Medical Utilization Review Jobs Near Me

Care Review Nurse Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing ...

Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing healthcare members ...

Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members ...

Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories ... Conducts prior authorization reviews to determine financial responsibility Qualifications * 2 years ...

Monitors and reviews MCO portals to track authorization status, pending requests, approvals ... medical billing, behavioral health administration, or related healthcare setting preferred.

Experience in utilization review, case management, medical records, or healthcare billing strongly preferred * Strong understanding of insurance authorization processes (Medicare, Medicaid, and ...

Care Review Clinician Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at ...

Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members ...

Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members ...

For billing and hospitalization utilization review purposes, the reviewer will identify and certify the acute hospitallength of stay authorized for each case. Initiate and maintain medical records ...

Medical background, prior authorization experience. * A minimum of 1-2 years' experience ... utilization review for other healthcare services. * Checks eligibility and verifies benefits ...

Medical background, prior authorization experience. * A minimum of 1-2 years' experience ... utilization review for other healthcare services. * Checks eligibility and verifies benefits ...

Medical background, prior authorization experience. A minimum of 1-2 years' experience. Knowledge ... or utilization review for other healthcare services. Checks eligibility and verifies benefits ...

A minimum 1 year of Managed care experience, Medical billing, within a healthcare background ... utilization review for other healthcare services * Checks eligibility and verifies benefits ...

Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as ...

A minimum 1 year of Managed care experience, Medical billing, within a healthcare background ... utilization review for other healthcare services * Checks eligibility and verifies benefits ...

Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services. Supports effective ...

A minimum 1 year of Managed care experience, Medical billing, within a healthcare background ... utilization review for other healthcare services * Checks eligibility and verifies benefits ...

Reviews physician and provider practice pattern analysis and other statistical data related to unusual medical service utilization. * Conducts research into new or controversial medical procedures ...

Reviews physician and provider practice pattern analysis and other statistical data related to unusual medical service utilization. * Conducts research into new or controversial medical procedures ...