- Kelly Services (Milwaukee, WI)
- …the federal government, is actively seeking Physicians (MD, DO) to conduct Veteran Disability Evaluations (DBQs)in Milwaukee. We are committed to filling gaps in our ... is actively seeking Physicians (MD, DO) to conduct Veteran Disability Evaluations (DBQs). We are committed to filling gaps...accident insurance, critical illness, a legal plan, and short-term disability . As a Kelly employee, you will have access… more
- Sharp HealthCare (San Diego, CA)
- …direction of Authorization Review for Sharp Health Plan (SHP). The Physician Reviewer will perform all reasonably necessary functions to ensure quality ... + 5 years' experience as a practicing primary care physician with knowledge of managed care and the process...of managed care and the process for prior authorization review . + California Physicians and Surgeons License - Medical… more
- Kelly Services (Melbourne, FL)
- …**Kelly Government Solutions is seeking Healthcare Providers (Physicians - MD, DO or Physician Assistants PA** to conduct one-time disability exams for Veterans. ... while gaining valuable insight into military culture. You will be conducting disability assessments for veterans in your office. This is a meaningful opportunity… more
- AmeriHealth Caritas (Washington, DC)
- …for approval or denial decisions + Identify and escalate complex cases requiring physician review or additional intervention + Ensure compliance with Medicaid ... cases are escalated to the Medical Director for further review . The reviewer independently applies medical and...benefits package, consisting of medical, vision, dental, life insurance, disability insurance, 401(k), paid time off and more. The… more
- HCA Healthcare (Brownsville, TX)
- …want to join an organization that invests in you as a Coding Quality Audit Reviewer ? At Parallon, you come first. HCA Healthcare has committed up to $300 million in ... Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans...We are looking for a dedicated Coding Quality Audit Reviewer like you to be a part of our… more
- Zelis (St. Petersburg, FL)
- …interests that shape who you are. Position Overview The Inpatient DRG Reviewer will be primarily responsible for conducting post-service, pre-payment and post pay ... Clinic and client specific coverage policies. Conduct prompt claim review to support internal inventory management to achieve greatest...provider in the form of medical records such as physician notes, lab tests, images (x-rays etc.), and with… more
- SSM Health (MO)
- …to clinical staff regarding these requirements during the concurrent record review process. + Maintains knowledge of mortality models, observed rate/expected rate ... (O/E ratios), industry trends, variable and diagnosis review group (DRG) frequency. + Serves as a liaison...of Clinical Documentation Improvement Specialists (ACDIS) + Or + Physician Assistant in Medicine, Licensed - Illinois Department of… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review . Refer to and work closely with Case Management to address member ... and treatment of members' medical health conditions, applying established clinical review criteria, guidelines and medical policies and contractual benefits as well… more
- The Cigna Group (Bloomfield, CT)
- …for the following: + Laboratory molecular and genetic testing clinical case review activities. + Evaluate telephone, fax, or web requests for authorization of ... coverage of molecular and genetic laboratory requests from physician offices; comparing requests against established clinical protocols; and authorizing coverage of… more
- Sutter Health (Sacramento, CA)
- …Sutter Health! **Organization:** SHSO-Sutter Health System Office-Valley **Position Overview:** The Physician Advisor (PA) is a key member of the hospital's ... care services. The PA will develop expertise on matters regarding physician practice patterns, over- and under-utilization of resources, medical necessity,… more
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