- 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
- MetroHealth (Cleveland, OH)
- ** Utilization Review Specialist - Utilization Management** **Location:** **METROHEALTH MEDICAL CENTER** **Biweekly Hours:** **80.00** **Shift:** ... **Responsible for communicating information to internal and external customers of the Utilization Review and Care Management Department. Follows up on inquiries… 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
- 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 (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
- McLaren Health Care (Bay City, MI)
- …management to expedite patient discharge. 4. Maintains current knowledge of hospital utilization review processes and participates in the resolution of ... Summary_** **:** In conjunction with the admitting/attending physician, the UR Specialist RN assists in determining the appropriate admission status based on… 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
- 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
- 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
- Fairview Health Services (St. Paul, MN)
- …meets regulatory requirements. Participates in interdisciplinary communication related to utilization review issues. Educates on status. Provides all ... M Health Fairview has an immediate opening for a Utilization Management Specialist RN. This position provides...+ Current RN licensure in MN + 3-5 years utilization review or case management experience in… 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
- 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
- Corewell Health (Caledonia, MI)
- …continued stay. Educates medical staff/other health care professionals regarding utilization management and quality requirements. Makes recommendations and provides ... financial and utilization management (UM) information to other members of the...- 4700 60th St - Grand Rapids Department Name Utilization Management - CHS Employment Type Full time Shift… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will facilitate, coordinate, and approve… more
- Cleveland Clinic (Stuart, FL)
- …nurses, and other caregivers in a family-oriented, supportive environment. As a PRN Utilization Management (UM) Specialist , you will perform UM activities, such ... as admission review , concurrent review , retrospective chart ...Has at least two years of care management or utilization management experience. + Has excellent organizational and communication… more
- Cleveland Clinic (Weston, FL)
- …Miami-Fort Lauderdale metro area and remains a top hospital in Florida. As a Utilization Management (UM) Specialist , you will work under the general supervision ... of the UM Team Manager to perform UM activities which include admission review , concurrent review , retrospective chart review and clinical systems review … more
