Excellent customer service and organizational skills. * Working knowledge of CMS and other review agency standards. * Proficient with software applications including CM, payer web applications, MITS ...
Excellent customer service and organizational skills. * Working knowledge of CMS and other review agency standards. * Proficient with software applications including CM, payer web applications, MITS ...
Electrical Applications Engineer
Columbus, OH · On-site
$90 - $110/hr
Collaborate with the sales team to develop engineered electrical solutions based on customer requirements. * Review project specifications and recommend products that best meet application needs ...
Electrical Applications Engineer
Columbus, OH · On-site
$90 - $110/hr
Collaborate with the sales team to develop engineered electrical solutions based on customer requirements. * Review project specifications and recommend products that best meet application needs ...
Customer Service Representative
Delaware, OH · On-site
$15.25 - $20.75/hr
Monthly review and update of Profitability Files. * * Provide pricing and availability on all daily quotes. CSRs will collaborate with Contracts Specialist who will execute customer contracts.
Customer Service Representative
Delaware, OH · On-site
$15.25 - $20.75/hr
Monthly review and update of Profitability Files. * * Provide pricing and availability on all daily quotes. CSRs will collaborate with Contracts Specialist who will execute customer contracts.
Monthly review and update of Profitability Files. * Provide pricing and availability on all daily quotes. CSRs will collaborate with Contracts Specialist who will execute customer contracts.
Monthly review and update of Profitability Files. * Provide pricing and availability on all daily quotes. CSRs will collaborate with Contracts Specialist who will execute customer contracts.
Care Review Processor
Columbus, OH · On-site
Provide excellent customer service for internal and external customers. * Meet department quality standards, including inter-rater reliability (IRR) testing and quality review audit scores. Notify ...
Care Review Processor
Columbus, OH · On-site
Provide excellent customer service for internal and external customers. * Meet department quality standards, including inter-rater reliability (IRR) testing and quality review audit scores. Notify ...
Care Review Processor
Columbus, OH · On-site
Provide excellent customer service for internal and external customers. * Meet department quality standards, including inter-rater reliability (IRR) testing and quality review audit scores. ? Notify ...
Care Review Processor
Columbus, OH · On-site
Provide excellent customer service for internal and external customers. * Meet department quality standards, including inter-rater reliability (IRR) testing and quality review audit scores. ? Notify ...
Field Technician - Columbus
Columbus, OH · On-site
$19 - $26/hr
Job sites must be clear of debris/trash and left in pristine condition for customer review and approval. Requirements Knowledge, Skills, and Competencies Required: Education: Minimum high school ...
Field Technician - Columbus
Columbus, OH · On-site
$19 - $26/hr
Job sites must be clear of debris/trash and left in pristine condition for customer review and approval. Requirements Knowledge, Skills, and Competencies Required: Education: Minimum high school ...
Financial Crime Review Analyst
Columbus, OH · On-site
$18.75 - $35.75/hr
The Financial Crime Review Analyst is responsible for performing transaction activity reviews, investigations and customer due diligence reviews on customers that have been alerted for potentially ...
Financial Crime Review Analyst
Columbus, OH · On-site
$18.75 - $35.75/hr
The Financial Crime Review Analyst is responsible for performing transaction activity reviews, investigations and customer due diligence reviews on customers that have been alerted for potentially ...
Care Review Processor I
Columbus, OH · On-site
Strong customer service skills with pleasant phone voice * Microsoft Excel (beginner level) * Works ... review for other healthcare services. * Checks eligibility and verifies benefits, obtains and ...
Care Review Processor I
Columbus, OH · On-site
Strong customer service skills with pleasant phone voice * Microsoft Excel (beginner level) * Works ... review for other healthcare services. * Checks eligibility and verifies benefits, obtains and ...
Care Review Processor Location : Columbus, OH Duration : 3+ Months Responsibilities : Temp for 90 ... Knowledge of ICD 10 codes or CPT codes Computer literate Strong customer service skills with ...
Care Review Processor Location : Columbus, OH Duration : 3+ Months Responsibilities : Temp for 90 ... Knowledge of ICD 10 codes or CPT codes Computer literate Strong customer service skills with ...
This individual will provide superior service to the bank's Customers, Commercial business line ... Perform reviews of appraisal and evaluation reports for all property types and value levels to ...
