare medical records for review by medical directors and provide clinical recommendations. + Ensure compliance with… more
- DC Group (Minneapolis, MN)
- …balance competing priorities within defined deadlines. + Direct experience with contract review is not required, but job experience in roles requiring similar levels ... + This is an entry level role for contract review requiring candidates to be detail oriented and organized,...to execute contract documents. + Track and maintain contract review status. + Work with several different departments throughout… more
- DC Group (Minneapolis, MN)
- …Microsoft Word Track Changes. + Experience coordinating and collaborating on contract review aspects that require input between various departments such as the legal ... to execute contract documents. + Track and maintain contract review status. + Review contract documents for alignment with DC Group's business policies… more
- Sutter Health (Berkeley, CA)
- …utilization of physician, nursing, and ancillary services. Responsible for concurrent review on specific patients. Develops, coordinates and monitors systems for the ... with hospital administration, medical staff, patient registration and representatives of review organizations and others to ensure effective utilization of services… more
- TEKsystems (Canoga Park, CA)
- …+ Audit denied provider and member claims for accuracy and compliance + Review and process claims in accordance with UM guidelines and regulatory standards + ... to reduce errors + Ensure HIPAA and PHI compliance throughout all claim review activities + Participate in special projects related to claim denials and appeals… more
- WestCare Foundation (Henderson, NV)
- …and/or Bachelors or Masters level CADC/LADC with 2 years utilization review experience, preferred experience working with individuals with psychiatric or substance ... use disorder Experience and Competencies: + Proven experience in conceptualizing a case and creating a clinical impression to present to all involved and approved parties, including managed care representatives + Knowledge of CPT, ICD 9 & ICD 10 coding, ASAM,… more
- US Bank (Brookfield, WI)
- …Responsible for conducting credit analyses including gathering, analyzing and interpreting all types of credit information on existing and prospective customers and ... At US Bank, we're on a journey to do our best. Helping the customers and businesses we serve to make better and smarter financial decisions and enabling the communities we support to grow and succeed. We believe it takes all of us to bring our shared ambition… more
- UCLA Health (Santa Monica, CA)
- …Play a key role within a world-class health system. Help ensure the delivery of safe, award-winning care and positive patient outcomes. Make the most of your ... background and abilities. You can do all this and more at UCLA Health. In this important position, you will be responsible for the identification, collection, and entry of quality data for the Clinical Registries, Patient Safety Indicators (PSIs), and Hospital… more
- State of Michigan (Lansing, MI)
- Financial Specialist 13 - Expenditure Review Section Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/4983385) Apply Financial ... Specialist 13 - Expenditure Review Section Salary $31.99 - $47.75 Hourly Location Lansing,...least three years of professional experience providing a systematic review , analysis, interpretation, and/or evaluation of budgets, mortgages, loans,… more