At Zelis, the Itemized Bill Review Facility Reviewer is responsible for analyzing facility inpatient and outpatient claims for Health Plans and ensuring adherence to proper billing guidelines. ...
What You’ll Be Doing:As a Cardiology, Physician Clinical Reviewer you will be a key member of the utilization management team. As well as, aids and acts as a resource to Initial Clinical Reviewers. What You Will Be Doing:Serve as the specialty match reviewer in Cardiology cases, that do not initiall...
The Inpatient DRG Reviewer will be primarily responsible for conducting post-service, pre-payment and post pay comprehensive inpatient DRG reviews based on industry standard inpatient coding guidelines and rules, evidence based clinical criteria plan, and policy exclusions. ...
At Zelis, the Itemized Bill Review Facility Reviewer is responsible for analyzing facility inpatient and outpatient claims for Health Plans and ensuring adherence to proper billing guidelines. ...
The Nurse Reviewer is primarily responsible for conducting post-service, pre or post payment in-depth claim reviews based on accepted medical guidelines and clinical criteria, billing and coding rules, plan policy exclusions, and payment errors/overpayments. ...
Specialist Staffing Group is an equal opportunity employer.All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status....
We help the world see new possibilities and inspire change for better tomorrows.Our analytic solutions bridge content, data, and analytics to help business, people, and society become stronger, more resilient, and sustainable.We are seeking Medical Analysts with experience in preparing Medicare Set ...
Boston, MA (on-site 5 days per week).GMP/GDP lab or lab adjacent experience (can be analytical or micro).Knowledge of QMS (Veeva), CMMS (Maximo, Nuvolo), and LIMS .Bachelor's Degree in Lab Sciences, such as Chemistry, Biochemistry, Material Science, Immunology.Strong technical knowledge including an...
At Zelis, the Itemized Bill Review Facility Reviewer is responsible for analyzing facility inpatient and outpatient claims for Health Plans and ensuring adherence to proper billing guidelines. ...
Within the Finance Department, the Financial Review is a dedicated and independent function in charge of permanent controls on accounting and financial information.The Financial Review is a key component of the Enterprise Risk Management framework.As part of the second line of defense, it consists o...
In this exciting position the content reviewer will localize, translate and adapt the content of various categories (i. ...
Why This Role is Important to Us.Reporting to the VP Quality & Controls Assurance, the incumbent is responsible for independent quality reviews of medical claims, and evaluating Call Center activities for compliance with policies and Standard Operating Procedures (SOP).Additionally, this role will r...
We are looking for a passionate and tech-savvy individual to join our team as a Korean Advertising Reviewer. ...
Travel Expenses Reviewer - hybrid - $25/hr. We’re looking for adetail-oriented Travel Expenses Reviewer to join a supportive, collaborativeteam at a prestigious university. ...
We are seeking Medical Analysts with experience in preparing Medicare Set Asides and Medical Cost Projections.This includes reviewing records, preparing the narrative and an appropriate allocation for medical treatment and prescription medications.Candidates will demonstrate knowledge of CMS policie...
Travel Expenses Reviewer - hybrid - $25/hr. We’re looking for adetail-oriented Travel Expenses Reviewer to join a supportive, collaborativeteam at a prestigious university. ...
Specialist Staffing Group is an equal opportunity employer.All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status....
E'S with FDOT experience in design and analysis of stormwater management and drainage systems, flood studies, bridge hydraulics and scour countermeasures.This role will be a 50% split between time on review of FDOT access and drainage connection permits and 50% in a design role on highways, flood mi...
NECO has an exciting opportunity in our Commonwealth Clinic for a Patient Billing and Claims Reviewer. The Patient Billing and Claims Reviewer (On-Site) will be located at 930 Commonwealth Avenue in our Commonwealth clinic. Patient Billing and Claims Reviewer (On-Site) Responsibilities:. Patient Bil...
In this exciting position the content reviewer will localize, translate and adapt the content of various categories (i. ...
Provide significant expertise as primary medical reviewer of individual adverse event reports. ...
The team has identified that they will need to add five highly qualified document reviewers to their growing team who have prior documentation review experience and good documentation practice experience as well. ...
Provide significant expertise as primary medical reviewer of individual adverse event reports. ...
We are seeking Medical Analysts with experience in preparing Medicare Set Asides and Medical Cost Projections.This includes reviewing records, preparing the narrative and an appropriate allocation for medical treatment and prescription medications.Candidates will demonstrate knowledge of CMS policie...
Collaborate with MHPAEA senior reviewer and Project Manager to conduct follow up calls/emails with carriers/vendors as needed for clarification and submission of additional documentation. ...