) JOB SUMMARY Utilizes clinical expertise, and reviews insurance appeals, and prospective and retrospective claims. The physician... reviewer will provide an interpretation of the medical necessity of services provided by other healthcare professionals...
. Physician Specialty: Plastic Surgery (Specializing in Lipedema) JOB SUMMARY Utilizes clinical expertise, and reviews... insurance appeals, and prospective and retrospective claims. The physician reviewer will provide an interpretation of the...
, Psychiatry, Rheumatology, Pediatrics, Ophthalmology. JOB SUMMARY Utilizes clinical expertise, reviews insurance appeals..., and prospective and retrospective claims. The physician reviewer will provide an interpretation of the medical necessity of services...
, Rheumatology, Pediatrics, Ophthalmology. JOB SUMMARY Utilizes clinical expertise, reviews insurance appeals, and prospective... and retrospective claims. The physician reviewer will provide an interpretation of the medical necessity of services provided...
Medicine, Orthopedics, Surgery, Urology, Hematology/Oncology) JOB SUMMARY Utilizes clinical expertise, and reviews... insurance appeals, and prospective and retrospective claims. The physician reviewer will provide an interpretation of the...
Specialty: Plastic Surgery (Specializing in Lipedema) JOB SUMMARY Utilizes clinical expertise, and reviews insurance... appeals, and prospective and retrospective claims. The physician reviewer will provide an interpretation of the medical...
Specialty: Organ Transplant (Solid organ and BMT....Lung, Heart, Kidney, Liver) JOB SUMMARY Utilizes clinical expertise..., and reviews insurance appeals, and prospective and retrospective claims. The physician reviewer will provide an interpretation...
Acute Ostomy Care RN COCN CredentialsSME Writer We are seeking a Ostomy Care RN with COCN certification with clinical...
and laboratory services for genomics, discovery pharmacology, forensics, advanced material sciences and in the support of clinical... also has a rapidly developing presence in highly specialized and molecular clinical diagnostic testing and in-vitro diagnostic products...
and laboratory services for genomics, discovery pharmacology, forensics, advanced material sciences and in the support of clinical... also has a rapidly developing presence in highly specialized and molecular clinical diagnostic testing and in-vitro diagnostic products...
Job Description: 1. Provides timely and thorough clinical information to insurance companies and other intermediaries... within the utilization management process. 10. Maintains proficiency in the application of organization selected clinical review...
Job Description: 1. Provides timely and thorough clinical information to insurance companies and other intermediaries... within the utilization management process. 10. Maintains proficiency in the application of organization selected clinical review...
sets or clinical guidelines. Provides support and review of medical claims and utilization practices. 80% May provide...
Duties Performs medical reviews using clinical/medical information provided by physicians/providers and established... criteria/protocol sets or clinical guidelines. Documents decisions using indicated protocol sets or clinical guidelines...
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical... perspective on workplace flexibility. Position Purpose: Perform clinical/coding medical claim review to ensure compliance...
and stays current on Billing guidelines or changes in Medical/Clinical policies. · Maintains strictest confidentiality; adheres...
is preferred. Coding/HIM Position - Requires RHIA, RHIT, CCS, CCS-P, CPC, CIC, COG or CHDA (based on position/focus). Clinical... to learn and develop in meaningful ways that matter most to you, such as advanced clinical training, leadership development...
is preferred. Coding/HIM Position - Requires RHIA, RHIT, CCS, CCS-P, CPC, CIC, COG or CHDA (based on position/focus). Clinical... to learn and develop in meaningful ways that matter most to you, such as advanced clinical training, leadership development...
and procedures. Manages initial, concurrent, and retrospective review of cases, including appeals, through evaluation of clinical..., and clinical judgment. Refers cases that are complex or outside the established criteria and guidelines to the Clinical Pharmacist...
coding preferred. Minimum of five (5) years of experience E/M-CPT-HCPCS clinical coding. Previous experience using...