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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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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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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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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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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 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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Provides training and service recovery with direct reports, including the supervision of the day-to-day activities of subordinates by assigning workload, reviewing retrospective utilization review records prepared for admissions and continued stay reviews, reviewing cases referred to the physician advisor, and providing technical guidance on unusual cases.
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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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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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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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Dauntless Discovery is an e-Discovery company that leverages technology to optimize accuracy and increase efficiency to provide our clients with world class e-Discovery services. We cover the entire Electronic Discovery Reference Model while focusing on innovation, cost control, and predictability through innovative technology and proven best practices and protocols.
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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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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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review job Title: front desk receptionist Company: Smile League Dental
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