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. ...
A company is looking for a Clinical Reviewer in New Mexico to assess the medical necessity and quality of healthcare services. ...
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...
A company is looking for a Risk Adjustment Clinical Reviewer - RN. ...
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. ...
A company is looking for a Quality Reviewer (QA) with expertise in AI Training to ensure high standards in AI training projects. ...
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. ...
This role is within the Credit Department under the Real Estate Valuation Services (REVS) division at Veritex Community Bank, reporting to the Chief Residential Appraiser.The REVS division handles all real estate appraisals, environmental assessments, equipment appraisals, and business validation se...
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. ...
What You’ll Be Doing:As a Physician Clinical Reviewer you will be a key member of the utilization management team. What You Will Be Doing:Serve as the Physician match reviewer in Imaging cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests ...
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. ...
This is a part time, 1099 position.Looking at newly built homes from a customer's perspective to identify defects in workmanship, quality, completeness, consistency, and professionalism.Reviews take on average 1 to 1.Each review is meant to evaluate the quality of the finished construction.Driving t...
We are looking for a passionate and tech-savvy individual to join our team as a Korean Advertising Reviewer. ...
We have an ongoing need for Document Reviewers. Document Reviewers will review documents for complex litigation matters using an electronic review platform to code for relevancy, confidentiality, and privilege. ...
Title: Quality Assurance Nurse Reviewer (Overread Team), (100% Remote). The HEDIS Quality Assurance Nurse Reviewer will validate abstracted medical record data and enter findings electronically into a specified data base to support HEDIS Reporting and Quality Improvement. ...
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. ...
Do you enjoy researching or know how to find what you're looking for with just a few keywords? Are you the type of person that already knows what someone is saying before they finish their sentence? If so, we have a unique opportunity for you to put your skills to the test!.In this position, you wil...
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. ...
We have a variety of remote tax projects with clients across the US; these clients consist of CPA firms who are looking for project assistance throughout busy seasons as well as special projects year-round.These are remote, career-building project opportunities with cutting-edge firms that are embra...
You are welcoming, reassuring, and have a passion for providing exceptional customer service.You are a go-to tax expert with 3+ years filing a minimum of 30 federal and state individual tax returns annually.You are an exceptional communicator and enjoy translating complex tax terminology into a lang...
Tax Return Reviewer, Global Mobility Services. KPMG is currently seeking a Tax Return Reviewer, Global Mobility Services to join our Global Mobility Services (GMS) practice. ...
Join us as a Claims Compliance Reviewer to make more of your specialist expertise and experience. ...
We are looking for a passionate and tech-savvy individual to join our team as a Korean Advertising Reviewer. ...
Reviews tax incentives, grants, and environmental review projects .Provides guidance and technical advice to applicants relative to required Secretary of the Interior’s Treatment of .Historic Properties, Section 106 and NEPA reviews.Supports other HPD program areas and participates in special projec...
Work hours will be 8:00 am to 5:00 pm Monday through Friday.You must have high-speed (non-satellite) internet service and a private home office to work from home.Performs medical claim reviews for one or more of the following: claims for medically complex services, services that require preauthoriza...