Data Review Specialist - Villa Rica, GA

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. · ...

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. · ...

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 ...

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

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 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 ...

+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. · + ...

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 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 ...

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

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 ...

A Fortune 500 marketing organization is seeking a strategic, detail-oriented Brand Review Support Specialist & Project Coordinator to support local marketing efforts across a large, distributed field network. · ...

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 ...

A Fortune 500 marketing organization is 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 mark ...

This is a full-time Monday–Friday position (40 hours/week) requiring working 3–4 holidays per year on a rotating schedule and one weekend every third weekend after training. · The Appeals Specialist is responsible for timely and accurate review processing and resolution of member ...

A Fortune 500 marketing organization is seeking a strategic, detail-oriented Brand Review Support Specialist & Project Coordinator to support local marketing efforts across a large, distributed field network. · ...