ABA Utilization Reviewer - Skokie - Spectrum Billing Solutions

We are looking for motivated, dependable and dedicated caregivers to provide exceptional direct care and support to our patients. The Utilization Review Coordinator is responsible for overseeing the Utilization Review Program. · ...

We are looking for motivated, dependable, and dedicated caregivers to provide exceptional direct care and support to our patients. The Utilization Review Coordinator is responsible for overseeing the Utilization Review Program.This includes the implementation of case management s ...

We are looking for motivated, dependable and dedicated caregivers to provide exceptional direct care and support to our patients. · Supervising and supporting performance improvement activities on a daily basis. · Receiving and reviewing department/service performance measures. · ...

This position is responsible for ensuring compliance of the Utilization Management (UM) and Quality Review (QR) functions performed by the Medical Groups/IPAs participating in the networks of client's HMOs. · ...

Provides clinically based case management to support the delivery of effective and patient care under the general supervision of the Manager. Partners with Social Workers and collaborates with other health care team members to identify appropriate utilization of resources. · ...

+Job summary · Lensa does not hire directly for these jobs but promotes them on behalf of its direct clients. · +Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations. · Evaluates documentation/information to de ...

This position is responsible for ensuring compliance of the Utilization Management (UM) and Quality Review (QR) functions performed by the Medical Groups/IPAs participating in the networks of client's HMOs. · 3 years clinical experience with 2 years' experience in utilization rev ...

Provides clinically based case management to support delivery of effective patient care. · ...

We are looking for a Utilization Review Specialist to join our team The Utilization Review Specialist bridges between a Utilization Review Nurse and Pre-Clinical Coordinator providing coverage for both teams. · Initiate and maintain appropriate verbal and/or written contacts with ...

We are looking for a Utilization Review Specialist to join our team The Utilization Review Specialist bridges between a Utilization Review Nurse and Pre-Clinical Coordinator providing coverage for both teams. · The full UR function can be performed in applicable jurisdictions. UR ...

The Utilization Review (UR) Coordinator is responsible for contacting external case managers/managed care organizations for certification and recertification of insurance benefits throughout the patient's stay. · Degree in nursing, social work, mental health/behavioral sciences, ...

This position is responsible for ensuring accurate and timely clinical review of behavioral health cases for medical necessity including assisting members on the telephone reviewing medical records reviewing cases which involve contract interpretation of behavioral health diagnos ...

+The Medical Director is responsible for the overall quality, effectiveness and coordination of medical review services. · +Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies. · Renderecoverage determinations. · ...

This position is responsible for ensuring accurate and timely clinical review of behavioral health cases for medical necessity. · ...

This position involves performing accurate and timely medical review of claims suspended for medical necessity using medically accepted criteria. · Knowledge of accreditation standards. · Awareness of claims processes. · PC proficiency including Microsoft Word and Excel. · ...

The Utilization Review (UR) Coordinator is responsible for contacting external case managers/managed care organizations for certification and recertification of insurance benefits throughout the patient's stay as well as assists the treatment team in understanding the insurance c ...

+ Utilization Review Specialists bridge between a Utilization Review Nurse and Pre-Clinical Coordinator + Facilitate and schedule appointments as needed + Maintain appropriate electronic and paper files + Interface with inter-disciplinary providers + Basic invoicing at completion ...

The Utilization Review (UR) Coordinator is responsible for contacting external case managers/managed care organizations for certification and recertification of insurance benefits throughout the patient's stay as well as assists the treatment team in understanding the insurance c ...

This position performs medical review of claims suspended for medical necessity using medically accepted criteria. · Candidates must reside in TX or IL · ...

Job summary · Registered Nurses – are you looking for a change? Want to work no nights, no weekends and no holidays? · Competitive salary and benefits · No weekends and nights · ...

Be part of a world-class academic healthcare system as a RN Manager in the Rev Cycle Department. · ...