- St. George Tanaq Corporation (Columbia, SC)
- …Experience and Skills** + One (1) year of Medicare appeals, medical review , clinical, healthcare regulatory interpretation/application, healthcare compliance or ... Dispute Resolution Reviewer I Fully Remote*GA Job Type Full-time Description...healthcare or related discipline Additional experience in Medicare appeals, medical review , clinical, or other related experience… more
- St. George Tanaq Corporation (Columbia, SC)
- …+ Must have 2-3 years of medical dispute resolution or Medicare appeals, medical review , clinical, or related experience in a healthcare setting + Healthcare ... Dispute Resolution Reviewer III Fully Remote*GA Job Type Full-time Description...healthcare or related discipline. Additional experience in Medicare appeals, medical review , clinical, or other related experience… more
- ManpowerGroup (Columbia, SC)
- …to effectively communicate with members and healthcare providers. **Key Responsibilities** ✔ ** Medical Review & Utilization Management (80%)** + Perform ... medical reviews using established criteria and guidelines. + Review medical claims and determine reasonable charge payments. + Ensure authorization of … more
- Evolent (Columbia, SC)
- …when available, within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to make a meaningful impact… more
- Evolent (Columbia, SC)
- …+ Provides clinical rationale for standard and expedited appeals. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... the culture. **What You'll Be Doing:** As a Field Medical Director, MSK Surgery you will be a specialty match reviewer for Spine Surgery cases. you will be a key… more
- Evolent (Columbia, SC)
- …when available, within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of...Will Be Doing:** + Serve as the specialty match reviewer in Cardiology cases, that do not initially meet… more
- Evolent (Columbia, SC)
- …and provides clinical rationale for standard and expedited appeals. . Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... the culture. **What You'll Be Doing:** As a Field Medical Director, Oncology, you will be a key member...Will Be Doing:** . Serve as the Physician match reviewer in Advanced Imaging cases, that do not initially… more
- Evolent (Columbia, SC)
- …is needed or required. What You Will Be Doing: + Serve as the Physician match reviewer in Medical Oncology and imaging cases, that do not initially meet the ... and provides clinical rationale for standard and expedited appeals. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the… more
- Terracon (North Charleston, SC)
- …of plans and specifications, observation and inspection, and the writing, preparation, and review of related reports for the services provided. Review drawings ... and recommend changes. Research and resolve design and construction problems. Assign, review , and evaluate laboratory or field data for inclusion in reports. Apply… more
- First Horizon Bank (SC)
- …or relocation will be provided for this role.** **SUMMARY** The Commercial Credit Review Officer, Sr (Sr CRO) is responsible for evaluating portfolio quality and ... strategy, and risk appetite. The Sr CRO typically reports to a Credit Review Manager and is expected to operate independently, following Credit Assurance Services… more