This individual will provide superior service to the bank's Customers, Commercial business line ... Perform reviews of appraisal and evaluation reports for all property types and value levels to ...
Tech Sales Thermal Application Engineer Intern (Summer 2027)
Westerville, OH · On-site
$100K - $123K/yr
Assists in developing clear, concise, and technically sound tailored solutions for customer review and acceptance based on customer requirements and/or Request for Proposals (RFPs), ensuring proper ...
Tech Sales Thermal Application Engineer Intern (Summer 2027)
Westerville, OH · On-site
$100K - $123K/yr
Assists in developing clear, concise, and technically sound tailored solutions for customer review and acceptance based on customer requirements and/or Request for Proposals (RFPs), ensuring proper ...
Project Foreman
Columbus, OH · On-site
Communicates all timelines with the Market Manager, support staff, and the Customer. * Review and complete all documentation and ensure it meets all installation standards. * Maintains open and ...
Project Foreman
Columbus, OH · On-site
Communicates all timelines with the Market Manager, support staff, and the Customer. * Review and complete all documentation and ensure it meets all installation standards. * Maintains open and ...
Tech Sales Thermal Application Engineer Intern (Summer 2027)
Westerville, OH · On-site
$100K - $123K/yr
Assists in developing clear, concise, and technically sound tailored solutions for customer review and acceptance based on customer requirements and/or Request for Proposals (RFPs), ensuring proper ...
Tech Sales Thermal Application Engineer Intern (Summer 2027)
Westerville, OH · On-site
$100K - $123K/yr
Assists in developing clear, concise, and technically sound tailored solutions for customer review and acceptance based on customer requirements and/or Request for Proposals (RFPs), ensuring proper ...
Transaction Review Associate
Ashville, OH · On-site
One customer, one family, one community at a time. ROLES & RESPONSIBILITIES * Assist with inbound and outbound calls * Validate purpose and legitimacy of any transactions that appear unusual or high ...
Transaction Review Associate
Ashville, OH · On-site
One customer, one family, one community at a time. ROLES & RESPONSIBILITIES * Assist with inbound and outbound calls * Validate purpose and legitimacy of any transactions that appear unusual or high ...
Assists in developing clear, concise, and technically sound tailored solutions for customer review and acceptance based on customer requirements and/or request for proposals (RFPs), ensuring proper ...
Assists in developing clear, concise, and technically sound tailored solutions for customer review and acceptance based on customer requirements and/or request for proposals (RFPs), ensuring proper ...
Assists in developing clear, concise, and technically sound tailored solutions for customer review and acceptance based on customer requirements and/or request for proposals (RFPs), ensuring proper ...
Assists in developing clear, concise, and technically sound tailored solutions for customer review and acceptance based on customer requirements and/or request for proposals (RFPs), ensuring proper ...
Onsite Reviewer - Ohio
Columbus, OH · On-site
$25/hr
Maintain strict confidentiality regarding provider information, findings, and review outcomes. * Meet established productivity, quality, and customer service performance standards. * Work ...
Onsite Reviewer - Ohio
Columbus, OH · On-site
$25/hr
Maintain strict confidentiality regarding provider information, findings, and review outcomes. * Meet established productivity, quality, and customer service performance standards. * Work ...
SBA Eligibility Review Officer III
Columbus, OH · On-site +1
$77K - $154K/yr
Maintains an individual pipeline of work, with loans typically of advanced complexity and customer ... Reviews use of proceeds, orders SBA Number, prepares SBA Loan Authorization and other SBA forms and ...
SBA Eligibility Review Officer III
Columbus, OH · On-site +1
$77K - $154K/yr
Maintains an individual pipeline of work, with loans typically of advanced complexity and customer ... Reviews use of proceeds, orders SBA Number, prepares SBA Loan Authorization and other SBA forms and ...
SBA Eligibility Review Officer III
Columbus, OH · On-site +1
$77K - $154K/yr
Maintains an individual pipeline of work, with loans typically of advanced complexity and customer ... Reviews use of proceeds, orders SBA Number, prepares SBA Loan Authorization and other SBA forms and ...
