- Spectrum Billing Solutions (Skokie, IL)
- …revenue cycle management company for healthcare organizations. We are looking to add a Utilization Review ( UR ) Specialist to our growing team. ... The UR Specialist will utilize his or her knowledge and skills...clinical information to ensure medical necessity and compliance of utilization review guidelines. + Obtain initial and… more
- Universal Health Services (Groton, CT)
- …Washington, DC, Puerto Rico and the United Kingdom. www.uhs.com Job Summary: The Utilization Review Specialist is responsible for the pre-certification, ... Inc. (UHS), has an immediate opening for a full-time UR Specialist . Stonington Institute is committed to...or related Human Service Field or RN. Knowledge of Utilization Review Processes, insurance plans, mental health… more
- Universal Health Services (Ambler, PA)
- Responsibilities The Horsham Clinic is seeking a dynamic and talented Utilization Review Specialist . The Horsham Clinic is a 206 bed private behavioral ... well-respected industry leader, then we invite you send your resume. The UR Specialist is responsible for evaluating medical records to determine severity of… more
- Parkview North Hospital (Fort Wayne, IN)
- …installing systems to obtain precertification and recertification for payment and utilization review . Attends treatment planning to advise regarding ... assurance experience preferred. Other Qualifications Application of and use of review criteria related to clinical evaluation of appropriate levels of psychiatric… more
- Bakersfield Behavioral Healthcare Hospital (Bakersfield, CA)
- …leadership, teamwork, and communication skills. ESSENTIAL DUTIES The primary responsibility of the Utilization Review Specialist is to review medical ... level of care, length of stay, authorizations and denials for patients. The UR Specialist is responsible for contacting external case managers/managed care… more
- Reno Behavioral Healthcare Hospital (Reno, NV)
- The UR Specialist reviews and monitors patients' utilization of health care services with the goal of maintaining high quality, cost-effective care. The ... duties include providing the medical and utilization expertise necessary to evaluate the appropriateness and efficiency...of care that may be covered. + Monitors all utilization reports to assure compliance with reporting and turnaround… more
- Bakersfield Behavioral Healthcare Hospital (Bakersfield, CA)
- …Empowerment Sincerity Job Summary The UR Coordinator is responsible for the utilization review process at BBHH. Administrative and clerical functions of the ... or 6pm. Ideally, someone with at least 6 months of experience as a UR Specialist will apply. BBHH encourages all qualified candidates to apply and will consider… more
- Ascension Health (Indianapolis, IN)
- …process. + Serve as content specialist for staff in the areas of utilization criteria, appeal and review process, and case management system documentation. + ... with your Talent Advisor for additional specifics._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing… more
- Apex Health Solutions (Houston, TX)
- …of contact to providers and members for the utilization review ( UR ) of healthcare services. The UM Specialist works within prescribed guidelines and ... analytical approach to drive business goals. Accountable for complying with utilization review procedures in accordance with Texas UR Certification… more
- Tufts Medicine (Burlington, MA)
- …(ICU, ED, Critical Care, strong Med/Surg Specialty) or equivalent case management, utilization review , denials management, or progressive leadership in an ... Specialist III is responsible for concurrent and retrospect review and analysis of the medical record to improve...indicators where indicated. 10. Collaborates with case management and utilization review team to ensure that documentation… more
- Universal Health Services (Conway, SC)
- …conducting utilization and quality assurance activities in accordance with Utilization Review , Business Office, Billing, and Coding policies and procedures. ... Data Review and Data entry as needed within the Business Office, Utilization Review Office, Medical Records Office, etc + Responsible for knowing… more