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Site: The Brigham and Women's Hospital, Inc.
Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive gr...

Site: The Brigham and Women's Hospital, Inc.
Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive gr...

Grow Healthy
If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a ...

Saratoga Medical is currently hiring a full-time REMOTE Medical Records Intake Reviewer. The position includes a competitive rate, PTO, paid federal holidays, medical benefits and flexible scheduling.
Required Qualifications
* Education: Must possess a high school diploma/GED
* Experience: Minimum of one year computer experience
If interested, please email me your most recent resume t...

Job Summary:
The Program Integrity Medical Coding Reviewer III generates comprehensive and concise in-depth reporting and analysis to track performance related to the Pre-Pay and Post-Paid Processes.
Essential Functions:
* Provide Provider Pre Pay production and progress reports and coordinate with management and team on recommendation for further actions and/or resolutions in order to inc...

Job Details
Level: Experienced Job Location: California Office - Roseville, CA Position Type: Full Time Education Level: Bachelor's Degree Salary Range: $75000.00 - $90000.00 Salary/year Travel Percentage: None Job Shift: Day Job Category: Insurance
Medical Itemized Bill Reviewer (IBRL-1)
Who We Are
Machinify is a leading healthcare intelligence company with exper...

Who is Comagine Health?
Comagine Health is a national, nonprofit, health care consulting firm. We work collaboratively with patients, providers, payers, and other stakeholders to reimagine, redesign and implement sustainable improvements in the health care system.
As a trusted, neutral party, we work in our communities to address key, complex health, and health care delivery problems. In all...

About Dane Street:
Dane Street is a leading Independent Review Organization (IRO) and national provider of Utilization Review services. As we continue to expand our physician panel, we're offering flexible, remote opportunities for board-certified physicians seeking supplemental income through non-traditional clinical work.
Position Overview:
We are currently seeking Board-Certified Psychiatr...

Responsibilities:
Under the direction of the supervisor, the Clinical Care Reviewer UM is responsible for completing medical necessity reviews. Using clinical knowledge and experience, the Clinical Care Reviewer UM reviews the provider requests for inpatient and outpatient services, working closely with members and providers to collect all information necessary to perform a thorough medi...

JOB TITLE (# 25032 ): Registered Nurse / Women's Health (Tier 3) / VA Reviewer - Remote
Minimum of 5 years active clinical practice within the specialty and 2 years of recent experience
Greenlife Healthcare Staffing is currently seeking a Women's Health Registered Nurse - VA Reviewer to fill an opening with a Non-profit organization
Requirements of the Registered Nurse / Women's Health...

JOB TITLE (#25164) : Nurse Practitioner / Med/Surg (Tier 3) / VA Reviewer - Remote
Minimum of 5 years of active clinical practice within the specialty and 2 years of recent experience
Greenlife Healthcare Staffing is currently seeking a Med Surg Nurse Practitioner - VA Reviewer to fill an opening with a Non-profit organization
Requirements of the Nurse Practitioner / Med/Surg (Tier 3) ...

JOB TITLE (# 25023 ): Emergency NP / VA Reviewer - Remote
Minimum of 5 years active clinical practice within the specialty and 2 years of recent experience
Greenlife Healthcare Staffing is currently seeking an Emergency Nurse Practitioner - VA Reviewer to fill an opening with a Non-profit organization
Requirements of the Emergency NP / VA Reviewer :
* Must hold a current, non-...

Job Description:
Duration: 4 months contract (with possible extension)
Mon-Fri (8.15 am – 5.15 pm EST)
*Please note: This is Fully remote, but Massachusetts RN license required.
Job Summary The Clinical Reviewer is a licensed professional –a Registered Nurse preferred– that is expected to function independently in her / his role and is responsible for managing a clinically complex ...

The Surgery Clinical Reviewer coordinates, collects, and submits reliable and accurate clinical data to the American College of Surgeon’s National Surgical Quality Improvement Program (NSQIP), through high-quality, complex clinical data interpretation, abstraction, and data validation. This position obtains data via standard and custom reports, analyzes, interpret data's, and identifies opportu...

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
Candidates must be in the state of California.
Position Purpose: Acts as a resource and supports the prior authoriza...

The Data Reviewer Specialist acts as a contributing specialist for studies, with the ability to carry out aspects of data review, expediting audit responses, and reporting (data reviewing with minimal guidance) through report finalization. The Data Reviewer Specialist has excellent organizational skills and utilizes a strong base in regulatory policy to assess data review and reporting and main...

JOB SUMMARY
The QA Specialist plays an integral role in the review process as they are responsible for communicating with the customer, reviewer, and management to ensure a completed report is delivered by the customer requested due date.
The QA Specialist is responsible for the timely completion and overall completeness of a reviewer report. Completeness is determined by customer requirements,...

JOB SUMMARY
The QA Specialist plays an integral role in the review process as they are responsible for communicating with the customer, reviewer, and management to ensure a completed report is delivered by the customer requested due date.
The QA Specialist is responsible for the timely completion and overall completeness of a reviewer report. Completeness is determined by customer requirements,...

AdventHealth Corporate
All the benefits and perks you need for you and your family:
· Benefits from Day One
· Career Development
· Whole Person Wellbeing Resources
· Mental Health Resources and Support
Our promise to you:
Joining AdventHealth is about being part
of something bigger. It’s about belonging to a community that believes in the wholeness of ...

The Customer Service Representative is responsible for receipt of new cases and ensuring proper system drafting and setup. The CSR also is responsible for taking direction and facilitating the case assignment/scheduling process.
MAJOR DUTIES & RESPONSIBILITIES
* Handling Receipt of New Cases:
* Intake new cases and review/verify information and requests. Draft cases by entering inform...