- Novo Nordisk Inc. (Shreveport, LA)
- …obesity to maximize sales within an assigned territory. The Obesity Care Specialist (OCS) must achieve sales goals by implementing marketing and sales strategies ... sales and marketing resources to expand the breadth and depth of appropriate utilization Novo Nordisks products, consistent with label and company policy Analyze and… more
- Blanchard Valley Hospital (Findlay, OH)
- PURPOSE OF THIS POSITION The primary purpose of the Professional Coding Integrity Specialist (PCIS) is to review , enter and/or modify charges as appropriate, ... charge/modifier assignments, for designated clinical areas. JOB DUTIES/RESPONSIBILITIES Duty 1: Review , enter and/or modify charge on encounters to ensure accurate… more
- Northeast Georgia Health System, Inc (Braselton, GA)
- …health of our communities. About the Role:Job SummaryUnder the supervision of the Utilization Review Manager, this position is responsible for ensuring the ... the pre-certification process.Works in conjunction with Physician offices, Case Management, Utilization Review , and patients to obtain supporting clinical data… more
- Marion County (Salem, OR)
- …initiate authorization process for requests for Long-Term Psychiatric Care.Ensure accuracy of utilization data of those admitted to the Oregon State Hospital and ... Ensure residential capacity, track referrals, placements, placement/discharge dates, and utilization data is being tracked by Choice team. Provide clinical… more
- Careerbuilder-US (Atlanta, GA)
- …Coding experience. . Requires a minimum of 5+ years' experience in Health Insurance/quality chart audits and/or Utilization Review . Bachelor's degree required. ... 95% accuracy on coding quality audits. Job Responsibilities: . Compile chart review findings statistics, analyze data results and implement meaningful action plans… more
- Blanchard Valley Hospital (Findlay, OH)
- …investigational or potential compliance risks. Duty 7: Work with Coding Claims Resolution Specialist (CCRS) to review denial trends, whether coding related or ... team members or other departments to provide accurate and credible guidance. Duty5: Review of quarterly internal quality audits of the PCIS team, in coordination… more
- BayCare Health System (Cotton Plant, AR)
- …responsibility and clinical excellence. **BayCare Health System** is currently seeking a ** Utilization Review Specialist Senior** to join our outstanding ... and compassionate team. **The Utilization Review Specialist Senior responsibilities include:** + Functions as the primary liaison between the funding agents… more
- BayCare Health System (Winter Haven, FL)
- …a foundation of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior responsibilities include:** + ... Critical Care or Emergency Service Equal Opportunity Employer Veterans/Disabled **Position** Utilization Review Specialist Senior **Location** Winter… 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 ... of candidates. Education Associates Degree preferred Minimum Work Experience Utilization Review experience preferably in a behavioral/psychiatric healthcare… more
- Providence (WA)
- …the best people, we must empower them._** **Providence Health Plan is calling an Associate Utilization Review Specialist who will:** + Be responsible for all ... the following clinical teams: + Prior-authorization (PA) + Concurrent Review (CCR) + SNF + Clinical Claims + Coordinate...+ Clinical Claims + Coordinate and execute the medical review and research functions required to support all teams… more
- WestCare Foundation (Henderson, NV)
- Utilization Review Specialist Job Details Job Location Henderson - 1711 Whitney Mesa - Henderson, NV Position Type Full Time Education Level 2 Year Degree ... LPN or RN and/or Bachelors or Masters level CADC/LADC with 2 years utilization review experience, preferred experience working with individuals with psychiatric… more
- HonorHealth (Scottsdale, AZ)
- …of communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
- The Mount Sinai Health System (New York, NY)
- …Operating Room Surgical Scheduling, Mount Sinai West - Full Time, Days** The Utilization Review Specialist coordinates scheduling of all surgical/endoscopic ... ** Utilization Review Admission Specialist (OR Scheduler),… more
- 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 ... admission and clinical information to ensure medical necessity and compliance of utilization review guidelines. + Obtain initial and continuing authorization for… more
- BayCare Health System (Cotton Plant, AR)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Denials Specialist - Utilization Review responsibilities include:** + Timely reviews ... year Medicaid/Medicare experience. Equal Opportunity Employer Veterans/Disabled **Position** Denials Specialist - Utilization Review **Location**… more
- Desert Parkway Behavioral Healthcare Hospital (Las Vegas, 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
- 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
- MetroHealth (Cleveland, OH)
- …**Responsible for communicating information to internal and external customers of the Utilization Review and Care Management Department. Follows up on inquiries ... from payors and provides the appropriate information to Utilization Review , providers, payors, and admitting. Upholds the mission, vision, values, and customer… more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** The Senior Utilization Review Physician Specialist collaborates with the healthcare team in the management and resolution of activities that ... patient population and HackensackUMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… more
- Henry Ford Health System (Troy, MI)
- …The support specialist is a support role crucial to the centralized Utilization Review team for time sensitive authorization tracking and resolution process. ... information to payers as needed. * Maintain a current knowledge of Utilization Management through interaction with staff and payor portal representatives. * Identify… more
