... join our remote MDS division as a Clinical Reimbursement Specialist . Clinical Reimbursement ... The CRS also reviews reimbursement systems for PDPM and Case Mix to ensure accurate and optimized ...
... join our remote MDS division as a Clinical Reimbursement Specialist . Clinical Reimbursement ... The CRS also reviews reimbursement systems for PDPM and Case Mix to ensure accurate and optimized ...
... join our remote MDS division as a Clinical Reimbursement Specialist . Clinical Reimbursement ... The CRS also reviews reimbursement systems for PDPM and Case Mix to ensure accurate and optimized ...
... join our remote MDS division as a Clinical Reimbursement Specialist . Clinical Reimbursement ... The CRS also reviews reimbursement systems for PDPM and Case Mix to ensure accurate and optimized ...
... join our remote MDS division as a Clinical Reimbursement Specialist . Clinical Reimbursement ... The CRS also reviews reimbursement systems for PDPM and Case Mix to ensure accurate and optimized ...
... join our remote MDS division as a Clinical Reimbursement Specialist . Clinical Reimbursement ... The CRS also reviews reimbursement systems for PDPM and Case Mix to ensure accurate and optimized ...
Inpatient Care Management Nurse - Remote
Kansas City, MO ยท On-site +1
$60K - $107K/yr
Compact RN license * 2+ years of acute inpatient case management experience/utilization review * 1+ years of experience in Utilization Review, either within an Acute Inpatient Hospital setting or ...
New
Inpatient Care Management Nurse - Remote
Kansas City, MO ยท On-site +1
$60K - $107K/yr
Compact RN license * 2+ years of acute inpatient case management experience/utilization review * 1+ years of experience in Utilization Review, either within an Acute Inpatient Hospital setting or ...
New
Inpatient Care Management Nurse - Remote
Kansas City, MO ยท Remote
$60K - $107K/yr
Compact RN license * 2 years of acute inpatient case management experience/utilization review * 1 years of experience in Utilization Review, either within an Acute Inpatient Hospital setting or ...
New
Inpatient Care Management Nurse - Remote
Kansas City, MO ยท Remote
$60K - $107K/yr
Compact RN license * 2 years of acute inpatient case management experience/utilization review * 1 years of experience in Utilization Review, either within an Acute Inpatient Hospital setting or ...
New
Claims Adjuster - Liability | Property Damage | Jurisdiction CO | Must reside in CO - Remote
Concordia, MO ยท Remote
$60K - $80K/yr
... in CO - Remote Are you looking for an opportunity to join a global industry leader where you can ... utilization review. * Maintains professional client relationships. * Performs other duties as ...
Claims Adjuster - Liability | Property Damage | Jurisdiction CO | Must reside in CO - Remote
Concordia, MO ยท Remote
$60K - $80K/yr
... in CO - Remote Are you looking for an opportunity to join a global industry leader where you can ... utilization review. * Maintains professional client relationships. * Performs other duties as ...
Revenue Cycle Medical Billing Resource Utilization Clinical Auditor
West Plains, MO ยท On-site +1
$73K/yr
Remote or On-Site, United States Annual Compensation: $73,000 (this position is bonus eligible ... Review and audit medical necessity justification for air and ground ambulance transports ...
Revenue Cycle Medical Billing Resource Utilization Clinical Auditor
West Plains, MO ยท On-site +1
$73K/yr
Remote or On-Site, United States Annual Compensation: $73,000 (this position is bonus eligible ... Review and audit medical necessity justification for air and ground ambulance transports ...
... internship/practicum year) * Experience participating in IEP meetings, acting as case manager, and ... An extensive virtual library of peer-reviewed studies and online assessments, including online ...
Quick apply
... internship/practicum year) * Experience participating in IEP meetings, acting as case manager, and ... An extensive virtual library of peer-reviewed studies and online assessments, including online ...
Senior Product Manager
Saint Louis, MO ยท On-site +1
$50 - $60/hr
... utilization review. ยท Proven experience with Amazon Connect migration projects, including ... US (Remote/Hybrid - Preferred locations: Brillio Offices or St. Louis, MO) Industry: Healthcare / ...
Quick apply
Senior Product Manager
Saint Louis, MO ยท On-site +1
$50 - $60/hr
... utilization review. ยท Proven experience with Amazon Connect migration projects, including ... US (Remote/Hybrid - Preferred locations: Brillio Offices or St. Louis, MO) Industry: Healthcare / ...
