Identifies utilization review studies and evaluates adverse trends in utilization of medical ... Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel ...
Identifies utilization review studies and evaluates adverse trends in utilization of medical ... Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel ...
Secure authorizations with insurance companies for inpatient treatment and continue to obtain ... Review clinical documentation from denied stays against criteria to determine if documentation is ...
Secure authorizations with insurance companies for inpatient treatment and continue to obtain ... Review clinical documentation from denied stays against criteria to determine if documentation is ...
Secure authorizations with insurance companies for inpatient treatment and continue to obtain ... Review clinical documentation from denied stays against criteria to determine if documentation is ...
Secure authorizations with insurance companies for inpatient treatment and continue to obtain ... Review clinical documentation from denied stays against criteria to determine if documentation is ...
Secure authorizations with insurance companies for inpatient treatment and continue to obtain ... Review clinical documentation from denied stays against criteria to determine if documentation is ...
Secure authorizations with insurance companies for inpatient treatment and continue to obtain ... Review clinical documentation from denied stays against criteria to determine if documentation is ...
Physician Reviewer-Radiology (Part Time)
Baton Rouge, LA · On-site
$95 - $100/hr
... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ... insurance benefits) to qualifying employees. All compensation determinations are based on the ...
Physician Reviewer-Radiology (Part Time)
Baton Rouge, LA · On-site
$95 - $100/hr
... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ... insurance benefits) to qualifying employees. All compensation determinations are based on the ...
Knowledge of medical billing, insurance verification, pre-certification, prior authorization, and utilization-review processes. * Familiarity with project-management tools and software.
Knowledge of medical billing, insurance verification, pre-certification, prior authorization, and utilization-review processes. * Familiarity with project-management tools and software.
Board-Certified ENT
Lafayette, LA · On-site
... peer review services, trusted by insurance carriers and organizations across the country for ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...
Board-Certified ENT
Lafayette, LA · On-site
... peer review services, trusted by insurance carriers and organizations across the country for ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...
Board-Certified ENT
Lafayette, LA · On-site
... peer review services, trusted by insurance carriers and organizations across the country for ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...
Quick apply
Board-Certified ENT
Lafayette, LA · On-site
... peer review services, trusted by insurance carriers and organizations across the country for ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...
Board-Certified ENT
Lafayette, LA · On-site
... peer review services, trusted by insurance carriers and organizations across the country for ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...
Board-Certified ENT
Lafayette, LA · On-site
... peer review services, trusted by insurance carriers and organizations across the country for ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...
... peer review services, trusted by insurance carriers and organizations across the country for ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...
... peer review services, trusted by insurance carriers and organizations across the country for ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...
Knowledge of medical billing, insurance verification, pre-certification, prior authorization, and utilization-review processes. * Familiarity with project-management tools and software.
Knowledge of medical billing, insurance verification, pre-certification, prior authorization, and utilization-review processes. * Familiarity with project-management tools and software.
... utilization review processes to assure continuity for the most appropriate level of care for ... Perform insurance benefit verifications and secure initial pre-authorization for treatment and ...
... utilization review processes to assure continuity for the most appropriate level of care for ... Perform insurance benefit verifications and secure initial pre-authorization for treatment and ...
Senior Director, Patient Access
New Orleans, LA · On-site
$140 - $180/hr
Lead check‑out scheduling, pre‑registration, insurance verification, and financial counseling ... Utilization Review, Emergency Preparedness, and Corporate Compliance to apply new and emerging ...
Senior Director, Patient Access
New Orleans, LA · On-site
$140 - $180/hr
Lead check‑out scheduling, pre‑registration, insurance verification, and financial counseling ... Utilization Review, Emergency Preparedness, and Corporate Compliance to apply new and emerging ...
... Utilization Review support to drive authorization and retention throughout treatmentWhat We're ... Insurance Dental VisionAccidentCritical IllnessHospital Indemnity Voluntary Short-Term ...
Quick apply
... Utilization Review support to drive authorization and retention throughout treatmentWhat We're ... Insurance Dental VisionAccidentCritical IllnessHospital Indemnity Voluntary Short-Term ...
Field Medical Director, Vascular Surgeon
Baton Rouge, LA · On-site
$130 - $140/hr
... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ... insurance benefits) to qualifying employees. All compensation determinations are based on the ...
Field Medical Director, Vascular Surgeon
Baton Rouge, LA · On-site
$130 - $140/hr
... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ... insurance benefits) to qualifying employees. All compensation determinations are based on the ...
Knowledge of medical and utilization review techniques. * Required Licenses and Certifications ... Health insurance industry experience * Experience in INPATIENT Rehabilitation * Medicare policy ...
