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Determine which claims require higher-level dental consultant review. The Clinical Review Specialist is a hybrid position requiring one day a week in our Centennial, Colorado office. Understand the dental review process, importance of applying accurate and consistent processing procedures, attention to detail, and acknowledge the affect these processes have on all aspects of operations within Delta Dental of Colorado.
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Under the direction of the Nurse Consultant III, Supervisor (NCIII), the Nursing Consultant, Program Review (NCPR) serves as a member of the Statewide Mental Health Program (SMHP) Utilization Management (UM) team responsible for developing an integrated system-wide framework for quality assurance and performance improvement.
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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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Three Saints Bay Evidence Review Specialist (2915) Wichita , Kansas Apply Now Apply Now ( Perform quality control review of images for NIBIN Partner sites; Eagle Harbor LLC, a subsidiary of Three Saints Bay, LLC and Federal Government Contractor industry leader, is seeking Crime Gun Forensics Technicians to support our customer, the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) in Wichita, KS.
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Minimum 10 years of credit examination, bank examiner or manager in credit (loan) risk review, credit administration or credit risk management in mid-size or larger ($50 billion or more) financial institution, regulatory agency or public accounting firm.
$127,626 - $237,014 a yearExpandApply NowActive JobUpdated 0 days ago - UpvoteDownvoteShare Job
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Department/Unit: Care Management/Social Work Work Shift: Day (United States of America) Utilization Review Nurse Salary Range: $31.28 - $51.61 per hour Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients.
$31.28 - $51.61 an hourFull-timeRemoteExpandApply NowActive JobUpdated 0 days ago - UpvoteDownvoteShare Job
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The Process Review Specialist will review, analyze, and audit data, information and processes as assigned. This position will also review processes within any assigned departments for accuracy and ensure these processes are being followed, improved, and provide quality control.
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Provide denial information for UR Committee, Denial and Revenue Cycle Collaborate with Patient Access, Case Management, Managed Care and Business Office to improve concurrent review process to avoid denial or process delays in billing accounts Accountable to identify and reports variances in appropriateness of medical care provided, over/under utilization of resources compared to evidence-based practice and external requirements.
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Minimum of 15 years Commercial credit experience in loan review, credit underwriting/analysis, credit management, credit risk management, Commercial lending or Regulatory examinations. As a long-tenured commercial credit expert, the Loan Review Examination Group Manager serves as both an Examiner-in-Charge and a personnel manager of a team of professional Commercial Examiners.
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As 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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Dam Safety Engineer - Inspection and Review. Managed Business Solutions (MBS) is seeking a full-time dam safety engineer to join our team with the Bureau of Indian Affairs (BIA) Safety of Dams Program (SOD) on-site in Pierre, South Dakota, or nearby in the State of South Dakota.
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Review bi-weekly job cost reports (Controller/CFO) Review weekly labor allocation (General Superintendent/COO) Review and approve invoices (Controller/CFO) Review change order log (Project Coordinator.
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Our Talent Acquisition team is reviewing applications for our Denial Coding Review Specialist opening. Review Medicare Recovery Audit Contractor (RAC) recoupment requests and process or appeal as appropriate.
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As a CGS Mandarin Document Reviewer you will play a key role in supporting various aspects of the company's litigation portfolio including eDiscovery activities, workflow management, and litigation support.
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Coordinates with and provides professional and technical guidance to review staff, project coordinators, planning and zoning staff, and traffic sections to address issues that may arise from the review of development applications.
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review job Title: sec reporting Company: Skillz
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