This is a flexible, remote, contract-based opportunity ideal for experienced administrators who are ... Support interns through coaching conversations, reflective questioning, and individualized guidance.
This is a flexible, remote, contract-based opportunity ideal for experienced administrators who are ... Support interns through coaching conversations, reflective questioning, and individualized guidance.
Remote - Inpatient Coder II
Saint Joseph, MO ยท On-site +1
$21 - $25.25/hr
This assignment is based on evaluation of the documentation in the medical record and utilization ... Reviews and appeals coding denials. * Educates/Communicates with providers, querying providers to ...
Remote - Inpatient Coder II
Saint Joseph, MO ยท On-site +1
$21 - $25.25/hr
This assignment is based on evaluation of the documentation in the medical record and utilization ... Reviews and appeals coding denials. * Educates/Communicates with providers, querying providers to ...
Lead operational governance activities across assigned Clubs, including creative review oversight ... Track and monitor Club marketing funding utilization to ensure compliance with Producer Agreements
Lead operational governance activities across assigned Clubs, including creative review oversight ... Track and monitor Club marketing funding utilization to ensure compliance with Producer Agreements
This program serves as one of the primary pipelines for the Underwriting Internship Program and the ... Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ...
New
This program serves as one of the primary pipelines for the Underwriting Internship Program and the ... Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ...
New
This program serves as one of the primary pipelines for the Underwriting Internship Program and the ... Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ...
New
This program serves as one of the primary pipelines for the Underwriting Internship Program and the ... Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ...
New
This program serves as one of the primary pipelines for the Underwriting Internship Program and the ... Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ...
New
This program serves as one of the primary pipelines for the Underwriting Internship Program and the ... Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ...
New
This program serves as one of the primary pipelines for the Underwriting Internship Program and the ... Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ...
New
This program serves as one of the primary pipelines for the Underwriting Internship Program and the ... Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ...
New
This program serves as one of the primary pipelines for the Underwriting Internship Program and the ... Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ...
New
This program serves as one of the primary pipelines for the Underwriting Internship Program and the ... Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ...
New
This program serves as one of the primary pipelines for the Underwriting Internship Program and the ... Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ...
New
This program serves as one of the primary pipelines for the Underwriting Internship Program and the ... Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ...
New
Senior Construction Project Scheduler (Data Centers) Interstates | Multiple Locations or Remote ... Coordinate labor, equipment, and material needs to optimize availability and utilization.
Senior Construction Project Scheduler (Data Centers) Interstates | Multiple Locations or Remote ... Coordinate labor, equipment, and material needs to optimize availability and utilization.
$94K - $124K/yr
Write automated tests, participate in code reviews, and contribute to release quality through CI/CD ... Fully remote, globally distributed work environment. * Flexible working hours and strong work-life ...
New
$94K - $124K/yr
Write automated tests, participate in code reviews, and contribute to release quality through CI/CD ... Fully remote, globally distributed work environment. * Flexible working hours and strong work-life ...
New
Internship Remote Utilization Review information
What are the main challenges interns face when working remotely in Utilization Review, and how can they overcome them?
What is a Remote Utilization Review Internship?
What is the difference between Internship Remote Utilization Review vs Utilization Review Specialist?
| Aspect | Internship Remote Utilization Review | Utilization Review Specialist |
|---|---|---|
| Credentials | Typically pursuing or holding relevant certifications (e.g., CCM, RN) | Requires active certification and experience in utilization review |
| Work Environment | Remote, internship setting, often part-time or supervised | Full-time, remote or onsite, with more independent responsibilities |
| Industry Usage | Entry-level, training phase within healthcare and insurance sectors | Professional role with established responsibilities in healthcare management |
In summary, an Internship Remote Utilization Review is a training position for individuals gaining experience in utilization review, often with supervision and limited responsibilities. A Utilization Review Specialist is a fully qualified professional responsible for evaluating healthcare services, requiring certifications and more independence in their role.
What are the key skills and qualifications needed to thrive as a Remote Utilization Review Intern, and why are they important?
- Utilization Review Physician
- Behavioral Health Utilization Review
- Evening Optum Health Utilization Review
- No Experience Utilization Management Nurse
- Therapist Utilization Review Remote
- Utilization Review Nurse
- Remote Utilization Review Rn
- Utilization Management
- Utilization Review Therapist
- Senior Behavioral Health Utilization Review
- Aetna Utilization Review Nurse
- Seasonal Remote Utilization Review
- Insurance Utilization Reviewer
- Behavioral Utilization Review
- Commission Authorization Utilization Review Bcba
- Remote Occupational Therapy Utilization Review
- Utilization Review Coordinator
- Authorization Utilization Review Bcba
- Anthem Utilization Review Nurse
- Authorization Utilization Review
Other
Medical, Dental, Life, Retirement, PTO
This job post hasย expired today.ย Applications are no longer accepted.