Knowledge of medical and utilization review techniques. * Required Licenses and Certifications ... Health insurance industry experience * Experience in INPATIENT Rehabilitation * Medicare policy ...
Knowledge of medical and utilization review techniques. * Required Licenses and Certifications ... Health insurance industry experience * Experience in INPATIENT Rehabilitation * Medicare policy ...
Knowledge of medical and utilization review techniques. * Required Licenses and Certifications ... Health insurance industry experience * Experience in INPATIENT Rehabilitation * Medicare policy ...
Knowledge of medical and utilization review techniques. * Required Licenses and Certifications ... Health insurance industry experience * Experience in INPATIENT Rehabilitation * Medicare policy ...
Knowledge of medical and utilization review techniques. * Required Licenses and Certifications ... Health insurance industry experience * Experience in INPATIENT Rehabilitation * Medicare policy ...
Knowledge of medical and utilization review techniques. * Required Licenses and Certifications ... Health insurance industry experience * Experience in INPATIENT Rehabilitation * Medicare policy ...
Knowledge of medical and utilization review techniques. * Required Licenses and Certifications ... Health insurance industry experience * Experience in INPATIENT Rehabilitation * Medicare policy ...
Knowledge of medical and utilization review techniques. * Required Licenses and Certifications ... Health insurance industry experience * Experience in INPATIENT Rehabilitation * Medicare policy ...
Knowledge of medical and utilization review techniques. * Required Licenses and Certifications ... Health insurance industry experience * Experience in INPATIENT Rehabilitation * Medicare policy ...
Weekday Insurance Utilization Review information
What is the difference between Weekday Insurance Utilization Review vs Weekday Claims Processor?
| Aspect | Weekday Insurance Utilization Review | Weekday Claims Processor |
|---|---|---|
| Primary Role | Assessing medical necessity and appropriateness of services | Processing and reviewing insurance claims for payment |
| Credentials | Often requires healthcare or insurance certifications | Typically requires insurance or administrative experience |
| Work Environment | Healthcare settings, insurance companies | Insurance companies, healthcare offices |
| Focus | Medical review and authorization | Claims data entry and verification |
Weekday Insurance Utilization Review focuses on evaluating medical necessity, while Weekday Claims Processors handle the administrative processing of insurance claims. Both roles are essential in the insurance industry but serve different functions related to claims management and healthcare authorization.
What are the most commonly searched types of Insurance Utilization Review jobs in Louisiana?
The most popular types of Insurance Utilization Review jobs in Louisiana are:
What cities in Louisiana are hiring for Weekday Insurance Utilization Review jobs?
Cities in Louisiana with the most Weekday Insurance Utilization Review job openings:
Internal Medicine Physician General Internist - Physicians Only Apply - Perm
Baton Rouge, LA
Full-time
Re-posted 11 days ago
Job description
Medical Doctors Only Apply. A Internal Medicine Physician General Internist practice is seeking a qualified physician for Baton Rouge, LA. This and other physician jobs brought to you by ExactMD. Position Purpose: Assist the VP of Clinical Programs to direct and coordinate the physician component of the utilization management functions for the Medicare Organization Determination team that supports health plan business units. Provides medical leadership for Medicare utilization management activities, Organizational Determinations, and medical review activities pertaining to utilization review, quality assurance, medical review of complex, and controversial or experimental medical services such as transplants utilizing the services of consultants Performs case reviews and appeals for all health plans Facilitates Grand Rounds and case reviews with other clinicians and external treating providers Participates as an active member of the Integrated Care team (ICT) In collaboration with the VP of Clinical Programs, develops clinical programs and approaches targeted to improve health outcomes for complex care and high acuity populations Assists VP of Clinical Programs in planning, establishing goals and policies to improve quality and cost-effectiveness of care and service for members. Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements. Identifies utilization review studies and evaluates adverse trends in utilization of medical services, unusual provider practice patterns, and adequacy of benefit/payment components. Identifies clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice in order to improve the quality and cost of care. Reviews claims involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment Qualifications: Knowledge/Experience: Requires a Medical Doctor or Doctor of Osteopathy, board certified preferably in a primary care specialty (Internal Medicine, Med/Peds, Family Practice, Pediatrics or Emergency Medicine). Previous experience within a managed care organization, specifically reviewing for Medicare Organizational Determinations, preferred. Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel Management is preferred. Experience treating or managing care for a culturally diverse population preferred. The candidate must be an actively practicing physician. License/Certifications: Board Certification through American Board Medical Specialties. Current state medical license without restrictions.
About Fortus Group
Sourced by ZipRecruiter
Industry
Real estate and rental and leasing
Company size
11 - 50 Employees
Headquarters location
Fort Wayne, IN, US
Year founded
2008