- Hackensack Meridian Health (Hackensack, NJ)
- **The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of ... population and Hackensack UMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… more
- BriteLife Recovery (Englewood, NJ)
- What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is ... responsible for overseeing and coordinating all aspects of utilization review and insurance authorization for clients receiving substance use disorder (SUD)… more
- MVP Health Care (Tarrytown, NY)
- …+ Assist with data entry, reporting, and tracking patient transitions and utilization metrics. + Review documentation for completeness ensuring compliance (eg: ... To achieve this, we're looking for an **Associate, Post-Acute Clinical Support Specialist ** to join #TeamMVP. If you have a passion for enhancing patient… more
- Molina Healthcare (Yonkers, NY)
- …managed care experience in the specific programs supported by the plan such as utilization review , medical claims review , long-term services and supports ... medical officer on denial decisions. * Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. * Identifies… more
- WMCHealth (Valhalla, NY)
- …to the the coding leadership team. + Participates in mandated medical record review processes. + Using current ICD10 CM/PCS coding systems, assigns and records an ... to inquiries regarding medical documentation and DRG'S to hospital staff including Utilization and Quality Assurance staff, Patient Accounts staff and the Risk… more