SBA Eligibility Review Officer III
Columbus, OH · On-site +1
$77K - $154K/yr
Maintains an individual pipeline of work, with loans typically of advanced complexity and customer ... Reviews use of proceeds, orders SBA Number, prepares SBA Loan Authorization and other SBA forms and ...
Customer Review information
See salary details
$9.86 - $11.41
2% of jobs
$11.41 - $12.96
4% of jobs
$12.96 - $14.51
11% of jobs
$15.37 is the 25th percentile. Wages below this are outliers.
$14.51 - $16.06
15% of jobs
The median wage is $17.49 / hr.
$16.06 - $17.61
20% of jobs
$17.61 - $19.17
15% of jobs
$20.23 is the 75th percentile. Wages above this are outliers.
$19.17 - $20.72
13% of jobs
$20.72 - $22.27
7% of jobs
$22.27 - $23.82
6% of jobs
$23.82 - $25.37
4% of jobs
$25.37 - $26.92
3% of jobs
$9
$18
$26
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Full-time
Re-posted 2 days ago
Nationwide Children's Hospital rating
6.9
Based on 131 frontline employees who took The Breakroom Quiz
548th of 1,062 rated hospitals
Job description
Schedule: Monday-Friday (8:00am-4:30pm)
Position is work from home after a 90 day in-office training period.
Job Description Summary:
Reviews behavioral health cases to determine medical necessity and appropriateness of care, ensuring compliance with established guidelines and policies. Performs pre-certifications, pre-authorizations, re-authorization, concurrent utilization reviews, retrospective reviews, and denial management. Interacts with staff and departments of the hospital to facilitate appropriate, cost-effective patient care.
Job Description:
Essential Functions:
- Conducts utilization reviews of behavioral health cases to determine medical necessity, appropriateness of care, and adherence to clinical guidelines.
- Communicates with healthcare teams and third-party payors to ensure the delivery of quality care and optimum payment.
- Assists with retrospective reviews and denial management to maintain appropriate and cost-effective patient care.
- Documents all case reviews and maintains accurate records of all clinical activities and coverage information.
- Provides education and support regarding utilization review and management activities and processes.
- Analyzes clinical data to identify trends and patterns that may impact patient care. Participates in quality improvement initiatives to enhance the overall delivery of behavioral health services.
- Facilitates reimbursement by communicating with payers, other staff, patients, and families concerning status of funding and required actions.
Education Requirement:
Bachelor's Degree in Social Work, Psychology, or related field, required.
Licensure Requirement:
(not specified)
Certifications:
(not specified)
Skills:
- Excellent written and verbal communication and interpersonal skills.
- Excellent customer service and organizational skills.
- Working knowledge of CMS and other review agency standards.
- Proficient with software applications including CM, payer web applications, MITS, and others.
Experience:
- Three years of behavioral health experience, required.
- One year of experience in pediatric care or services, required.
- Utilization review or utilization management experience, preferred.
Physical Requirements:
OCCASIONALLY: Bend/twist, Climb stairs/ladder, Flexing/extending of neck, Lifting / Carrying: 0-10 lbs, Reaching above shoulder, Squat/kneel
FREQUENTLY: Standing, Walking
CONTINUOUSLY: Audible speech, Color vision, Computer skills, Decision Making, Depth perception, Hand use: grasping, gripping, turning, Hearing acuity, Interpreting Data, Peripheral vision, Problem solving, Repetitive hand/arm use, Seeing - Far/near, Sitting
Additional Physical Requirements performed but not listed above:
(not specified)
"The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet"
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About Nationwide Children's Hospital
Sourced by ZipRecruiter
Nationwide Children's Hospital, established in 1894, is a leading pediatric healthcare system based in Columbus, Ohio, United States. They serve as a primary pediatric network, providing wellness, preventive, diagnostic, treatment, and rehabilitative care for infants, children, adolescents, and adults with congenital disease. Being the third-largest pediatric hospital in the nation, Nationwide Children's Hospital prides itself on its relentless commitment to children and their families, driven by their core values of respect, integrity, determination, empathy, and solidarity. The institution's comprehensive mission is to enhance the health of children by providing high-quality, family-centered care, conducting groundbreaking research, advocating for pediatric health, and training top healthcare professionals.
Industry
Hospitals
Company size
10,000+ Employees
Headquarters location
Columbus, OH, US
Year founded
1892