Job description
MDS Solutions, a division of Key Rehabilitation, is looking for fun, energetic, and self-driven team members to join our remote MDS division as a Clinical Reimbursement Specialist.
Clinical Reimbursement Specialist (CRS)The Clinical Reimbursement Specialist (CRS) plays a critical role in supporting clients through specialized project work, including conducting RAI assessments, developing comprehensive care plans, and delivering targeted education and training to MDS Coordinators on the Resident Assessment Instrument (RAI) process. This work is performed in strict alignment with applicable laws, regulations, and company standards. The CRS also reviews reimbursement systems for PDPM and Case Mix to ensure accurate and optimized reimbursement. Additionally, the CRS provides support with interim long-term and short-term contract coordination, ensuring the smooth completion of these efforts
About Us:
At Key Rehab, we're shaking up rehab services with a fresh, standout approach. We offer a wide range of services, stick to top-notch systems, and work in strategic locations to get the best results for our patients and support our clients' goals. We're all about clear communication, using our deep experience to deliver therapy that's both effective and affordable. Our reputation is built on great patient care, happy clients and staff, and solid management. We are proud to exceed expectations for patients, families, healthcare providers, and businesses.
We prioritize both exceptional patient care and the well-being of our employees. We are committed to delivering compassionate, results-driven therapy while offering the flexibility and comprehensive benefits needed to thrive in today's healthcare environment. Our team is large enough to offer competitive pay and benefits but small enough to ensure personalized attention and support for your career aspirations.
Whether you're looking for a role that accommodates family commitments, travel plans, home projects, or future savings, we provide tailored solutions to fit your lifestyle. Join us and experience a workplace that values your individual needs and career goals. Come experience a rewarding career where you're valued and supported every step of the way.
We offer a creative, engaging, and flexible work environment, alongside a comprehensive benefits package designed to support your success and well-being:
- Competitive salaries with bonus opportunities
- Ample opportunities for promotion, transfer, and advancement
- Work that is meaningful, fulfilling, and provides high job satisfaction
- Reasonable working hours promoting work-life balance
- Continuing education (CE) opportunities for ongoing professional development
- Generous paid time off
- Comprehensive health, dental, and life insurance packages
- 401K with discretionary matching
- Mileage and licensure reimbursements
- Flexible Spending Account (FSA) and Health Savings Account (HSA) options
- Serve as a trusted advisor to healthcare agencies and facilities, offering expert guidance and insights to optimize their operations.
- Assist clients in assessing, planning, developing, and implementing systems and processes related to reimbursement, tailored to the specific needs and contracts established with each client.
- Provide consulting services and technical expertise, including interim MDS management, ensuring providers receive the support they need to achieve optimal outcomes.
- Stay up-to-date on professional standards of clinical care, federal and state regulations, QM measures, and the RAI process to ensure the delivery of accurate, compliant, and effective solutions.
- Deliver high-quality, professional services that encompass reimbursement optimization, staff education, in-depth research, system analysis, creative problem-solving, and the presentation of actionable recommendations to clients.
- Identify and address training needs, developing and conducting training sessions or in-service programs as requested by clients to enhance staff competency and performance.
- Operate within the defined scope of work, maintaining strict adherence to client agreements and expectations.
- Uphold client confidentiality and ensure full compliance with HIPAA regulations, safeguarding sensitive information throughout the engagement.
Minimum Qualifications:
- Bachelor's degree in nursing from an accredited college or university, with at least five (5) years of clinical experience, including 3+ years specializing in the RAI process.
- Current and unrestricted RN ,along with active RAC-CT certification, ensuring adherence to industry standards and best practices.
- Possesses exceptional critical thinking skills, with the proven ability to make informed decisions, demonstrate sound clinical judgment, and apply expert knowledge in quality improvement concepts and processes.
- Demonstrates strong leadership abilities and excels in interpersonal communication, fostering collaboration, and guiding teams to achieve optimal clinical outcomes.
Key Rehab is an equal opportunity employer/service provider.
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Employment Type: OTHER