Talent.com
Texas Licensed Utilization Review Specialist

Texas Licensed Utilization Review Specialist

VirtualVocationsLouisville, Kentucky, United States
job_description.job_card.variable_hours_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
job_description.job_card.job_description

A company is looking for a Utilization Review Specialist to monitor and ensure the effective use of outpatient services.

Key Responsibilities

Establish and maintain methods for ensuring medical necessity and appropriateness of outpatient admissions

Perform concurrent reviews to justify extended patient stays and document findings

Compile monthly reports and statistics for the Utilization Review Committee

Required Qualifications

Graduation from an accredited university in Psychology, Sociology, or a similar behavioral health field

One year of utilization review experience preferred

Active CPR Certification

serp_jobs.job_alerts.create_a_job

Utilization Review Specialist • Louisville, Kentucky, United States

Job_description.internal_linking.related_jobs
  • serp_jobs.job_card.promoted
ABA Intake Admin Assistant

ABA Intake Admin Assistant

VirtualVocationsLouisville, Kentucky, United States
serp_jobs.job_card.full_time
A company is looking for an ABA Intake & Authorizations Admin Assistant - Spanish Speaking.Key Responsibilities Facilitate the client onboarding process and ensure accurate documentation and comm...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
Medicare Eligibility Representative

Medicare Eligibility Representative

VirtualVocationsLouisville, Kentucky, United States
serp_jobs.job_card.full_time
A company is looking for an Enrollment - Eligibility Representative.Key Responsibilities Research benefits, eligibility, and site of care for Medicare Part B members Communicate with doctor's of...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
Workers' Compensation Claims Examiner

Workers' Compensation Claims Examiner

VirtualVocationsLouisville, Kentucky, United States
serp_jobs.job_card.full_time
A company is looking for a Claims Examiner, Medical Only.Key Responsibilities Investigate workers' compensation claims for medical care without lost wages Approve medical treatments, schedule ap...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Workers Compensation Claims Adjuster (GA Licensed)

Workers Compensation Claims Adjuster (GA Licensed)

VirtualVocationsLouisville, Kentucky, United States
serp_jobs.job_card.full_time
A company is looking for a Senior Workers Compensation Claims Adjuster.Key Responsibilities Manage and resolve workers compensation claims by analyzing exposure and planning appropriate actions ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_less
  • serp_jobs.job_card.promoted
Accreditation Specialist

Accreditation Specialist

VirtualVocationsLouisville, Kentucky, United States
serp_jobs.job_card.full_time
A company is looking for an Accreditation Specialist to lead quality improvement efforts and ensure NCQA Health Plan Accreditation. Key Responsibilities : Develops and prepares documentation for NC...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Health Claims Examiner

Health Claims Examiner

VirtualVocationsLouisville, Kentucky, United States
serp_jobs.job_card.full_time
A company is looking for a Health Claims Examiner I.Key Responsibilities Review medical documents to ensure completeness and validity for claim adjudication Determine covered services and calcul...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Licensed Physician Reviewer

Licensed Physician Reviewer

VirtualVocationsLouisville, Kentucky, United States
serp_jobs.job_card.full_time
A company is looking for a Physician Reviewer - Utilization Review.Key Responsibilities Conduct timely medical reviews to ensure compliance with quality parameters Make clinical determinations b...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
Michigan Licensed Workers Compensation Adjuster

Michigan Licensed Workers Compensation Adjuster

VirtualVocationsLouisville, Kentucky, United States
serp_jobs.job_card.full_time
A company is looking for a Senior Workers Compensation Claims Adjuster.Key Responsibilities Execute decision-making to analyze and resolve claims while managing claims exposure Interact with var...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Health Information Specialist I

Health Information Specialist I

VirtualVocationsLouisville, Kentucky, United States
serp_jobs.job_card.full_time
A company is looking for a Health Information Specialist I - OnBase Indexer.Key Responsibilities : Perform chart processing functions including preparation, scanning, indexing, and quality review ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
Patient Intake Coordinator

Patient Intake Coordinator

VirtualVocationsLouisville, Kentucky, United States
serp_jobs.job_card.full_time
A company is looking for a Patient Intake Coordinator - Specialty Pharmacy.Key Responsibilities Support patients and providers in navigating insurance benefits for prescribed injectable therapies...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Clinical Trial Assistant

Clinical Trial Assistant

VirtualVocationsLouisville, Kentucky, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Trial Assistant (Remote & Full-Time).Key Responsibilities Maintain and manage the Trial Master File (TMF) for accuracy and inspection readiness Act as a prima...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Healthcare Credentialing Coordinator

Healthcare Credentialing Coordinator

VirtualVocationsLouisville, Kentucky, United States
serp_jobs.job_card.full_time
A company is looking for a Healthcare Credentialing Coordinator, part-time and remote.Key Responsibilities Manage the credentialing and re-credentialing process for healthcare providers, ensuring...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Pennsylvania Licensed Clinical Appeals Reviewer

Pennsylvania Licensed Clinical Appeals Reviewer

VirtualVocationsLouisville, Kentucky, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Appeals Reviewer.Key Responsibilities Process appeals while ensuring compliance with regulatory milestones Review medical records for documentation and billin...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
Eligibility Specialist

Eligibility Specialist

VirtualVocationsLouisville, Kentucky, United States
serp_jobs.job_card.full_time
A company is looking for an Eligibility Specialist to manage and maintain accurate eligibility and enrollment records for health and welfare benefit plans. Key Responsibilities : Process eligibilit...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Remote Medical Insurance Verifier

Remote Medical Insurance Verifier

VirtualVocationsLouisville, Kentucky, United States
serp_jobs.filters.remote
serp_jobs.job_card.full_time
A company is looking for a Remote Medical Insurance Verification Specialist.Key Responsibilities Assist patients with obtaining coverage for prescription medications Make inbound / outbound calls ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
Massachusetts Licensed Patient Engagement Specialist

Massachusetts Licensed Patient Engagement Specialist

VirtualVocationsLouisville, Kentucky, United States
serp_jobs.job_card.full_time
A company is looking for a Patient Engagement Specialist with a MA Pharmacy License.Key Responsibilities : Proactively coordinate medication refills and adjudicate pharmacy claims Make outbound p...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
Ohio Licensed Clinical Counselor

Ohio Licensed Clinical Counselor

VirtualVocationsLouisville, Kentucky, United States
serp_jobs.job_card.full_time
A company is looking for a Licensed Professional Clinical Counselor (LPCC) to provide outpatient services through a telehealth program. Key Responsibilities Provide outpatient mental health servic...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Workers' Compensation Claims Adjuster (FL, RI, TX Licensed)

Workers' Compensation Claims Adjuster (FL, RI, TX Licensed)

VirtualVocationsLouisville, Kentucky, United States
serp_jobs.job_card.full_time
A company is looking for a Workers' Compensation Claims Adjuster to manage complex claims in various jurisdictions across the United States. Key Responsibilities Adjudicate higher complexity worke...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours