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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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The Utilization Review Specialist will also perform pre-certification reviews, concurrent reviews and will perform appeal reviews as needed. Three to Five (5) years experience in Case Management/Utilization Review (as either CADC, LAADC, LCSW, LMHC, LMFT, Case Manager, or Utilization Review Coordinator.
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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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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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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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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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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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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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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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Three to Five (5) years experience in Case Management/Utilization Review (as either CADC, LAADC, LCSW, LMHC, LMFT, or Utilization Review Coordinator). Utilization Review Specialist/Behavioral Health Substance Abuse.
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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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Experience with Veeva Promomats, Aprimo, Asana, Zinc, JIRA and Adobe Experience Manager or other promotional review software and marketing project management tools a plusStrong written and verbal communication skills, ability to organize, prioritize and meet deadlinesStrong planning, organizational, and project support skillsProofreading and editing skillsStrong communication skills, both written and oral.
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Conduct individual face-to-face sessions with each Support Coordinator to review individual cases on a weekly basis - Review ten percent (10%) of each Support Coordinator's case records monthly for completeness, compliance with these standards, and quality of service delivery.
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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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review job Title: sales representative Company: George J Grove Son
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