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The Utilization Review Specialist will also perform pre-certification reviews, concurrent reviews and will perform appeal reviews as needed. Utilization Review Specialist/Behavioral Health Substance Abuse FLSA Status : Exempt Classification: Full-Time Reports To: The UR Specialist will report to UR Manager.
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If you're an experienced clinician looking to forge a new career path where your clinical knowledge is valued, consider our Clinical Utilization Review Specialist position. As a Utilization Review Specialist, you will play a pivotal role in ensuring the efficient and effective utilization of healthcare resources.
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Utilization Review Specialist | Highland Hospital | Charleston, West Virginia. Coordinates, performs, and monitors all utilization review/management activities of the hospital to continuously improve the collection, reimbursement, coordination, and presentation of utilization review information; Educates hospital staff about requirements and trends.
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Experienced Document Review Attorney – Remote Great opportunity for licensed attorneys with significant document review experience interested in quality focused eDiscovery. JOB DETAILS Project-based eDiscovery document review (litigation and/or investigation) Fully remote work environment.
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The Utilization Review Specialist is responsible for using clinical best practice knowledge and skilled intervention to determine patient level of care and provide concurrent review with insurance payers in order to achieve quality outcomes and ensure appropriate reimbursement.
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Must have at least eighteen months’ worth of document review experience (preferably on the Relativity platform) during the last two years. Must have at least eighteen months’ worth of document review experience (preferably on the Relativity platform) during the last two years.
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Position Summary This position supports the day-to-day management of operations and activities for the Small Business Development Center (SBDC), a unit-specific program of the College of Business Administration with clients and program participants primarily in a seven-county service area.
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Review aging accounts receivable with Project Controls Specialist and Operation Manager to determine who will follow up with clients for payment status. Meet with Project Controls Specialist and Operation Manager to review, discuss, and resolve issues with invoicing and documentation provided.
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Participate in the annualHEDIS andQARR hybrid medical record review project:Work with provider offices to facilitate request and review of charts Supports temporary staff in the review of medical records (electronic and paper-based) Serve as a final reviewer of HEDIS and QARR records Other duties as assigned by Quality Review Lead or QM Operations Director.
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What you'll be doingThe Compliance Review Specialist playsan important role on the marketing communications (marcom) team to support our Front Line Care category content approvals & distribution, i.e. product advertising, promotions, communication, and educational content, ensuring that all claims included in these marketing materials have been reviewed and validated by the appropriate legal, medical affairs, and regulatory personnel.
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Experienced Document Review Attorney – Remote. Project-based eDiscovery document review (litigation and/or investigation) Great opportunity for licensed attorneys with significant document review experience interested in quality focused eDiscovery.
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Utilization Review Specialist/Behavioral Health Substance Abuse. Job Overview: The Utilization Review Specialist is responsible for all aspects of the authorization of treatment via insurance and managed care companies.
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Review Project with Controller & Project Accountant - Project Duration, Scope, Heavy Job Reporting Format, Davis-Bacon Wages, Per Diem needs, Billing Cycle, Project Budget, Profit Goals & Project Risks - Can be handled during turn over meeting.
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Riverview Behavioral Health searching for a Utilization Review Specialist to join our team! Facilitate peer review calls between facility and external organizations. Previous experience in utilization management is preferredLICENSES/DESIGNATIONS/CERTIFICATIONS: Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
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Maintains daily contact with Utilization Review Specialist, Denial Specialist Nurse, Utilization Management Team Leader, and Patient Access Services. Inform team members of denials and potential denials so appropriate action can be taken by Utilization Review nurse.
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review job Title: accounts receivable specialist Company: 24seven
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