Clinical Reviewer

The Clinical Reviewer is responsible for reviewing medical records to identify Medicare Risk Adjusting diagnoses. · Strong clinical understanding and ability to interpret complex medical records · Knowledge of CMS Risk Adjustment models (e.g., HCC, ACO REACH) · ...

We are seeking an experienced Clinical Quality Reviewer to support an annual Medical Record Review initiative. · The reviewer will play a key role in meeting state and federal reporting requirements, including submissions to the New York State Department of Health and CMS. · Main ...

Acentra Health is seeking a dedicated and experienced Clinical Reviewer to join our growing and mission-driven team. · ...

Jet Health, Inc is seeking an experienced Home Health Clinical Reviewer.Review OASIS assessments, · validate appropriate ICD-10 coding and ensure documentation supports medical necessity and skilled services. · Review OASIS assessments, · Validate appropriate ICD-10 coding and en ...

+The Clinical Reviewer is responsible for evaluating conversations between patients and our AI system to determine whether the patient's reported condition meets specified clinical criteria. · +Evaluating conversations between patients and our AI system · ...

The Post-Service Claims Nurse Reviewer is a pivotal role responsible for safeguarding the integrity of our claims process in a post-service, pre-payment environment. · ...

Job summary The Post-Service Claims Nurse Reviewer is a pivotal role responsible for safeguarding the integrity of our claims process in a post-service pre-payment environment In this position you will leverage your deep clinical expertise and business acumen to ensure all claims ...

Acentra Health is seeking a dedicated and experienced Clinical Reviewer to join our growing and mission-driven team. · This is a remote work position; however, candidates must reside in the state of California and hold an active California LMFT or LCSW license to be considered.In ...

Clinical reviewer oportunidad de trabajar en la recopilación, análisis y reporte de datos clínicos para mejorar calidad y seguridad. · ...

The Clinical Reviewer receives and reviews prospective patient screening materials (to include admissions screening interview [ASI] and various internal or external records), delivers clinical/programmatic recommendations to department and division team members, collaborates with ...

While working remotely as an independent contractor, you will apply your clinical expertise to provide objective recommendations on patient care based on standards of care. · ...

We are seeking Board-Certified Specialists to join our team as remote independent contractors. You will provide objective recommendations on patient care based on standards of care while working remotely. · ...

The Clinical Reviewer will review and process requests for Independent Reviews from External Agencies. · The ability to interact with providers. · Excellent communication skills. · ...

Jet Health Inc seeks an experienced Home Health Clinical Reviewer to ensure compliance with Medicare guidelines and company policies reviewing clinical documentation. · ...

Jet Health, Inc is seeking an experienced Home Health Clinical Reviewer to review clinical documentation. This role supports quality improvement efforts by verifying the accuracy of documentation submitted by field clinicians. · ...

+Apply clinical expertise to provide objective recommendations on patient care based on standards of care. · +Provide objective recommendations on patient care based on standards of care. · ...

Clinical Reviewer opportunity who will be responsible for collecting analyzing and reporting clinical data elements on eligible cases for CMS TJC and multi hospital collaborations to improve Quality & Safety CQI. · Part time benefited position scheduled 40 hours bi weekly. · ...

Clinical Reviewer opportunity who will be responsible for collecting analyzing and reporting clinical data elements on eligible cases for CMS TJC and multi hospital collaborations to improve Quality & Safety CQI. · ...

A Clinical Reviewer at Adventist HealthCare reviews clinical information to ensure accuracy and completeness. They oversee coding, care plan effectiveness, and patient care provision. · ...

We are seeking qualified radiology healthcare professionals to review and evaluate medical content used in the development of healthcare artificial intelligence systems. · Review medical and clinical content for accuracy Evaluate AI-generated outputs against accepted medical stan ...

Surgical Clinical Reviewer position available in Flushing NY for 3 months with possible extension. Bachelor's degree in healthcare required along with min 5 yrs clinical exp and previous experience w/ American College of Surgeons National Surgical Quality Program. · ...