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The Utilization Review RN utilizes his/her skills to coordinate internal and external resources to facilitate appropriate resource management of an age specific patient population which spans from newborns to geriatrics, identifying opportunities for process improvement, high risk cases and sentinel events, to the achievement of an acceptable outcome.
$35.43 - $52.44 an hourPart-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Seven or more years of financial services credit review/credit risk management experience through: past work in credit/loan review, credit risk management, internal audit credit risk coverage, commercial loan underwriting departments at large banking institutions; regulatory agency credit review/credit risk experience; or credit review/credit risk experience at a large consulting firm.
$116,280 - $150,480 a yearFull-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Strong understanding of applicable laws, regulations, financial services, and regulatory trends that impact credit risk management, particularly related to credit review activities. Large Bank experience through risk advisory, internal audit, regulatory oversight, or credit review.
$116,280 - $150,480 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Must have hands-on familiarity with a variety of computer applications, including word processing, databases (such as document review and file management systems), spreadsheets, and imaging. Obtains needed information from case files, law enforcement agencies, civil client agencies, or other sources, and submits completed legal documents to the appropriate client assistant attorney for review and approval.
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Responsibilities The position is primarily accountable for performing initial clinical appropriateness reviews of requests for services that require prior authorization or retrospective review Facilitates cost-effective and quality patient care by effective communication with leadership, providers, and patient care team.
$36.42 - $60.33Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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6-7 x 12 hour shifts per bi-weekly pay period and may include a mix of days, nights, and/or mid-shifts.
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Review and disposition all assigned BSA/AML & OFAC alerts (including complex or complicated alerts) that may be generated by the bank's transaction monitoring and/or screening systems(s). The Senior AML Specialist - Alert Review is responsible for various functions related to BSA/AML/OFAC compliance.
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Utilization Review- RN Reviewer- Regional Coverage for Loyola, Gottlieb and MacNeal Hospitals. The Regional Utilization Review Documentation Specialist nurse works with the multidisciplinary team including physicians, staff and payers to ensure patient's progress along the continuum of care in an efficient and cost-effective manner that ensures quality outcomes.
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A minimum of two (2) years quality/utilization review experience in an HMO, managed care organization, or similar experience as a hospital inpatient coder or auditor required. The Clinical Review and Coding Nurse is responsible to attain procedure and diagnosis coding accuracy and consistency on referred cases.
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Job Summary and QualificationsAs a Denials Coding Review Specialist, you will be responsible for applying correct coding guidelines and payor requirements as it relates to researching, analyzing, and resolving outstanding clinical denials and insurance claims.
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New Business Review Supervision: Oversee the review process for new variable annuity, direct mutual fund, and all other Broker-Dealer business, ensuring they meet all compliance and regulatory standards before implementation.
$90,000 - $105,000Full-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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As a member of the CPRT team, the Vice President will provide independent review and challenge across the capital management and planning continuum encompassing business-as-usual capital management, ongoing and quarterly business and capital planning forecasts (including CCAR/DFAST.
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Eight years of retail banking credit experience in one or more of the following functions: credit analyst, underwriter, portfolio manager, relationship manager, credit risk review officer, or credit approval officer.
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Expert level credit analysis skills and experience to evaluate business unit underwriting and portfolio management processes, loan structure, borrower financial condition, repayment capacity, collateral, exceptions, risk rating, key credit risk drivers, and credit review principles and methodologies.
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The position of Forensic Scientist I, Data Review is within our Toxicology Division located at Richmond, VA at Alere Toxicology Services. Forensic Scientist I, First Review. Initial review of LC-MS/MS, GC-MS and GC-FID headspace data including, but not limited to, calibration, control performance, chain of custody, and donor results.
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review job Title: reporting Company: Skillz
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