- Luminis Health (Annapolis, MD)
- …as deemed necessary. Pay Range $40-$60 USD Luminis Health Benefits Overview: * Medical , Dental, and Vision Insurance * Retirement Plan (with employer match for ... responsible for any charges incurred by the recipient. Candidates are encouraged to review their mobile carrier's plan for applicable text messaging rates and usage… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …appropriate. At the request of the Senior Medical Director of the Physician Review Unit (PRU), the reviewer also provides clinical leadership in other areas ... your true colors to blue. The Role The Physician Reviewer is responsible for evaluating pre & post-service clinical...as determined by plan benefit design, plan riders, and medical necessity criteria. In making coverage decisions regarding level… more
- Healthfirst (NY)
- **Duties/Responsibilities:** + The Medical Peer Reviewer will assess/ review requests for authorization, and claims payment, based on medical records and ... adjusted based on changing needs of the organization. **Weekday Requirements:** + The Medical reviewer requires 25 hours a week of coverage/5 days per week. +… more
- LA Care Health Plan (Los Angeles, CA)
- Physical Accessibility Review Survey Reviewer II Job Category: Clinical Department: Facility Site Review Location: Los Angeles, CA, US, 90017 Position Type: ... to achieve that purpose. Job Summary The Physical Accessibility Review Survey (PARS) Reviewer II is responsible...PARS assessments, FSR Survey up to 150 points, and Medical Record Review up to 30 charts.… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …At the request of the Associate Medical Director of the Physician Psychologist Review Unit, the Reviewer also provides clinical leadership in other areas of ... your true colors to blue. The Role The Physician Reviewer is responsible for evaluating clinical service requests made...+ Perform additional tasks as assigned by the Associate Medical Director of the Physician Psychologist Review … more
- Intertek (Bentonville, AR)
- Label Reviewer - Remote Intertek, helping companies around the world develop products to be used safely by millions of people every day, is searching for reliable ... and protect the environment. What are we looking for? The Label Reviewer position is responsible for reviewing product labels and documentation against regulatory,… more
- AmeriHealth Caritas (Washington, DC)
- …When necessary, cases are escalated to the Medical Director for further review . The reviewer independently applies medical and behavioral health ... document and assess patient cases + Strong understanding of utilization review processes, including medical necessity criteria, care coordination, and… more
- AECOM (Sacramento, CA)
- …**Job Description** **AECOM** is seeking an **Assistant Project Manager - Utility Design Reviewer ** to work **remotely** . The client is located in Sacramento, CA ... of Investigation ("ROI") and the Utilities Senior Project Manager, the Utility Design Reviewer contributes alongside a team of Utility Design Reviewers to prepare, … more
- Dana-Farber Cancer Institute (Brookline, MA)
- …conduct billing compliance investigations as required, which may include audits designed to review the adequacy of medical record documentation to support claims ... Reporting to the Director of Billing Compliance, the Senior Billing Compliance Reviewer will be responsible for the identification and performance of Billing… more
- Hartford HealthCare (Hartford, CT)
- …than 30 different specialties. The primary responsibility of the Metabolic and Bariatric Surgical/ Medical Clinical Reviewer (MBSCR) is to ensure the accurate and ... And this is *your moment.* **Job:** **Administrative* **Organization:** **Hartford HealthCare Medical Group Specialists* **Title:** *Surgical Clinical Reviewer -… more
- Chenega Corporation (Rockville, MD)
- …Professional Services Strategic Business Unit** company, is looking for a Physician- Contract Medical Reviewer (CMR) to support the Department of Health and ... innovative solutions for our clients. **Responsibilities** + Serve as Contract Medical Reviewers who write medical eligibility determination recommendations via… more
- Chenega Corporation (Rockville, MD)
- …Services Strategic Business Unit** company, is looking for a Nurse Practitioner-Contract Medical Reviewer (CMR) to support the Department of Health and ... medicine, as this aligns closely with the types of cases we review . Clinicians with backgrounds in Internal Medicine, Family Medicine, Emergency Medicine, or… more
- Robert Half Finance & Accounting (Woodbridge, NJ)
- …season. A specialized tax preparation firm in the Woodbridge area seeks a Tax Reviewer to handle the review of individual (1040) tax returns. This opportunity ... is unique because the Tax Reviewer can work flexible hours four days per year...United States. Benefits are available to contract/temporary professionals, including medical , vision, dental, and life and disability insurance. Hired… more
- Zelis (St. Petersburg, FL)
- …maintain claim review content, including but not limited to DRG Reviewer Rationales, DRG Clinical Validation Policies and Dispute Rationales + Perform regulatory ... are. Position Overview At Zelis, the DRG Clinical Dispute Reviewer role is responsible for the resolution of facility...provider disputes. + Utilize the most up-to-date approved Zelis medical coding sources for claim review maintenance.… more
- Fluor (CA)
- …of Investigation ("ROI") and the Utilities Senior Project Manager, the Utility Design Reviewer contributes alongside a team of Utility Design Reviewers to prepare, ... review , coordinate, and track all utility Reports of Investigation...Reports of Investigation for the Authority. The Utility Design Reviewer is responsible for preparing ROI reports in conformance… more
- System One (Andover, MA)
- Job Title: Quality Assurance Batch Record Reviewer I Location: Andover, MA Hours/Schedule: Monday-Friday, 8 am to 5 pm Type: Contract Overview The Quality Assurance ... Batch Record Reviewer I is an entry-level, floor-based QA role supporting...QA role supporting manufacturing operations through real-time batch record review and GMP oversight. This position works directly in… more
- System One (Indianapolis, IN)
- Job Title: QC Microbiology Data Reviewer and Writer Location: Indianapolis, IN Hours/Schedule: Monday - Friday, Business Hours Type: Contract Overview Leading ... pharmaceutical company looking for an experienced QC Microbiology Data Reviewer . Ideal candidates should have 4 years of experience in GMP Microbiology laboratory… more
- Carle Health (Peoria, IL)
- …Arts (LPHA) authorizing Integrated Assessment and Treatment Plans. Will complete thorough review of each document, provide clinical guidance to team members, and ... ensure compliance with IATP standards. LPHA reviewer provides behavioral health assessment, intervention, and consultation to individuals and/or groups identified as… more
- St. Luke's University Health Network (Bethlehem, PA)
- …health care. The Admission's Clinical Reviewer is responsible for the comprehensive medical review and screening of all referrals made to the inpatient Acute ... and responds to all inquiries for admission to ARC + Completes thorough review of documentation and information and assesses a patient's appropriateness for ARC… more
- Volunteers of America Los Angeles (Los Angeles, CA)
- …AND PURPOSE Under the direction of a Quality Assurance Coordinator, the Quality Assurance Reviewer I performs Quality Assurance review and audit of VOALA Program ... Quality Assurance Reviewer Location:Los Angeles, CA Job ID:4493 Salary:$24.84 -...funder audits and ensure all requirements are in place. Review audit results from funders- audits. Participate in after… more
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