- Graham Windham (Brooklyn, NY)
- Case Record Reviewer Job Details Level Experienced Job Location 1 PIERREPONT PLAZA SUITE 901 - BROOKLYN, NY Position Type Part Time Education Level 4 Year ... Degree Salary Range $30.00 - $37.00 Hourly Case Record Reviewer Case Record Reviewer About Program Performance & Planning In full partnership… more
- Graham Windham (Brooklyn, NY)
- Case Record Reviewer Job Details Level Entry Job Location 1 PIERREPONT PLAZA SUITE 901 - BROOKLYN, NY Position Type Part Time Education Level 4 Year Degree ... Salary Range $30.00 - $37.00 Hourly Case Record Reviewer Case Record Reviewer About Program Performance & Planning The Program Performance and… more
- City of New York (New York, NY)
- …within the Division of Child Protection (DCP) across each borough and zone. The Case Reviewer utilizes a standardized instrument to assess case practice. ... improvement efforts. - Rate key indicators of child welfare case practice based on standards and records ...unaddressed safety and risk related concerns identified during the case review . - Complete a quality control… more
- CACI International (Panama City, FL)
- Case Reviewer (Experienced) Job Category: Investigation Time Type: Full time Minimum Clearance Required to Start: Top Secret Employee Type: Regular Percentage of ... Field Investigators, Record Searchers, and management * Work closely with review team members, field investigators, and record searchers to develop training… more
- City of New York (New York, NY)
- …is recruiting for (1) one Supervisor of Nurses to function as a Complex Medical Case Reviewer , who will: - Conduct medical reviews and analyses claims to ... or other catastrophic or medically complex cases. - Consult Medicaid payment records , bills of particulars, and other legal or medical documents provided. Update… more
- City of New York (New York, NY)
- …- Record the information and documentation obtained from the POS case record , One Viewer, interviews, computer matches and collateral sources onto ... Administrative Associate II to function as a Quality Control Case Reviewers, who will: - Review POS,...the accuracy of the information provided from the POS record , participant interview information and HRA One Viewer documentation.… more
- Kepro (IL)
- … to join our growing team. Job Summary: Our Behavioral Health Clinical Reviewer will coordinate program services and review activities associated with the ... of Illinois. Job Responsibilities: + Use clinical expertise to review and interpret patient records and compare...years as a Behavioral Health Specialist, Behavioral Health Utilization Reviewer or Behavioral Health Case Manager for… more
- Kepro (Richmond, VA)
- … Reviewer (RN, LCSW,LPC, and/or LBA) will use clinical expertise to review medical records against appropriate criteria in conjunction with contract ... public sector. Acentra seeks a Behavioral Health UM Clinical Reviewer (PRN, Remote within Virginia) with an active RN,...located within the State of Virginia. Job Responsibilities: + Review and interpret patient records and compare… more
- Public Consulting Group (Columbus, OH)
- …of our clients and the people they serve. **Responsibilities** **Onsite Reviewer ** **(OH Department of Medicaid) in Ohio** (Location -Toledo, Columbus, Cleveland, ... Akron, Canton, Sandusky areas) **Onsite Reviewer Job Description:** The overarching responsibility for this position...good sense of direction, valid driver's license, good driving record and auto insurance certificate. + Two year's plus… more
- Trinity Health (Livonia, MI)
- **Employment Type:** Full time **Shift:** Rotating Shift **Description:** HMS collaborative reviewer The Clinical Nurse Reviewer 's chief responsibility is to ... HMS database of all eligible cases for the hospital. The Clinical Nurse Reviewer also works closely with the physician champion and appropriate hospital leadership… more
- University of Miami (Hialeah, FL)
- …and/or procedures based on clinical data to facilitate appropriate DRG assignment. + Records review findings and other data elements accurately into CDI Software ... (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Clinical Documentation Integrity (CDI) Second Level Reviewer performs high-level, complex, secondary case reviews… more
- Kepro (Tallahassee, FL)
- …is fueled by passion and driven by purpose. Position Summary The Clinical Reviewer is integral to our team, conducting Preadmission Screening and Resident Review ... which encompass a detailed analysis of medical and behavioral health records , comprehensive assessments, and active collaboration with the treatment team. As… more
- Guthrie (Sayre, PA)
- Position Summary: The Utilization Management (UM) Reviewer , in collaboration with other internal and external offices, payors, and providers and staff, is ... authorization/certification for reimbursement of patient care services. The Utilization Reviewer : * Secures authorization as appropriate * Documents payer… more
- Magellan Health Services (Boise, ID)
- …Conducts reviews of clinical interactions and clinical documentation including reviews of case management records and provider treatment records . Collects ... Critical/Adverse incidents related to clinical services. + Audits and reviews case manager and provider clinical documentation and telephone interactions against… more
- Insight Global (Eden Prairie, MN)
- …medical coding role, rather more of a reviewer type position. Perform clinical review of professional claims vs. medical records to determine if the claim is ... consisting of other certified coders. Top Responsibilities: - Clinical Case Reviews -75% - Perform clinical review ...review of professional (or facility) claims vs. medical records to determine if the claim is supported or… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …manner. + Fluent in Spanish preferred. + Working experience with electronic medical records , and/or discharge planning and case management systems. + Able to ... Position Purpose: Works in partnership with physicians, nurse case managers, and other disciplines to ensure the appropriateness for the corresponding level of care… more
- Ventura County (Ventura, CA)
- …occurrences related to quality, risk and/or patient safety which are identified during case review or other activities; + Reviews, analyzes and identifies ... Per Diem Registered Nurse III - Hospital Case Management/Utilization Review Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4396275) Apply … more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- The Utilization Review Case Manager is responsible for working with insurance companies and managed care systems for the authorization, concurrent and ... + Prepares and submits appeals to third party payors. + Maintains appropriate records of the Utilization Review Department. + Performs related duties, as… more
- Prime Healthcare (Bloomington, IN)
- …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of ... and maintain current. #LI-AS2 Connect With Us! (https://careers-primehealthcare.icims.com/jobs/141999/ case -manager utilization- review -on-site/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityMonroe Hospital LocationUS-IN-Bloomington… more
- Prime Healthcare (Lynwood, CA)
- …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of ... experience, education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/156578/rn- case -manager utilization- review /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilitySt. Francis Medical Center… more