Talent.com
Nevada Licensed Clinical Review Coordinator
Nevada Licensed Clinical Review CoordinatorVirtualVocations • Birmingham, Alabama, United States
No longer accepting applications
Nevada Licensed Clinical Review Coordinator

Nevada Licensed Clinical Review Coordinator

VirtualVocations • Birmingham, Alabama, United States
7 days ago
Job type
  • Full-time
Job description

A company is looking for a Clinical Review Coordinator to conduct mandatory case reviews and quality assurance activities.

Key Responsibilities

Ensure an efficient case review process and identify problem areas

Support physician reviewers by summarizing case facts and resolving issues

Communicate with Medicare beneficiaries and healthcare providers regarding quality improvement activities

Required Qualifications

Graduation from an accredited nursing school and current RN or LPN licensure

A degree in a healthcare-related field with clinical experience in Medicare QIO

Experience in quality of care review or medical review related to Medicare

Minimum of two to four years of clinical decision-making experience with Medicare patients

Must notify HR of any changes to licensure or certifications within five calendar days

Create a job alert for this search

Clinical Coordinator • Birmingham, Alabama, United States

Related jobs
Texas Licensed Physician Reviewer

Texas Licensed Physician Reviewer

VirtualVocations • Birmingham, Alabama, United States
Full-time
A company is looking for Board Certified Physician Reviewers in Internal Medicine / Allergy & Immunology with a Texas license. Key Responsibilities Review treatment requests and appeals for medical ...Show more
Last updated: 4 days ago • Promoted
Registered Nurse Medicaid Reviewer

Registered Nurse Medicaid Reviewer

VirtualVocations • Birmingham, Alabama, United States
Full-time
A company is looking for a Medicaid Medical Review Subject Matter Expert.Key Responsibilities Collaborate with Data Analysis and Program Integrity teams to conduct proactive studies meeting CMS r...Show more
Last updated: 6 days ago • Promoted
Health Services Review Coordinator

Health Services Review Coordinator

VirtualVocations • Birmingham, Alabama, United States
Full-time
A company is looking for a HS Review Coordinator II responsible for coordinating and supporting intake functions within the Utilization Management Department. Key Responsibilities Triage, research...Show more
Last updated: 4 days ago • Promoted
Pre-Certification Coordinator

Pre-Certification Coordinator

VirtualVocations • Birmingham, Alabama, United States
Full-time
A company is looking for a Pre-Certification Coordinator I (Remote) in Pediatrics Central Administration.Key Responsibilities Initiates and facilitates the pre-determination process for insurance...Show more
Last updated: 30+ days ago • Promoted
Maryland Licensed Clinical Psychiatric Assessor

Maryland Licensed Clinical Psychiatric Assessor

VirtualVocations • Birmingham, Alabama, United States
Full-time
A company is looking for a Clinical Psychiatric Assessor to conduct clinical assessments for research participants.Key Responsibilities Conducts participant assessments while adhering to protocol...Show more
Last updated: 2 hours ago • Promoted • New!
Certified Medical Coding Reviewer

Certified Medical Coding Reviewer

VirtualVocations • Birmingham, Alabama, United States
Full-time
A company is looking for a Program Integrity Medical Coding Reviewer II, requiring CPC, RHIT, or RHIA certification.Key Responsibilities Review vendor audit activities and make claim payment deci...Show more
Last updated: 30+ days ago • Promoted
Remote Medical Coding Reviewer

Remote Medical Coding Reviewer

VirtualVocations • Birmingham, Alabama, United States
Remote
Full-time
A company is looking for a Medical Coding Reviewer (DRG).Key Responsibilities Perform clinical and coding medical claim reviews to ensure compliance with coding practices Analyze provider billin...Show more
Last updated: 30+ days ago • Promoted
DC Licensed Utilization Nurse Reviewer

DC Licensed Utilization Nurse Reviewer

VirtualVocations • Birmingham, Alabama, United States
Full-time
A company is looking for a Utilization Nurse Reviewer (Remote).Key Responsibilities Conduct timely clinical chart reviews and communicate effectively with third-party payers Review admission ser...Show more
Last updated: 6 days ago • Promoted
Clinical Sourcer

Clinical Sourcer

VirtualVocations • Birmingham, Alabama, United States
Full-time
A company is looking for a Clinical Sourcer.Key Responsibilities Proactively identify and engage clinical professionals through various sourcing channels Build and maintain a pipeline of high-qu...Show more
Last updated: 3 days ago • Promoted
State Licensed Clinical Documentation Specialist

State Licensed Clinical Documentation Specialist

VirtualVocations • Birmingham, Alabama, United States
Full-time
A company is looking for a Clinical Documentation Quality Improvement Specialist II.Key Responsibilities Facilitates improvement in the quality, completeness, and accuracy of medical record docum...Show more
Last updated: 30+ days ago • Promoted
Inpatient Auditor

Inpatient Auditor

VirtualVocations • Birmingham, Alabama, United States
Full-time
A company is looking for an Inpatient Auditor PRN.Key Responsibilities Perform inpatient facility coding audits and provide rationale for identified changes Stay updated on regulatory changes an...Show more
Last updated: 3 days ago • Promoted
Texas Licensed Care Review Clinician

Texas Licensed Care Review Clinician

VirtualVocations • Birmingham, Alabama, United States
Full-time
A company is looking for a Care Review Clinician (RN) for Prior Authorization.Key Responsibilities Assess services for members to ensure optimum outcomes and compliance with regulations Analyze ...Show more
Last updated: 6 days ago • Promoted
Medical Records Specialist

Medical Records Specialist

VirtualVocations • Birmingham, Alabama, United States
Full-time
A company is looking for a Medical Records Specialist.Key Responsibilities Complete analysis and reanalysis of medical records accurately and timely Follow up with departments and providers rega...Show more
Last updated: 30+ days ago • Promoted
Certified ED Coder

Certified ED Coder

VirtualVocations • Birmingham, Alabama, United States
Full-time
A company is looking for an ED Remote Coder.Key Responsibilities Perform accurate code assignments for ED records in a remote setting Meet client productivity targets while maintaining a coding ...Show more
Last updated: 30+ days ago • Promoted
Clinical Review Coordinator

Clinical Review Coordinator

VirtualVocations • Birmingham, Alabama, United States
Full-time
A company is looking for a Clinical Review Coordinator to support their Specialty Infusion Pharmacy remotely.Key Responsibilities Completes prior authorization reviews by evaluating patient clini...Show more
Last updated: 17 days ago • Promoted
Health Information Specialist

Health Information Specialist

VirtualVocations • Birmingham, Alabama, United States
Full-time
A company is looking for a Health Information Specialist I to manage medical record requests and documentation.Key Responsibilities Process medical record requests by communicating with patients,...Show more
Last updated: 30+ days ago • Promoted
Hawaii Licensed Utilization Review Clinician

Hawaii Licensed Utilization Review Clinician

VirtualVocations • Birmingham, Alabama, United States
Full-time
A company is looking for a Utilization Review Clinician - Behavioral Health.Key Responsibilities Evaluates treatment for mental health and substance abuse to ensure medical appropriateness Perfo...Show more
Last updated: 5 days ago • Promoted
New York Licensed Clinical Reviewer

New York Licensed Clinical Reviewer

VirtualVocations • Birmingham, Alabama, United States
Full-time
A company is looking for a Clinical Review Clinician - Appeals.Key Responsibilities Performs clinical reviews to resolve and process appeals by analyzing medical records and clinical data Ensure...Show more
Last updated: 30+ days ago • Promoted