Clinical Reviewer - Silver Spring

AHC Home Assistance Adventist Healthcare Home Health seeks to hire an experienced Clinical Reviewer (RN/PT/OT) who will embrace our mission to extend God's care through the ministry of physical, mental and spiritual healing. · ...

Adventist Healthcare Home Health seeks to hire an experienced Clinical Reviewer (RN/PT/OT) who will embrace our mission to extend God's care through the ministry of physical, mental and spiritual healing. · We do this by offering:Work life balance through nonrotating shifts · Rec ...

The Clinical Concurrent Reviewer position exists to support Quality and Performance Improvement at Holy Cross Hospital by assisting staff to implement strategies that identify, prioritize, measure and improve key clinical processes and outcomes. · Maintain current knowledge of cl ...

The Clinical Concurrent Reviewer position exists to support Quality and Performance Improvement at Holy Cross Hospital by assisting staff to implement strategies that identify prioritize measure and improve key clinical processes and outcomes. · Maintain current knowledge of clin ...

This position is responsible for maintaining proper clinical review and interpretation of medical records and claim documentation to assist with the appeals of denied insurance claims including drafting appeal letters based on clinical judgment and knowledge. · ...

Maximus is seeking a Clinical Reviewer (Registered Nurse) to support the Tennessee Appeals area of the contract. · ...

At Commence, we're the start of a new age of data-centric transformation, elevating health outcomes and powering better, more efficient process to program and patient health. · ...

The Clinical Review Coordinator conducts all mandatory case review and quality assurance activities as stipulated by contracts and maintains the required timeliness and accuracy within the review process. · ...

The Clinical Medical Review Specialist will report to the Clinical Support Supervisor and be part of the Quality Team. · Chart retrieval · Conduct thorough medical record reviews in line with NCQA specifications using proprietary tools and software. · Retrieval follow-up, escalat ...

This position requires residence in Maryland and the ability to work on-site at our client's Baltimore office 2-3 days per week. Join a dedicated Government Programs quality team at a leading healthcare organization. · Perform detailed abstractions of clinical data from member me ...

Seeking a Medical Review Nurse for long term contract position with major Healthcare Insurance organization in Maryland area. · ...

Clinical medical review nurse to collect medical records and extract clinical data from provider offices in MD. · ...

This role combines clinical medical review and medical record abstraction responsibilities. The position handles day-to-day review of professional and institutional claims, provider appeals, · and medical record abstraction to determine benefit eligibility and support claims proc ...

The Clinical HEDIS Nurse (Medical Review Specialist) is responsible for supporting the organization's HEDIS and Quality initiatives through medical record retrieval, clinical data abstraction, and quality review processes in alignment with NCQA specifications. · The nurse must ma ...

We are seeking Licensed Practical Nurses (LPN) or Registered Nurses (RN) to join the Quality team as Clinical Medical Review Nurses. ...

+This role combines clinical medical review and medical record abstraction responsibilities. The position handles day-to-day review of professional and institutional claims, provider appeals, and medical record abstraction to determine benefit eligibility and support claims proce ...

We are seeking two skilled and detail-oriented Clinical Review Nurses for a 5-month contract. · Perform detailed abstractions of clinical data from member medical records. · Review and extract key information from provider records to support HEDIS quality measures. · ...

The Clinical Medical Review Nurse handles day to day review of professional and institutional claims and provider appeals that require medical review to determine if the claim is eligible for benefits and to support claims processing and/or adjudication. · Ability to effectively ...

We are seeking a Medical Review Nurse for long term contract position with our customer in the Maryland area.This position assists in determining acceptable medical risk to the organization by analyzing medical information of applicants for enrollment in specific policies. · ...

We are seeking Licensed Practical Nurses (LPN) or Registered Nurses (RN) to join the Quality team as Clinical Medical Review Nurses. · Review and abstract data from medical records · Extract relevant clinical data using Electronic Medical Record (EMR) systems · ...