Utilization Review Specialist - Villa Rica - Southeastrans

· SUMMARY:  · Under the direction of the Regional Manager review, communicate and report previous day late trips with providers that have exhibited higher late percentages. · ESSENTIAL FUNCTIONS:  · Collect and analyze the daily data regarding the on-time performance of non-emer ...

The primary responsibility of this role consists of reviewing member transportation requests that are over the contractual mileage guidelines. · Reviewing and making approval/denial determinations for all member transportation requests that are outside of the geographical mileage ...

Under the direction of the Regional Manager review, communicate and report previous day late trips with providers that have exhibited higher late percentages. · ...

The primary responsibility of this role consists of reviewing member transportation requests that are over the contractual mileage guidelines. · ...

Review previous day late trips with providers that have exhibited higher late percentages. · ...

Lead and manage the Utilization Review team that reviews member transportation requests outside contractual mileage guidelines and non‑covered Medicaid services/locations. · ...

This role is responsible for leading and managing the Utilization Review team that reviews member transportation requests outside contractual mileage guidelines and non‑covered Medicaid services/locations. · ...

The Utilization Review Specialist is responsible for performing utilization review services in compliance with URAC guidelines and applicable state regulations. · ...

As a Utilization Review Specialist at Davies North America, you will be responsible for performing utilization review services in compliance with URAC guidelines and applicable state regulations. You will conduct precertification, concurrent, retrospective, and appeal reviews; co ...

+h2>Job summary · As a vital part of the global Davies Group we help businesses navigate risk optimize operations and spearhead transformation in the insurance and regulated sectors. · + ...

Department: Claims Administration & Adjusting · Location: Home United States · Compensation: $65,000 - $75,000 / year · Description · Our Story · Imagine being part of a team that's not just shaping the future but actively driving it. At Davies North America, we're at the forefro ...

The Audit Review Specialist leverages extensive expertise in premium audit standards to meticulously review audits and ensure adherence to established criteria and timelines. The position involves timely analysis of assigned audits in compliance with state regulations; verifying ...

The Audit Review Specialist leverages extensive expertise in premium audit standards to meticulously review audits, · ensuring adherence to established criteria and timelines. · Ensure timely analysis of assigned audits in compliance with state regulations; · verify that all data ...

The Audit Review Specialist leverages extensive expertise in premium audit standards to meticulously review audits, ensuring adherence to established criteria and timelines. · ...

Department: · Claims Administration & Adjusting · Location: · Home United States · Compensation: · $65,000 - $75,000 / year · Description · Our Story · Imagine being part of a team that's not just shaping the future but actively driving it. At · Davies North America · , we're at ...

We're at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. · The Utilization Review Specialist is responsible for performing utilization review services in compliance with URAC guidelines, · applicable state regulati ...

The Utilization Review Specialist is responsible for performing utilization review services in compliance with URAC guidelines, · Perform precertification reviews using accepted medical criteria in accordance with URAC standards and state-mandated timeframesEnsure medical request ...

· About OncoHealth · OncoHealth is a leading digital health company dedicated to helping health plans, employers, providers, and patients navigate the physical, mental, and financial complexities of cancer through technology enabled services. Supporting more than 14 million peop ...

The Audit Review Specialist leverages extensive expertise in premium audit standards to meticulously review audits. · The position requires ensuring timely analysis of assigned audits in compliance with state regulations, · and providing coaching and feedback on audit procedures ...

We're on a journey to do our best. · Helping customers make better financial decisions, · enabling communities to grow and succeed. · A career here gives you opportunities to discover what makes you thrive.Conduct credit analyses including gathering information from credit report ...

We are seeking a strategic detail-oriented Brand Review Support Specialist & Project Coordinator to support local marketing efforts across a large distributed field network. This role focuses on reviewing brand submissions supporting local marketing alignment managing project wor ...