- Spectrum Billing Solutions (Skokie, IL)
- …and behavioral health treatment services. Utilization Review Specialist | Utilization Management Specialist | UR Specialist | Revenue Cycle ... streamlined manner. We are seeking to add an ABA Utilization Review ( UR ) Specialist... UR Specialist | Revenue Cycle Utilization Review Specialist | ABA… more
- BriteLife Recovery (Englewood, NJ)
- What you will be doing? The Utilization Review ( UR ) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is ... responsible for overseeing and coordinating all aspects of utilization review and insurance authorization for clients...information and advocating for appropriate levels of care. The UR Specialist works closely with clinical staff,… more
- CaroMont Health (Gastonia, NC)
- …RAC for reversal of original determination. May serve on the Medical Record/ Utilization Review Committee, providing detailed logs of denial activity and appeal ... retrospective clinical reviews/appeals as part of denial process. The UR Specialist will be cross trained to...NC (NC license or multi-state (compact) license). Certification in Utilization Review / Management, Quality and/or Case… more
- HonorHealth (AZ)
- …here -- because it does. Learn more at HonorHealth.com. Responsibilities Job SummaryThe Utilization Review RN Specialist reviews and monitors utilization ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
- Westborough Behavioral Healthcare Hospital (Westborough, MA)
- … UR Specialist to provide Per Diem coverage. Job Description: The Utilization Review Specialist is responsible for monitoring adherence to the ... hospital's utilization review plan to ensure the effective...related experience. + 2-3 years experience working as a UR Specialist , Medical Billing or health care… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a* Utilization Review Manager* to join ourTransitional Care Team.This is a full-time role and will be required to work ... this position: *Manages the design, development, implementation, and monitoring of utilization review functions. Oversees daily operations, which include… more
- UNC Health Care (Kinston, NC)
- …support the clinical documentation specialists and Patient Financial Services. Supports the Utilization Review Nurse team when necessary by applying established ... dollars and appeal win rates. 12. Assists in documentation review in the clinical documentation specialist role...experience as a Registered Nurse required. + 2 years utilization review , care management, or compliance experience… more
- SUNY Upstate Medical University (Syracuse, NY)
- …including PC, Windows, Microsoft applications, Zoom/WebEx platforms, etc. Preferred Qualifications: Utilization management or utilization review experience, ... Job Summary: The UR -CR Specialist I is primarily responsible...reimbursement entities. This is achieved through a thorough chart review and utilization of first-level screening criteria… more
- WellSpan Health (Chambersburg, PA)
- …and efficiently. + Identifies system/organizational processes which may affect effective utilization of resources, timely scheduling of tests, appropriate level of ... Thoroughly and accurately documents actions/communication surrounding discharge planning and/or utilization management in the medical record. + (BHU Only)… more
- Datavant (Nashville, TN)
- …The purpose of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for medical necessity ... letter Identification of referrals to the medical director for review + Select appropriate preferred and contracted providers +...experience + 2 years Health Plan or Acute Care UR /CM + Preferred Experience: 5 years acute care or… more
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